摘要
目的总结中国农村高血压人群心电图非特异性ST-T改变的流行病学特点及相关影响因素。方法数据来源于中国脑卒中一级预防研究(CSPPT),于2008年5月19日至2013年8月24日共纳入20 702例来自江苏省及安徽省32个社区中年龄45~75岁的高血压患者,行血压、脉率、体质量指数(BMI)、血脂等测定,记录合并使用降压药物情况,同时行十二导联心电图。心电图采用明尼苏达编码的方法进行分析。最终入组15 038例患者,分析统计总体及不同性别非特异性ST-T改变的发生率。并根据心电图分为ST-T正常组和ST-T改变组,分析年龄、空腹血糖、吸烟、饮酒等危险因素与非特异性ST-T改变的关系。结果中国农村高血压人群心电图非特异性ST-T改变的发生率为8.5%,其中男性为5.7%,女性为10.3%,女性高于男性(P<0.05)。Logistics回归分析显示:女性(OR=2.07,95%CI1.68~2.54)、高龄(55~<65岁组OR=1.28,95%CI1.10~1.49;65~75岁组OR=1.64,95%CI1.39~1.93)、高收缩压(160~<180 mm Hg组OR=1.62,95%CI 1.18~2.24;≥180 mm Hg组OR=2.20,95%CI 1.59~3.04)、高胆固醇血症(OR=1.14,95%CI 1.01~1.29)及口服利尿剂(OR=1.69,95%CI1.20~2.37)是非特异性ST-T改变发生的危险因素(均P<0.05);而口服血管紧张素转换酶抑制剂(ACEI)为非特异性ST-T改变发生的保护因素(OR=0.68,95%CI0.54~0.86,P<0.05)。结论在中国农村高血压人群中,心电图非特异性ST-T改变较常见,总体发生率为8.5%,其危险因素为女性、高龄、高收缩压、高胆固醇血症及口服利尿剂,其保护因素为口服ACEI。
Objective To investigate the epidemical characteristics and the related factors of non-specific ST-T changes among rural Chinese hypertensive population. Methods A total of 20 702 hypertensive patients aged 45-75 years recruited from 32 communities in Jiangsu and Auhui between May 19 2008 and August 24 2013 in the China Stroke Primary Prevention Trial（the CSPPT） were selected in the study. Baseline information of blood pressure （BP）, pulse, body mass index （BMI） , lipid levels and medication were collected. Electrocardiograms （ECG） was analysed by the Minnesota Code. Finally 15 038 patients were selected for analysis. The prevalence of non-specific ST-T changes was calculated in total and different sex population. The associations between non-specific ST-T changes and age, fasting glucose, smoking and alcohol drinking were analysed. Results The prevalence of non- specific ST-T changes was 8.5 % in rural hypertensive population,which was higher in females than males （10.3 vs 5.7 %, P〈0.05）. Multivariate logistic regression analysis indicated that female （OR= 2.07, 95% CI 1.68- 2.54）, age （55-〈65 years old group OR=1.28, 95% CI 1.10-1.49; 65-75 years old group OR=1.64, 95% CI 1.39-1.93）, SBP （160-180 mm Hg group OR=1. 62, 95% CI 1.18-2. 24; ≥180 mm Hg group OR=2.20, 95M CI 1.59-3.04）, hypercholesterolemia {OR=1. 14, 95% CI 1.01-1.29} and taking diuretic （OR=1.69, 95% CI 1.20-2.37） were risk factors for the incidence of non-specific ST-T changes （all P〈0.05）, while taking angiotensin-converting enzyme inhibitor （ ACEI） was protective factor （ OR= 0.68,95 % CI 0. 54- 0.86, P〈 0.05）. Conclusion Non-specific ST-T changes is not rare in rural hypertensive population in China. Its risk factors are female, age, SBP, hypercholesterolemia and taking diuretic and protective factor is taking ACEI.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2017年第8期750-755,共6页
Chinese Journal of Hypertension
