长沙市社区居民血压、年龄及性别与心电图相关性分析

目的：探讨社区居民年龄、性别、血压与心电图异常的关系。方法：1997年在长沙市开福区对该地区人群819例（其中男377例、女442例）进行了心脑血管病的调查，并对心电图进行了临床诊断分析。结果：高血压病心电图异常率（64．9％）显高于血压正常（35．1％）（P＜0．005），老年人心电图异常率（57．4％）显高于中青年人（47．8％）（P＜0．01）、且老年女性（63．4％）显高于老年男性（50．9％）（P＜0．025），随年龄增大，心电图异常逐渐增高。结论：心电图异常与年龄、性别及血压关系密切。     

Graves病年龄与甲状腺激素、血糖及血脂的相关分析

目的:探讨弥漫性毒性甲状腺肿(Graves病,GD)患者年龄与甲状腺激素(TH)、血糖及血脂的相关性。方法:对55例老年GD患者、70例中青年GD患者进行游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺素、糖耐量试验及血脂水平测定。结果:老年组FT3水平低于中青年组(P<0.001),甘油三酯、总胆固醇、低密度脂蛋白胆固醇及血糖水平高于中青年组(P<0.001～0.05);老年组糖耐量异常率(58.2%)高于中青年组(38.6%)(P<0.05)。结论:GD患者的TH水平及血糖、血脂代谢异常程度与年龄有关。     

不同年龄段老年高血压病患者动态血压及血压昼夜节律的变化特征

目的探讨不同年龄段老年高血压病患者动态血压及血压昼夜节律的变化特征。 方法将346例老年高血压患者,按年龄段分为A组(60～69岁,n＝77)、B组(70～79岁,n＝109)和C组(≥80岁,n＝160),分析3组患者动态血压参数、动态血压昼夜节律异常发生率。 结果A组、B组24 h平均舒张压(24 h DBP)[A组(74.85±11.11)mmHg,B组(71.88±10.52) mmHg]均高于C组[(68.80±9.06) mmHg] (1 mmHg＝0.133 kPa)(F＝9.95,P<0.05);A组、B组、C组的血压昼夜节律异常率分别为76.63%、87.16%和90.63%,差异有统计学意义(χ²＝8.79,P<0.05);血压昼夜节律异常率C组高于A组,差异有统计学意义(χ²＝8.50,P<0.05)。 结论老年高血压患者随着年龄的增大,24 hDBP降低;老年高血压患者血压昼夜节律异常,多数表现为非杓型和反杓型,老年高血压患者血压昼夜节律随增龄变化昼夜节律异常率增高。     

单纯性肾囊肿发生率与年龄和性别的关系

目的通过对北京地区普通人群的单纯性肾囊肿流行病学调查,探讨该病患病率与性别、年龄的关系。方法对17 821例体检者进行常规B超检查,其中男性9 844例,女性7 977例。结果发现742例单纯性肾囊肿,患病率为4.16%,男性(5.56%)高于女性(2.44%)(P<0.01);中老年人(>50岁)患病率(9.64%)显著地高于青壮年(2.33%)(P<0.01);单纯性肾囊肿的发生率与年龄增长之间存在相关性(P<0.01)。结论单纯性肾囊肿的发生率不但与性别有关而且与年龄有关。     

煤尘对作业工人肺通气功能、心电图及血压的影响

目的探讨煤尘对作业工人肺通气功能、心电图及血压的影响。方法以2017年某企业行职业健康检查的500名煤尘作业工人为观察组,对其行健康检查(包括肺通气功能、心电图、血压等),以同期行健康体检的非接尘后勤人员50名为对照组。结果观察组肺功能异常率、心电图异常率、高血压异常率分别为25.20%、22.00%、19.60%,均显著高于对照组的12.00%、10.00%、8.00%(P0.05);肺功能异常率、血压异常率随煤尘作业工人年龄、工龄增长而显著上升(P0.05),不同年龄、工龄煤尘作业工人心电图异常率比较无显著差异(P0.05)。结论煤尘会增加作业工人肺通气异常、心血管系统异常风险,且其发生可能与作业工人年龄、工龄有关。     

老年人血小板聚集功能及影响因素调查

目的:初步了解老年人群的血小板聚集功能,分析影响血小板聚集功能的危险因素方法:选取2018年3月?8月在福建医科大学附属泉州市第一院体检中心健康检查的60岁以上老年人群226例,其中男性120例,女性106例。采用PL-12血小板功能分析仪测定二磷酸腺苷(ADP)和花生四烯酸(AA)诱导的血小板最大聚集率(MAR)。采用贝克曼AU5800生化分析仪测定总胆固醇、甘油三酯、低密度脂蛋白等生化指标。分析年龄、性别、血糖、血脂、吸烟、血压等对老年人群血小板聚集功能的影响.结果:老年人群A A诱导的PLT-MAR为(54.27±17.93)%,ADP诱导的PLT-MAR为(44.90±13.81)%,相关性分析显示,AA诱导的PLT-MAR与ADP诱导的PLT-MAR具有显著相关性(r=0.471,P<0.001)。AA诱导的PLT-MAR与血小板的数量具有显著正相关(r=0.254,P<0.001),而ADP诱导的PLT-MAR与血小板的数量无明显相关(r=0.014,P=0.837);同时研究显示AA诱导的PLT-MAR及ADP诱备的PLT-MAR均与平均血小板体积MPV呈正相关的关系(ADP:r=0.302,P<0.001)(AA:r=0.261,P<0.001)。逐步回归分析进一步证明:AA诱导的PLT-MAR与血小板的数量及MPV具有显著相关(P<0.001);ADP诱导的PLT-MAR与MPV显著相关(P<0.001).样本组中胆固醇异常且M A R位于血栓发生风险区的比例为10.1%(15/149),明显高于胆固醇正常且MAR位于血栓发生风险区比例2.6%(2/77)(P<0.05)结论:老年人群中,AA诱导的PLT-MAR与ADP诱导的PLT-MAR具有显著相关性本研究表明,血小板数量、MPV影响血小板的聚集功能。高胆固醇老年人群,发生血栓的风险增加.     

高血压患者血尿酸的检测及临床意义

目的探讨原发性高血压患者的血尿酸水平与血压的关系。方法回顾性地分析我院2010年6月至2010年10月心脑血管内科收治的高血压患者80例与年龄性别相近的健康体检者80名,用酶法查血尿酸,对其血尿酸水平进行对比分析。结果高血压组血尿酸异常增高40.0%,对照组异常增高10.0%,两组比较有显著差异(P<0.01);高血压组血尿酸水平(385.1±95.7μmol/L)明显高于对照组(288.6±84.2μmol/L)(P<0.01)。结论高血压患者常并存高尿酸血症,高尿酸血症与高血压密切相关。     

合肥地区5314名中年干部血压分类及其与临床心电图诊断类型的关系

目的　研究合肥地区中年干部血压水平及其与临床心电图诊断类型的关系。方法　对合肥地区 5 314名中年干部进行体检 ,计算不同性别的血压分类及高血压患病率 ,分析不同血压水平的临床心电图表现。结果　合肥地区中年干部男性 :正常高限血压占 12 % ,高血压病占 2 9% ;女性 :正常高限血压占8 3% ,高血压病占 17 8%。高血压患病率男性显著高于女性 (P <0 0 1)。随着血压升高 ,临床心电图异常分类如窦性心动过速、室性早搏、束支传导阻滞、ST T变化、左室高电压、左室肥厚等的检出率显著升高。结论　随着血压升高 ,临床心电图异常发生率显著升高。心电图异常以心室性为主     

亚洲型和西方型多发性硬化多形式脑诱发电位的比较

目的:探讨亚洲型和西方型多发性硬化(multiplesclerosis,MS)多形式脑诱发电位的差异。方法:对19例亚洲型和24例西方型MS患者进行了视觉诱发电位(visualevokedresponse,VEP)、脑干听觉诱发电位(brain-stemauditorye-vokedpotential,BAEP)和躯体感觉诱发电位(somatosensoryevokedpo-tential,SEP)的综合研究,并对两者的临床特点进行了比较。结果:亚洲型多发性硬化发病年龄犤(35±12)岁犦明显高于西方型犤(27±11)岁犦(t=2.3378,P<0.05)。EDSS评分在亚洲型MS(5.3±2.3)也明显高于西方型(3.8±2.1)(t=2.2304,P<0.05)。亚洲型MS的VEP异常率(89%)显著高于西方型(54%)(χ2=4.7053,P<0.05),而BAEP异常率低(42%)显著低于西方型(71%)(χ2=70.4663,P<0.001)。结论:亚洲型和西方型是多发性硬化的两种不同的临床亚型。     

2476例中老年退休职工脂肪肝患病情况分析

目的探讨中老年退休职工的脂肪肝患病情况及其相关因素。方法分析2476例中老年退休职工的体检资料,包括病史、身高、体重、血压、血糖、血脂、血尿酸、超声等检测结果,进行性别、年龄分层后脂肪肝患病率及相关因素比较。结果 2476例中老年退休职工,检出脂肪肝887例(35.82%),女性脂肪肝检出率39.58%,男性脂肪肝检出率33.27%,女性退休职工脂肪肝检出率较男性显著升高(P<0.01);脂肪肝组血压、BMI、TG、TC、FBG、UA均显著高于非脂肪肝组(P<0.01),而HDL-C显著低于非脂肪肝组(P<0.01)。脂肪肝组超重、空腹血糖升高、高血脂、高血压病、高尿酸血症比率均显著高于非脂肪肝组(P<0.01)。结论退休中老年人尤其老年女性的脂肪肝发病率较高,中老年人脂肪肝患病率与性别、血压、BMI、TG、TC、FBG、UA等因素密切相关。     

Prevalence of ECG findings in 18–19 year old Swedish men

2268 consecutive men, 18–19 years of age, were examined at an enlistment centre regarding their health, some anthropometric variables and electrocardiogram. ECG items according to the modified Minnesota code [1] were found in 230 subjects (10%). Most common ECG findings were T wave abnormalities (2.2%). Heart rate was higher in the groups with QRS axis deviation, T wave items, sinus tachycardia and supraventricular ectopic beats. Systolic and/or diastolic blood pressure was increased in the groups with T wave items, sinus tachycardia and ventricular ectopic beats. A dysfunction of the autonomic tone can often be suspected as a cause of the abnormality, especially in the groups with tachycardia, T wave changes, AV block grade I and AV junctional rhythm. An ECG recording during orthostasis was considered to be of value to clarify the nature of the ECG abnormality.     

冠心病病人非心脏手术后心肌缺血原因分析

目的 :为探讨冠心病病人术后麻醉苏醒期发生心肌缺血加重的原因及临床表现特点。方法 :对16 3例冠心病病人术后进行持续血压、脉搏血氧饱和度 (SPO2 )、肛温、心电监护、中心静脉压 (CVP)监测 ,观察心电图ST -T变化。结果 :发现术后低温、低氧血症、心动过速、血压异常可引起ST -T改变。结论 :冠心病病人术后出现心肌缺血 ,甚至心肌梗死可无临床症状 ,提示应加强监护 ,及时发现各种危险因素 ,防止心脏严重并发症的发生。     

Holter monitoring for 24 hours in patients with thromboembolic stroke and sinus rhythm diagnosed in the emergency department

It is well known that patients with ischemic stroke show ST-T abnormalities and various rhythm abnormalities on an electrocardiogram (ECG). The most commonly encountered rhythm abnormality is atrial fibrillation. It was recently shown that paroxysmal atrial fibrillation (PAF) is an important causative factor in patients with stroke. Detection of PAF is important in identifying the cause, prognosis, and treatment in patients with thromboembolic stroke. Investigators in the present study followed patients with thromboembolic stroke who had been admitted to the emergency department in sinus rhythm; 24-h Holter monitoring was used, and patients were assessed at referral and every 6 h for 24 h with ECG, which was used to detect rhythm disturbances, especially PAF. In 26 patients with stroke who came to the emergency department, acute thromboembolic stroke was diagnosed on the basis of magnetic resonance imaging; no rhythm abnormalities were noted on Holter monitoring. Eighteen patients were male and 8 were female (mean age: 66±13 y). Arrhythmia was identified on ECG in 3 patients (11%) and on 24-h Holter monitoring in 24 patients (92%). PAF was diagnosed in 3 patients (11%) on ECG and in 11 patients (42%) on Holter monitoring. In 2 patients, nonsustained ventricular tachycardia was detected only on Holter monitoring, which was found to be significantly superior to ECG for the detection of arrhythmias (P < .001). Investigators found no significant relationship between PAF and variables such as hypertension, diabetes, coronary artery disease, history of myocardial infarction, ST-T changes, and elevations in cardiac markers. However, a significant relationship (P < .01) was seen between nonsustained ventricular tachycardia and a history of myocardial infarction. No relationship was discerned between arrhythmia and stroke localization. Study results suggested that (1) PAF is a commonly diagnosed rhythm abnormality, and (2) Holter monitoring is superior to routine ECG for the detection of arrhythmias such as PAF in patients anticipated to have thromboembolic stroke with sinus rhythm.     

Predictors of Atrio-Ventricular Conduction Disease, Long-Term Outcomes in Patients with Myotonic Dystrophy Types I and II

Background: Patients with myotonic dystrophy (DM) have an annual mortality of approximately 3.5%, one-third of which is sudden cardiac death. The predictors of cardiac conduction disease in these patients are incompletely defined. Methods: A single-center cohort study included 211 patients with DM type 1 (DM1) and 25 DM type 2 (DM2). A severe electrocardiogram (ECG) abnormality was defined as a PR interval of ≥240 ms or QRS duration of ≥120 ms. Results: A severe ECG abnormality was found in 24% of DM1 patients and 17% of DM2 patients. Among DM1 patients, those with a severe ECG abnormality were older (41.6 ± 14.6 vs 35.4 ± 12.6 years) and more likely to have hypertension (13.2% vs 4.2%, P = 0.038), heart failure (4.4% vs 0%, P = 0.056), atrial arrhythmias (6.6% vs 0.7%, P < 0.001), a higher number of trinucleotide repeats (689 ± 451 vs 474 ± 322, P = 0.01), and a family history of sudden cardiac death (26.7% vs 5.6%, P < 0.001) or pacemaker implantation (20% vs 0.7%, P < 0.001). Pacemakers or defibrillators were implanted in 14% of all patients, including 65% of patients with severe ECG abnormalities. During 57 ± 46 months, 13 patients died (1.16% per year), including three patients who died suddenly, two of whom had normally functioning pacemakers. Conclusion: In DM1, atrio-ventricular conduction disease is associated with increasing age, concomitant cardiovascular disease, nucleotide repeat length, and family history. The systematic identification of conduction disease and aggressive use of prophylactic pacemakers is associated with low rate of sudden cardiac death. (PACE 2012; 35:1262-1269).     

凉山彝族自治州公务员健康体检分析

目的分析某中部地区公务员血压、血脂和心电图的检测情况,并分析其与年龄、性别的关系。方法将某地区公务员725人作为研究对象,并按照年龄分为6组,按性别分为男、女两组。利用体检相关数据,采用χ2检验。结果统计学分析显示,本次调查高血压检出率为21.6%,高血脂检出率为20.0%,心电图异常率为24.5%,并随年龄增长而增高。高血脂的发病率男性高于女性。结论公务员高血压、高血糖及心电图异常情况比例较高,应采取多种有效措施,加强其身体定期检测,积极开展健康教育,养成健康生活方式。     

Postprandial variations in ST-segment in a patient with Brugada syndrome and partial gastrectomy

A 74-year-old man with a history of partial gastrectomy presented with an electrocardiogram consistent with Brugada syndrome and marked meal related fluctuations in the ST segment. ST-segment elevation was prominently attenuated at 30 minutes and increased at 120 minutes after meals. Analysis of heart rate variability revealed a relationship between postprandial heightened parasympathetic activity and increase in Brugada-type ECG abnormality. A rapid postprandial increase in blood glucose may initially stimulate sympathetic nervous activity and secondarily increase parasympathetic tone. Food intake can be associated with fluctuations in ST-segment elevation in patients with the Brugada syndrome.     

急性有机磷农药中毒患者心电图的改变

目的 探讨急性有机磷农药中毒(AOPP)患者的心电图变化,重点阐述AOPP患者的QTc间期长短与血浆胆碱酯酶浓度(ChE)的关系.方法 回顾分析2006-01～2008-06期间入住我院的32例AOPP患者.收集患者入院2h内的心电图和血浆ChE检查结果,并对心电图QTc间期和血浆ChE进行相关性分析.结果 患者年龄为(37.6±18.6)岁,女性患者23例(71.8%).QTc间期的平均长度为(441.2±22.5)ms.QTc间期延长12例(37.5%),是最常见的心电图的异常变化;其次是非特舁性ST-T改变7例(21.8%),窦性心动过速6例(18.8%),P-R间期缩短4例(12.5%),期前收缩5例(15.6%),窦性心动过缓2例(6.25%).QTc间期长短和血浆ChE呈负相关(r=-0.419,P<0.05).结论 AOPP患者常见的心电图变化包括:QTc间期延长、非特异性ST-T改变和心律失常.QTc间期长短和血浆胆碱酯酶浓度呈负相关.由此推测,AOPP患者的QTc间期的长短对判断患者的中毒程度有一定的意义.     

Utilization of the electrocardiogram in the pediatric emergency department

ObjectiveReview pediatric electrocardiogram (ECG) result severity classification and describe the utilization of ECG testing, and rate of clinically significant results, in the pediatric emergency department (PED).MethodsThis was a review of patients ≤18 years who had an ECG performed in a tertiary children's hospital PED 2005–2017. Using established guidelines and expert consultation, ECG results were categorized: Class 0 = normal, Class I = mild abnormality (no cardiology follow-up), Class II = moderate abnormality (cardiology follow-up), Class III = severe abnormality (immediate intervention). Chi-square tests were used to examine differences between patients with clinically insignificant (Class 0/I) and clinically significant (Class II/III) results. Multivariable regression was used to examine factors associated with clinically significant results.Results16,147 unique PED encounters with ECG performed were included for analysis. The most common ECG indications were chest pain (32.5%), syncope (22.0%), arrhythmia (11.8%), toxicology/ingestion (9.4%), and seizure (5.7%). Overall, 12.7% (n = 2056) of ECGs had clinically significant (Class II/III) results, and only 2.0% (n = 325) had severe abnormality (Class III) that would require immediate intervention or cardiologist input. Factors associated with increased odds of clinically significant ECG were age ≤ 1 year (OR = 1.20, 95% CI: 1.02–1.41), male (OR = 1.33, 95% CI: 1.20–1.46), and indications of arrhythmia (OR = 1.84, 95% CI: 1.59–2.13), cardiac (OR = 2.57, 95% CI: 1.99–3.31), blank indication (OR = 1.52, 95% CI: 1.17–1.98), and electrolyte abnormality (OR = 1.42, 95% CI: 1.03–1.95).ConclusionsIn this study, we provided a valuable review of ECG result severity classification in the pediatric population. We found that chest pain and syncope represented over half of all ECGs performed. We found that clinically significant results are rare in the pediatric population at 12.7% of all ECGs performed, and very few (2.0%) have severe abnormalities that would require immediate intervention. Those with increased odds of a clinically significant ECG include young patients ≤1 year of age, male patients, and certain ECG indications.     

急性脑血管病应激状态的临床观察

目的：研究脑血管病人急性期应激状态的机制和特点。方法：回顾性分析急性脑血管病194例的心电图、心肌酶、血压和血糖等指标的变化特点。结果：脑血管病人急性期（发病48h之内）心电图发生改变，血压、心肌酶、血糖和外周血白细胞均增高。结论：积极调控急性脑血管病病人的应激反应，对于提高脑血管病的治愈率有重要意义。