2型糖尿病患者校正QT间期延长与多种心血管危险因素的相关性

目的分析QTc延长与多种心血管危险因素的关系。方法除外影响QTc因素的患者后,收集完成糖尿病并发症筛查和12导联心电图检查的数据。根据QTc正常与否（QTc〈0．44S为正常,QTc≥0．44s为延长）,将患者分为正常组和延长组。比较和分析两组患者的多种心血管危险因素。结果人选2型糖尿病患者3426例,其中37％的患者合并有QTc延长。与正常组相比,延长组患者年龄大、糖尿病病程长、女性比例高、腰围和腰臀比大、血压高、心率快,糖化血红蛋白（HbAlc）、餐后2小时血糖、空腹胰岛素、血胆固醇和甘油三酯以及尿白蛋白／肌酐比值高。Logistic回归分析显示,年龄、性别、体质量指数、腰围、腰臀比、心率和血肌酐与QTc延长明显相关。结论略多于1／3的2型糖尿病患者合并QTc延长,并有更多更严重的多种心血管疾病危险因素。     

糖尿病与冠心病人QT间期及离散度变化的相关性研究

糖尿病和冠心病人的QTc和QTd明显长于非患病病者，町为预测心血管事件的发生提供依据。方法：采用病例一病例对照的研究方法，将130例糖尿病、冠心病病人分为冠心病组（G1）53例、糖尿病组（C2）47例、糖尿病合并冠心病组（G3）30例，对比QTc和QTd的变化及其与糖尿病和冠心病的相关性。结果：G3组病人的QTc和QTd较G1、G2组明显延长（P=0．010和0．017），相关分析结果显示QTd与QTc明显相关（R=0．252P=0．004），糖尿病或CHD病人的QTc与是否合并CHD或糖尿病独立相关（？=0．368和0．336P=0．007和0．046）。结论：糖尿病对心肌电活动的影响与心肌缺血引起的相近，二者合并出现后加重了心肌电活动的l不稳定性。     

极低出生体重儿支气管肺发育不良的危险因素分析

目的 分析极低出生体重儿支气管肺发育不良的危险因素.方法 选取2015年4月至2020年4月于中科大附一院新生儿监护室住院治疗,胎龄<32周且体重<1500克的新生儿253例,排除患有畸形、遗传代谢性疾病及放弃治疗等患儿,分为疾病组60例及对照组193例.收集孕母、患儿出生信息及生后治疗措施.回顾性分析极低出生体重儿支...     

极低出生体重儿红细胞输注的危险因素分析

目的:确立极低出生体重儿红细胞输注的独立危险因素,并探讨独立危险因素数量与红细胞输注发生率之间的关系。方法:对2020年6月至2021年3月在华中科技大学同济医学院附属武汉儿童医院住院治疗的出生体重≤1500 g的患儿进行回顾性分析,根据有无红细胞输注,将患儿分为输血组和非输血组。比较2组的临床资料、检查结果、临床并发症和住院期间的治疗措施,以确定红细胞输注的危险因素,并分析极低出生体重儿输血危险因素数量与红细胞输注发生率的关系。结果:70例极低出生体重儿中,44例接受红细胞输注,输注率为62.9%,输血组与非输血组比较,患儿的出生体重、住院身长、住院天数、妊娠天数、妊娠并发症总数以及5 min Apgar评分<7分、机械通气、肺出血、支气管肺发育不良、脓毒血症、颅内出血、住院天数>40 d的例数差异有统计学意义,多因素二元logistic回归分析表明,机械通气、5 min Apgar评分<7分和妊娠并发症是极低出生体重儿红细胞输注的独立临床预测因素,极低出生体重儿输血危险因素数量与红细胞输注发生率的关系呈正相关。结论:新生儿成熟度和临床严重程度相关的临床特征与极低出...     

西安地区郊区农村心血管疾病及危险因素的相关性研究

目的通过调查西安市郊区农村心血管疾病及危险因素的流行情况,分析无心血管病史的人群未来10年缺血性心血管病(ICVD)的发病风险。方法对调查人群进行问卷调查、体格及生化检查,统计心血管疾病及危险因素的流行情况并对无心血管病史的人群采用"国人缺血性心血管病10年发病危险度评估表"进行评估未来10年ICVD的发病风险。结果卒中和冠心病的标化患病率为0.72%、2.31%;高血压、糖尿病、血脂异常、超重、肥胖、中心性肥胖的标化患病率为14.7%、5.98%、15.9%、10.2%、3.82%、9.81%;40~59岁无心血管病史的人群未来10年ICVD的发病风险≥10%的检出率为15.8%。结论西安市郊区人群心血管疾病及危险因素的患病率明显增高,未来10年ICVD的发病风险大;建议早期加强危险因素的干预。     

三明市三元区公务员心血管危险因素的分析

目的:研究三明市三元区公务员心血管病危险因素的情况,以便指导其防治工作.方法:分别从2005年和2010年体检对象中随机选择年龄为30～89岁的公务员,测量血压、血脂、血糖3种心血管病危险因素,询问病史,进行统计分析.结果:(1)随着年龄的增长,心血管病危险因素的检出率在逐渐升高;女性在50岁之前的检出率较低,50岁之...     

胰岛素原与心血管危险因素聚集的流行病学研究

目的 研究人群中胰岛素原水平与心血管危险因素聚集的关系。方法 按照随机抽样的原则，在江苏省邳州市的农村共调查1：196名35～59岁的常住居民，其中男性533名，女性663名，平均年龄为46．7岁。应用灵敏度与特异度均较高的单克隆抗体为基础的酶联免疫吸附试验方法检测空腹胰岛素原。结果由低至高胰岛素原四等分组的心血管危险因素评分分别为0．97、1．15、1．53及2．04(F=46．086，P=0．000)，危险因素聚集检出率分别为25．8％、30．8％、45．8％、58．5％(x^2=86．107，P=0．000)；Spearman相关分析及调整年龄、性别、体重指数与腰围后的偏相关分析结果显示，胰岛素原与危险因素评分的相关系数分别为0．308与0．2095(P值均为0．000)；单因素及多因素Logistic回归分析显示，胰岛素原的水平与心血管危险因素聚集显著相关，其OR值(95％可信区问)分别为1．656(1．483—1．851)(P=0．000)、1．661(1．485—1．859)(P=0．000)。结论 胰岛素原水平与心血管危险因素聚集呈剂量反应关系，且其关系独立于年龄、性别。     

Brugada综合征患者体温与QT间期相关性研究及临床意义

目的 探讨Brugada综合征（BrS）患者不同体温状态对心电图校正的QT间期（QTc）的影响,并对两者进行相关性分析,阐述其可能的机制及临床意义.方法 选择2008年5月至2013年5月在南京医科大学第一附属医院明确诊断的BrS患者为实验组,以年龄、性别相匹配的阵发性室上性心动过速（PSVT）患者为对照组,对每例患者均每日多次测量体温并同时行心电图检查,采用Bazett公式计算QTc,将体温和QTc关系绘制成散点图并进行相关性检验.结果 8例BrS患者均为男性,平均年龄（47.38±15.05）岁,均有晕厥史,有家族猝死史（1例）,临床记录室性心动过速（VT）或心室颤动（VF）4例,电生理检查（EPS）诱发VT或VF 5例.8例PSVT患者（男女比例为4∶4）,平均年龄（43.75±10.47）岁,房室结折返性心动过速5例,房室折返性心动过速3例.BrS组体温与QTc之间具有相关性,相关系数0.6（P＜0.05）,而对照组两者之间无相关性（P＞0.05）.结论 BrS患者体温与QTc呈正相关,随着体温的升高,QTc呈升高趋势,容易发生室性心律失常.     

QT、QTU间期的测量及临床意义

QT间期是QRS波起始至T波终末部的时间间期,代表心室除极和复极的总过程。QT间期的改变主要与心室复极化有关,其中ST段相当于心室肌细胞动作电位2相平台期,这一间期的长短呈心率依赖性。T波反映3相快速复极过程,该间期受自主神经张力、血钾浓度以及心脏本身病变等因素的影响。当     

缓释二氢奎尼丁血药浓度与QTc间期、QT间期离散度、QUc间期的相关性研究

目的：观察缓释二氢奎尼丁血药浓度与ＱＴｃ间期、ＱＴ间期离散度、ＱＵｃ间期等参数的相关性。方法：４０例心房颤动病人口服缓释二氢奎尼丁。心电图记录采用５０ｍｍ／ｓ纸速，２倍电压的方法。血药浓度测定采用ＴＤＸ方法。结果：①缓释二氢奎尼丁疗效明显，转复窦性心律５４．６％（６／１１例），预防心房颤动复发有效率７１．４％（２５／３５例）。②血药浓度与ＱＵｃ间期高度相关（ｒ＝０．９３，Ｐ＜０．０１）。③服药前、后心肌复极离散度比较无差异。用药后Ｕ波发生率明显增加，但未见药物的致心律失常作用。结论：缓释二氢奎尼丁血药浓度与ＱＵｃ间期高度相关。     

中年人群代谢综合征及其组分与心电图QT间期关系研究

目的探讨中年人群代谢综合征(metabolic syndrome,MS)及其组分与心电图QT间期的关系。方法2003—2006年对975名"宫内发育与成人疾病"队列人群(1948—1954年在北京协和医院出生的活产单子,其中男494名,女481名,年龄41~53岁)进行流行病学调查、身体测量、血生化指标测定及MS诊断,记录标准12导联心电图,用Bazett公式计算校正的QT间期(QTc)。采用稳态模式评估法计算胰岛素抵抗指数(HOMA-IR)。结果该中年人群心电图QT间期延长者262例(占26.9%),MS、HOMA-IR、中心性肥胖、高血压、高血糖、高三酰甘油(TG)、低高密度脂蛋白胆固醇(HDL-C)的检出率分别为19.7%,19.5%,42.5%,34.3%,26.3%,34.6%,31.1%。心电图QT间期延长与中心性肥胖、高血糖、高TG、胰岛素抵抗(IR)、MS及异常组分聚集有相关关系(P<0.05)。结论心电图QT间期延长与多项代谢异常组分、代谢异常聚集及代谢综合征有相关联系。     

The prognostic value of the QT interval and QT interval dispersion in all-cause and cardiac mortality and morbidity in a population of Danish citizens

Aims. To evaluate the prognostic value of the QT interval and QT intervaldispersion in total and in cardiovascular mortality, as wellas in cardiac morbidity, in a general population. Methods and results. The QT interval was measured in all leads from a standard 12-leadECG in a random sample of 1658 women and 1797 men aged 30–60years. QT interval dispersion was calculated from the maximaldifference between QT intervals in any two leads. All causemortality over 13 years, and cardiovascular mortality as wellas cardiac morbidity over 11 years, were the main outcome parameters.Subjects with a prolonged QT interval (430ms or more) or prolongedQT interval dispersion (80ms or more) were at higher risk ofcardiovascular death and cardiac morbidity than subjects whoseQT interval was less than 360ms, or whose QT interval dispersionwas less than 30ms. Cardiovascular death relative risk ratios,adjusted for age, gender, myocardial infarct, angina pectoris,diabetes mellitus, arterial hypertension, smoking habits, serumcholesterol level, and heart rate were 2·9 for the QTinterval (95% confidence interval 1·1–7·8)and 4·4 for QT interval dispersion (95% confidence interval1·0–19·1). Fatal and non-fatal cardiac morbidityrelative risk ratios were similar, at 2·7 (95% confidenceinterval 1·4–5·5) for the QT interval and2·2 (95% confidence interval 1·1–4·0)for QT interval dispersion. Conclusion. Prolongation of the QT interval and QT interval dispersion independentlyaffected the prognosis of cardiovascular mortality and cardiacfatal and non-fatal morbidity in a general population over 11years.     

健康国人QT间期离散度的检测及其相关因素分析

目的　建立健康国人 12导联同步心电图QT间期离散度平均值及其相关因素分析。方法　对 1～ 87( 3 9 4± 17 3 )岁健康国人 2 0 78例 ,用广东中山SR 10 0 0A心电综合自动分析仪采集 12导联同步体表心电图数据并录入软盘 ,专人在显示器上进行回放分析。增益放大 1mV =2 0～ 4 0mm ,纸速放大 5 0～ 10 0mm/s。测量QTmax、QTmin,按Bazett公式校正QTcmax、QTcmin,计算QTd(QTmax减QTmin)及QTcd(QTcmax减QTcmin)。微机数理统计。结果　QTmax、QTmin、QTcmax、QTcmin、QTd及QTcd平均值随增龄呈增大趋势 ,但在年龄组间及男女间差别无统计学意义。 1～ 87岁QTmax平均值为 ( 3 99 3 9± 3 2 93 )ms,QTmin为 ( 3 64 99± 3 1 0 6)ms,QTcmax为 ( 4 45 87± 2 8 2 1)ms,QTcmin为 ( 4 0 6 60± 2 9 84 )ms,QTd为( 3 3 97± 11 15 )ms,QTcd为 ( 3 8 14± 12 84 )ms。 1～ 14岁儿童QTd为 ( 3 3 4 1± 9 5 9)ms,QTcd为 ( 4 1 83± 12 14 )ms。QTmax在V2 ～V6 导联出现率占 80 5 0 % ,QTmin在V1导联出现率占 5 4 98%。结论　健康国人各年龄QTd为 12～ 5 0ms,QTcd为 13～ 60ms。QTd与心率、年龄及性别无明显相关性。     

QT interval change with age in an overtly healthy older population

Background: Prolonged QT interval on the surface electrocardiogram (ECG) is known to be associated with arrhythmias, coronary heart disease, and sudden cardiac death. Increased QT dispersion has also been related to arrhythymias which are more frequent in the elderly. Hypothesis: This study investigated the relationship between aging, QT interval, and QT dispersion. Methods: Normal resting ECGs were recorded from 96 healthy subjects (73 women, age range 40-102 years). No subject had symptoms or signs of heart disease and none was on medication affecting cardiac function. All had normal heart size on chest x-ray and normal electrolytes. Using a digitizing board, the RR and QT intervals were measured on each lead of each ECG, excluding only the leads in which the T wave was not visible. Mean RR, mean QT interval, and heart rate-adjusted QTc interval (standard Bazet's formula) were obtained from these measurements. Further, QT dispersion was calculated for each ECG as (1) the difference between the maximum and minimium QT interval, and (2) as the coefficient of variance of QT interval of all measurable leads. Results: A significant correlation between aging and prolonged QTc was noted in the total population (r = 0.43, p <0.05), as well as in men (r = 0.4, p <0.05) and women (r = 0.23, p<0.05) separately. There was no association between QT dispersion and increasing age regardless of the method of calculation (r= -0.04, r= -0.08 respectively, both NS). Conclusion: The rate-adjusted QT interval is prolonged with increasing age and may contribute to the increased risk of ventricular arrhythmias and cardiac mortality in elderly patients.     

Ideal cardiovascular health in Chinese urban population

Background

The American Heart Association's 2020 Strategic Goals define a new concept of cardiovascular health. However, the prevalence of ideal cardiovascular health outside of the United States is unclear, and its relationship with psychological status has not been reported.

Method

We included 9962 participants (mean age 47.1 years; 44.2% women) from the survey of the Disease Risk Evaluation and Health Management study from October 2009 to Feb 2012. The prevalence of poor, intermediate, and ideal cardiovascular health levels were calculated, and psychological status was assessed using the 21-item Depression Anxiety Stress Scales.

Results

After adjusting for sex and age, only 0.5% of the participants met ideal levels of all 7 cardiovascular health metrics, and 26.9% presented with 5 to 7 ideal health metrics. Fasting plasma glucose was the most prevalent ideal metric (71.2%), whereas physical activity was the least prevalent (18.1%). Women had a significantly higher proportion of 5 to 7 ideal health metrics compared with men (40.4% versus 13.4% after adjusting for age), and the proportion of participants who had 5 to 7 ideal health metrics significantly decreased with age (P < 0.001 for trend). Furthermore, the scores for depression, anxiety, and stress showed a negative correlation with the number of ideal health metrics, with regression coefficients of − 0.07, − 0.07, and − 0.11, respectively (P < 0.05).

Conclusions

Few adults met ideal levels of cardiovascular health. Individuals, communities, and health-care providers in China should be better integrated to pay closer attention to primordial prevention of unhealthy lifestyles and psychological problems.     

学龄期儿童心血管疾病危险因素现状调查

目的：为了解城市学龄期儿童心血管疾病危险因素的现状。方法：对长沙市 ４９５ 名９～１４ 岁儿童的血压、血脂、血糖、肥胖、膳食与运动习惯以及心血管病家族史等心血管疾病危险因素进行调查。结果：血压偏高检出率为４．８４％ ,血脂单项指标异常检出率为０．４０％ ～１７．３７％ ,总异常检出率为２１．８２％ 。３７．７５％ 儿童血脂水平超过膳食干预的推荐值。１．０１％ 儿童的空腹血糖≥６．７２ｍ ｍ ｏｌ／ Ｌ。４．６５％ 儿童超重度≥２０％ ,体重指数≥２４ 者占３．６３％ 。大部分儿童摄入脂肪及胆固醇较多,２２．６２％ 的儿童缺乏体育锻炼,５７．７８％ 家庭中有吸烟者,２６．８６％ 有心血管疾病家族史。结论：加强儿童时期心血管病危险因素的监测与干预势在必行。     

中国民航飞行员心血管病可控危险因素的流行病学调查

目的 了解中国民航飞行员心血管病可控危险因素的发生情况,为实施心血管疾病干预措施提供依据.方法 以整群抽样的方法抽取中国民航飞行员进行心血管病可控危险因素的流行病学调查,对不同地区、年龄民航飞行员的高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇和糖尿病的患病率,吸烟率,超重或肥胖率进行比较.结果 (1)共抽取中国民航飞行员5012名,分析其中资料完整有效者4684名.(2)中国民航飞行员高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇和糖尿病的患病率依次为8.07%、7.47%、14.45%、27.63%和0.43%,吸烟率为66.45%,超重或肥胖率为49.64%.(3)不同地区民航飞行员高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇的患病率,吸烟率,超重或肥胖率差异均有统计学意义(P均<0.01);不同年龄段民航飞行员高血压、高总胆固醇、高甘油三酯患病率,吸烟率,超重或肥胖率差异有统计学意义(P均<0.01),低高密度脂蛋白胆固醇患病率差异无统计学意义(P>0.05).(4)具有1个及以上心血管病可控危险因素的民航飞行员占88.96%,具有2个及以上心血管病可控危险因素的民航飞行员占54.46%,无同时具有≥7个心血管病可控危险因素的民航飞行员.不同地区之间具有2个及以上心血管病可控危险因素的飞行员比例差异具有统计学意义(P<0.01);不同年龄之间具有2个及以上心血管病可控危险因素的飞行员比例差异具有统计学意义(P<0.01).结论 中国民航飞行员具有心血管病可控危险因素的比例高,应积极加强对心血管病可控危险因素的干预.

Abstract：

Objective To investigate the status of controllable risk factors of cardiovascular disease in Chinese pilots. Methods Pilots in seven regions of China were selected with cluster sampling.The rates of hypertension, diabetes mellitus,smoking and abnormal body mass index(BMI) as well as levels of total cholesterol, triglyceride and high density lipoprotein-cholesterol were obtained. Results (1)A total of 5012 pilots were selected and 4684 pilots whose data were effective were studied.(2) The prevalence rates of hypertension, high total cholesterol, triglyceride, low high density lipoprotein-cholesterol and diabetes mellitus were 8.07%,7.47%,14.45%,27.63% and 0.43%, respectively.The rate of smoking was 66.45%.The rat of increased BMI was 49.64%.(3) Significant difference existed on the rates of hypertension, total cholesterol, triglyceride, low high density lipoprotein-cholesterol,smoking and abnormal BMI among pilots from different regions (all P<0.01).There was also a significant difference between the rates of hypertension, total cholesterol, triglyceride, smoking and abnormal BMI in different age groups (all P<0.01).The rate of low high density lipoprotein-cholesterol was similar in different age groups (P>0.05).(4) 88.96% of the participants had at least one controllable risk factor.54.46% of the participants had at least two controllable risk factors.None of the participants had more than seven risk factors.There was a significant difference between the rates of pilots who have more than two controllable risk factors in different regions (P<0.01).There was a significant difference between the rates of pilots who have more than two risk factors in different age groups(P<0.01). Conclusions There was high prevalence of controllable cardiovascular risk factors in Chinese pilots.Active intervention targeting these cardiovascular disease risk factors needs to be considered to reduce the risk of developing cardiovascular disease in Chinese pilots.     

Relationship of QT interval duration with carotid intima media thickness in a clinically healthy population undergoing cardiovascular risk screening

OBJECTIVES: To investigate the relationship between cardiac repolarization (QT interval duration) and intima media thickness (IMT) of the carotid arteries as surrogate measures of subclinical atherosclerosis. DESIGN: Prospective study with consecutive subjects enrolled in the SAPHIR program (Salzburg Atherosclerosis Prevention Program in Subjects at High Individual Risk). SETTING: The analysis of the material was performed at the departments of medicine and neurology of a university hospital. SUBJECTS: The study cohort comprises a population-based sample of 1199 clinically healthy subjects (851 men and 348 women; age 39-66 years). Exclusion criteria were cardiovascular disease, diabetes, atrial fibrillation, bundle branch block and use of medication affecting QT interval duration. MAIN OUTCOME MEASURES: IMT of common (CCA) and internal carotid arteries (ICA) was measured by B-mode ultrasound. QT interval duration was determined in the resting 12-lead electrocardiogram by an automatic analysis program. The QT intervals were corrected for heart rate with five standard equations (QTc-Bazett, -Fridericia, -Framingham, -Hodges and -Rautaharju) and tested for their relationship with carotid IMT after adjustment for clinical and metabolic variables. Results. Females had higher heart rates than males (64 +/- 10 b min(-1) vs. 60 +/- 9 b min(-1), P <0.0005), with longer mean QT (410 +/- 28 ms vs. 404 +/- 28 ms, P=0.003) and QTc intervals in all correction formulae (P <0.0005). Significant correlations between QT/QTc and ICA IMT (r=0.14-0.16) were found in males. In the general linear model the association between QTc (except for Bazett) and ICA IMT remained significant after adjusting for age, BMI and further cardiovascular risk factors. In females the crude correlations between QT/QTc and ICA IMT were lower than those with CCA IMT. Only the correlation between uncorrected QT and CCA IMT (r=0.15, P=0.006) remained significant after adjustment for covariates. CONCLUSIONS: The results of the present study demonstrate that QT and QTc prolongation are in part associated with IMT of carotid arteries, which is an established risk marker of subclinical atherosclerosis. In men the data support the hypothesis of an association between QTc and ICA IMT. In women a statistically significant relationship was found between the uncorrected QT interval and CCA IMT. These findings suggest that differences in carotid IMT and ventricular repolarization between genders might be related to hormonal and nonhormonal effects.