高原筑养路职工异常心电图分析

目的:了解筑养路职工在高原低氧环境下心电图的改变及其意义.方法:对667名不同海拔地区高原养路职工进行心电图检查,对不同海拔地区、年龄、性别及工种进行比较.结果:高原筑养路工心电图异常指标发生率,前十位由高到低依次出现的顺序为:电轴右偏(18.7%)、窦性心律不齐(15.4%)、窦性心动过缓(10.2%)、电轴左偏(6.3%)、不完全性右束支传导阻滞(4.5%)、ST-T异常(3.9%)、窦性心动过速(3.1%)、左室高电压(2.5%)、右室肥厚(2.4%)、左前分支阻滞(2.4%);(20～＜30)岁、(30～＜40)岁、(40～＜50)岁三组ST-T改变随年龄增大而增加,窦性心律不齐及电轴右偏发生率随年龄增大而降低,电轴左偏及右室肥厚发生率随年龄增大而增加;男性左前分支阻滞、不完全性右束支传导阻滞、室性早搏、交界性早搏、肺型P波及房室传导阻滞异常发生率均高于女性,但差别无显著性(P＞0.05);工人组窦性心动过缓、窦性心律不齐、左前分支阻滞、房性早搏、室性早搏及房室传导阻滞心电图指标发生率均高于司机组和干部组,但差别无显著性(P＞0.05).结论:长期工作在高原低氧环境下会对高原筑养路职工心肌电生理产生影响,且海拔越高、居住时间越长,影响越大.

Abnormal Electrocardiogram of Constructors at High Altitude

Objective: To investigate the changes and its clinical implication of electrocardiogram of constructors under altitude hypoxic environment. Methods:The electrocardiograms (ECG) in 667 constructors, who were working at different altitudes, were measured. Comparison of different altitudes, ages, genders and occupations for ECG results was performed. Results: The incidence rate of abnormal electrocardiogram was as following: right axis deviation (18.7%), sinus arrhythmia (15.4%), sinus bradycardia (10.2%), left axis deviation (6.3%), incomplete right bundle branch block (4.5%), ST-T abnormality (3.9%), sinus tachycardia (3.1%), left ventricular high voltage (2.5%), right ventricular hypertropHy (2.4%), and left anterior hemiblock (2.4%). ST-T segment was elevated with the increasing ages in 20~49 years old group, as well on the left axis deviation and right ventricular hypertropHy; in contrast, the sinus arrhythmia and right axis deviation. The incidence of left anterior hemiblock, incomplete right bundle branch block, ventricular premature beat, nodal premature beat, pulmonary P wave and atrioventricular block abnormality in the male constructors were higher than those in female but P value was >0.05. The incidence of sinus tachycardia, sinus arrhythmia, left anterior hemiblock, atrial premature beat, ventricular premature beat and atrioventricular block in workers were higher (P>0.05) than those in chauffeurs and leaders. Conclusions: There is great effect of altitude hypoxia on myocardium of constructors in electropHysiology, and the abnormal change of ECG is more obvious with increasing altitude, prolonged exposure.