目的 探讨军事训练中运动性猝死高危人员的初步筛查方法。方法 先通过问卷调查和体格检查从某部拟参加5 km越野训练的460名官兵中筛选出心血管高危人员进入高危组,从无高危因素的官兵中按照年龄匹配原则随机选择同样例数人员进入正常对照组。然后,比较两组官兵5 km越野前后(训练前30 min,训练后10 min)常规十二导联心电图检查结果。结果 通过问卷调查和体格检查,共有44名为心血管高危人员,其中确诊1名高血压,1名疑似冠心病人员,不适宜再参加5 km越野活动,予以剔除。剩余的42名作为高危组,选择42名健康人作为对照组。运动前,高危组异常心电图的比例高于对照组,异常心电图比例分别为33.33%和0;运动后高危组出现异常心电图的比例更高于对照组,异常心电图比例分别为52.38%和7.14%,差异有统计学意义(P<0.05)。结论 先通过问卷调查和体格检查,再利用心电图筛查军事训练中运动性猝死高危人员有一定的实际意义。

Objective To explore the methods of screening of high-risk groups of sudden death during military training.Methods First, a questionnaire survey and physical examination were used to screen those at high risk of cardiovascular diseases as the high-risk group from among 460 soldiers who were going to participate in the 5 km cross-country training, while the same number of soldiers at no risk of cardiovascular diseases were selected as age-matched controls. The results of routine twelve lead electrocardiograms (ECGs) were compared between the two groups before and after training (30 min before training and 10 min after training).Results Through a questionnaire survey and physical examination, a total of 44 soldiers were found to be at high risk of cardiovascular diseases, including one case diagnosed with hypertension, and another case suspected of coronary heart disease, both of whom were disqualified for the 5 km cross-country training. The remaining 42 were selected as the high risk group, and 42 healthy people as the control group. Before exercise, the incidence of abnormal ECGs in the high-risk group was higher than that in the control group, and the percentage of abnormal ECGs was 33.33% and 0 respectively. After exercise, the incidence of abnormal ECGs in the high risk group was 52.38%, significantly higher than 7.14% in the control group, and the difference was statistically significant (P<0.05).Conclusions A questionnaire survey and physical examination that precede the use of ECG for screening soldiers at high risk of sudden death during military training can be of some value.