目的 探讨高原驻训官兵心电图状况及其与年龄、驻训海拔高度和驻训时间的相关性。方法 随机抽取阿坝藏区各驻训部队官兵中575份体检心电图报告作为研究对象,以海拔高度、驻训时间和年龄作为分组变量。所有心电图报告由同一心内科高级职称医师复核并修正后形成最终的心电图报告,记录异常心电图情况。结果 575例中,异常心电图者238例,占41.39%。其中窦性心动过缓188例,占32.70%,窦性心律不齐109例,占18.96%。其他异常心电图28例,占4.87%,包括ST段改变13例,束支传导阻滞4例,T波改变3例,房室传导阻滞2例,房性期前收缩2例,心房颤动1例,频发室性期前收缩1例,异常Q波1例,P波增宽1例。窦性心动过缓、窦性心律不齐发生率在不同年龄组、不同海拔高度组和不同驻训时间组之间的差异无统计学意义。其他异常心电图的发生率在不同海拔高度组和不同驻训时间组之间的差异有统计学意义(P<0.05),显示海拔高度越高驻训时间越长发生率越高。结论 高原驻训官兵心电图异常以窦性心动过缓和窦性心律不齐为主,其他异常心电图类型发生率低,但与海拔高度和驻训时间呈正相关,需重点关注及防治。
Abstract
Objective To investigate the electrocardiogram (ECG) status of officers and soldiers stationed at high altitude and analyze its correlation with age, altitude and training time. Methods The ECG reports were randomly selected from the physical examination reports of 575 officers and soldiers in Aba prefecture, Sichuan Province. The altitude, training time and age were taken as grouping variables. All the ECG reports were reviewed and corrected by the same cardiologist with senior title to form the final ECG reports and the abnormal ECG were recorded. Results Among all the ECG reports, there were 238 abnormal ones, accounting for 41.39%, with 188 cases of sinus bradycardia, accounting for 32.70%, and 109 cases of sinus arrhythmia, accounting for 18.96%. There were 28 cases of other abnormal ECG, accounting for 4.87%, including 13 cases of ST segment changes, 4 cases of bundle branch block, 3 cases of T wave changes, 2 cases of atrioventricular block, 2 cases of atrial premature beats, 1 case of atrial fibrillation, 1 case of frequent ventricular premature beats, 1 case of abnormal Q wave and 1 case of P wave widening. There was no significant difference in the incidence of sinus bradycardia and sinus arrhythmia among different age groups, different altitude groups and different training time groups (P>0.05). There was significant difference in the incidence of other abnormal ECG between different altitude groups and different training time groups (P<0.05).The incidence rate increased with the increase of altitude and training time. Conclusion Among the ECG abnormalities in officers and soldiers stationed on plateaus sinus bradycardia and sinus arrhythmia are the main types, which have no correlation with age, altitude and training time. The incidence of other abnormal ECG types is low, but it is positively correlated with altitude and training time, which needs to be paid more attention and trained scientifically.
关键词
高原 /
官兵 /
心电图 /
海拔高度 /
驻训时间
Key words
plateau /
officers and soldiers /
ECG /
altitude /
training time
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Xu C, Zhu H, Nakatsuka T, et al. Sampling strategy and climatic implication of tree-ring cellulose oxygen isotopes of Hippophae tibetana and Abies georgei on the southeastern Tibetan Plateau[J]. Int J Biometeorol, 2019, 63(5):679-686.
[2] Tymko M M, Tremblay J C, Bailey D M, et al. The impact of hypoxaemia on vascular function in lowlanders and high altitude indigenous populations[J]. J Physiol, 2019, 597(24):5759-5776.
[3] Pham K, Parikh K, Heinrich E C. Hypoxia and inflammation: insights from high-altitude physiology[J]. Front Physiol, 2021, 12:676782.
[4] Bebic Z, Brooks P M, Polaner D M. Respiratory physiology at high altitude and considerations for pediatric patients[J]. Paediatr Anaesth, 2022, 32(2):118-125.
[5] 任晓兰,肖迎平,杨 洋. 驻高原武警官兵EQ-5D调查与心血管疾病风险评估[J]. 武警医学, 2019, 30(9):784-786.
[6] 刘小云,孙 莉,胡小兵. 部队进驻高原急性高原病预防策略分析[J]. 武警医学, 2021, 32(11):995-998.
[7] Zhao Y, Lin S, Wu J, et al. A study of the clinical application value of ultrasound and electrocardiogram in the differential diagnosis of cardiomyopathy[J]. Am J Transl Res, 2021, 13(5):5200-5207.
[8] Parodi J B, Ramchandani R, Zhou Z, et al. A systematic review of electrocardiographic changes in healthy high-altitude populations[J]. Trends Cardiovasc Med, 2022, in press.
[9] Shroff N A, Balbin J, Shobitan O. High-altitude illness: updates in prevention, identification, and treatment[J]. Emerg Med Pract, 2021, 23(9):1-24.
[10] Richalet J P. Adaption to chronic hypoxaemia by populations living at high altitude[J]. Rev Mal Respir, 2021, 38(4):395-403.
[11] Grant I D, Giussani D A, Aiken C E. Blood pressure and hypertensive disorders of pregnancy at high altitude: a systematic review and meta-analysis[J]. Am J Obstet Gynecol MFM, 2021, 3(5):100400.
[12] Lang M, Bilo G, Caravita S, et al. Blood pressure and high altitude: physiological response and clinical management[J]. Medwave, 2021, 21(4):e8194.
[13] Mallet R T, Burtscher J, Richalet J P, et al. Impact of High Altitude on Cardiovascular Health: Current Perspectives[J]. Vasc Health Risk Manag, 2021, 17:317-335.
[14] Niu Z, Li M, Pu P, et al. Effects of temperature on the locomotor performance and contraction properties of skeletal muscle from two Phrynocephalus lizards at high and low altitude[J]. J Comp Physiol B, 2021, 191(5):907-916.
[15] Rao M, Li J, Qin J, et al. Left ventricular function during acute high-altitude exposure in a large group of healthy young Chinese men[J]. PLoS One, 2015, 10(1):e0116936.
[16] Mikolajczak K, Czerwinska K, Pilecki W, et al. The Impact of Temporary Stay at High Altitude on the Circulatory System[J]. J Clin Med, 2021, 10(8):1622.
[17] 李峤珂,江国强,毛建斌,等. 高原驻守官兵体检心律失常心电图分析[J]. 中华心律失常学杂志,2011,15(3):225-227.
[18] 王 旭,马 忆,高玉婷,等. 高原维稳执勤官兵心电图结果分析与对策[J]. 中国误诊学杂志, 2011,11(6):1314.
[19] 张兆清,朱 敏,刘争建,等. 青藏线394名官兵心电图分析[J]. 西南军医,2011,13(4):627-629.
[20] 左 强,李峤珂,江国强,等. 105例高原官兵心电图ST-T改变分析[J]. 四川医学, 2011,32(4):534-536.
[21] 王 旭,郑敬曦. 高原地区中青年官兵心律失常监测分析[J]. 河北医药,2015,37(22):3495-3496.
基金
武警部队高层次科技人才培养计划项目(【2021】93号);四川乐山“嘉州英才培养计划”项目(乐人才办【2021】5号);乐山市重点科技计划项目(20SZD125)
PDF(973 KB)
