摘要
目的：分析人群血清促炎因子水平、心电图ST-T改变、ROSE问卷心绞痛、代谢综合征的相互关系。方法：采用整群抽样方法,选取顺德桂洲镇马岗村35~59岁村民1100例进行横断面研究。对人群进行病史、冠心病ROSE问卷、身高、体重、腰围、血压、血脂、高敏C反应蛋白（hs CRP）、心电图检测。对样本按高敏C反应蛋白（hs CRP）水平高低、心电图ST-T改变的程度作分层分析。结果：资料完整、纳入分析的实际样本数为1093例。代谢综合征患病率为17.4%。人群平均hs-CRP水平为（3.46±1.14）mg/L,其中代谢综合征患者最高（4.72±0.38）mg/L,其余依次为ROSE问卷心绞痛患者（4.63±0.47）mg/L、心电图ST-T异常患者（4.38±0.72）mg/L,心电图无ST-T改变患者最低（3.21±0.89）mg/L,比较差异有统计学意义（P〈0.05）。心电图异常患者、ROSE问卷心绞痛患者、代谢综合征患者与各自的正常患者比较,血清促炎因子hs-CRP水平较高,比较差异具有统计学意义（P〈0.05）。心电图ST-T改变的总发生率为21.5%,心电图ST-T轻度改变的发生率为12.5%,心电图ST-T明显改变的发生率为9.0%。ROSE问卷心绞痛的检出率为15.2%,其中,心电图ST-T异常患者的Rose问卷心绞痛检出率为47.7%,显著高于心电图ST-T正常患者,比较差异有统计学意义（P〈0.05）。心电图异常患者中,心电图异常越严重者,其血清促炎因子水平越高。血清促炎因子水平增高与心电图ST-T段异常存在明显的正相关关系。结论：血促炎因子水平升高可作为心血管疾病的预测手段。hs CRP检测结合Rose问卷及心电图ST-T改变,更有助于冠心病高危人群的筛选。
Objective： To evaluate the association among levels of serum proinflammatory factors, ST-T abnormalities on electrocardiogram （ ECG ）, Rose questionnaire based angina pectoris, and Metabolic Syndrome in a rural population. Method： An analysis on the cross-sectional study data was performed, which 1100 subjects were sampled from a clustered sample of the total population （ n=3000 ） in adults aged 35-59 years , from Guizhou Community, Shunde, Guangdong, in2003. Demographic information, personal and family histories of diseases and Rose questionnaire were collected.Physical examination and laboratory tests included high-sensitivity C-reactive protein （ hs-CRP ） and serum lipids were done.Subjects underwent examination on resting 12-lead ECG.ECG tracings were coded with Minnesota Code and classified as ST-T abnormalities ECG or normal ST-T ECG, and ST-T abnormalities ECGs were classified as marked ST-T abnormalities ECG （ codes 4-1, 4-2, 5-1 and 5-2 ） or lesser degrees of ST-T abnormalities ECG （ codes 4-3, 4-4, 5-3 and 5-4 ） .Result： A total number of1093 subjects （ 521 men and 572 women ） were finally included in this analysis.The prevalence of Metabolic Syndrome was 17.4%.The average hs-CRP level was （ 3.46 ±1.14 ） mg/L.The Metabolic Syndrome patients had the highest mean hs-CRP level （ 4.72 ± 0.38 ） mg/L followed by the Rose questionnaire based angina pectoris patients （ 4.63 ± 0.47 ） mg/L, and then the ST-T abnormalities ECG patients （ 4.38 ± 0.72 ） rag/L, successively.They had significantly higher hs-CRP level compared to the normal ST-T ECG patients （ P〈0.05 ）, which had the lowest hs-CRP level （ 3.21 ± 0.89 ） mg/L.ST-T abnormalities ECG patients, Rose questionnaire based angina pectoris patients and the Metabolic Syndrome patients had significantly higher hs-CRP levels compared with their respective normal patients （ P〈0.05 ） .The standardized prevalence of ST-T abnormalities ECG was 21.5% （ 9.0% in marked ST-T abnormalities ECG group and 12.5% in lesser degrees of ST-T abnormalities ECG group ） .The prevalence of Rose angina was 15.2% .The prevalence of Rose angina was significantly higher in ST-T abnormalities ECG group （ 47.7% ） than in normal ST-T ECG patients （ P〈0.05 ） .It was found that the severer the ST-T abnormalities, the higher the hs- CRP levels in abnormal ST-T patients （ P〈0.05 ） .The level of hs-CRP positively correlated with ST-T abnormalities.Conclusion： Level of serum proinflammatory factors is predictors of cardiovascular diseases.It is a contributor to detecting subjects at high risk of coronary heart diseases with hs-CRP combining ECG ST-T abnormalities and Rose questionnaire.
出处
《中国医学创新》
CAS
2015年第19期12-15,共4页
Medical Innovation of China
基金
广东省医学科研基金立项资助项目(A2002061)
关键词
血清促炎因子
高敏C反应蛋白
ROSE问卷
心电图
ST-T改变
明尼苏达编码
横断面研究
Electrocardiography
Serum inflammatory factors
High-sensitivity C-reactive protein
Rose questionnaire
ST-T abnormalities
Minnesota code
Cross-sectional study
