特发性室速短期暴露危险因素的病例交叉研究

Association between incidence of idiopathic ventricular tachycardia and risk factors with short-term effects： a case-crossover study

目的探索特发性室速（IVT）短期暴露的危险因素。方法采用病例交叉设计，通过广义估计方程对2007年11月1日至2008年12月31日期间江苏省人民医院和东南大学附属医院IVT病例和短期暴露危险因素之间的联系进行分析。结果多因素分析结果显示的危险因素有强体力活动（OR=2．20，95％CI：1．51—3．19）、生气（OR=1．87，95％CI：1．07—3．27）、悲伤（OR=3．58，95％CI：2．19～5．84）、激动（OR=3．06，95％CI：1．61～5．83）、感染（OR=2．25，95％CI：1．44～3．50）。结论强体力活动、生气、悲伤、激动、感染是IVT的危险因素。病例交叉研究能有效地识别，并揭示其作用强度。

Objective To explore the transient risks regarding idiopathic ventricular tachycardia （IVT）. Methods A symmetric bidirectional case-crossover design was used to estimate the short-term risk of IVT. In the case-crossover design each case served as its own matched control while case-period were compared to two control-periods, 7 days before and after the case-period. Ninety-four subjects were recruited from People＇s Hospital of Jiangsu Province and Affiliated Hospital of Southeast University from Dec. 2007 to Nov. 2008. Generalized estimating equation, with binomial distributed dependent variable and logit link-function, was used to estimate OR and 95%CI. Results The risk factors that were associated with IVT would include： physical exertion （OR = 2.20,95%CI： 1.51-3.19）, in the state of anger （OR= 1.87,95%CI： 1.07-3.27） sad feelings （OR = 3.58, 95%CI： 2.19-5.84）, or agitation （OR=3.06, 95%CI： 1.61-5.83） and having infection of some kind （OR =2.25, 95% CI： 1.44-3.50）. Conclusion Factors as physical Exertion, in the mood of anger, sadness agitation, having some kind of infection were related to IVT. Case-crossover design seemed to be able to identify the risk factors of IVT and its intensity.