军事训练后急性心血管事件高危人群筛选方法的研究

Screening methods for high risk population of acute cardiovascular events after military training

目的探讨增加血清学检测后的综合筛选方案在筛查军事训练后急性心血管事件高危人群中的意义。方法采用问卷调查、体格检查和心电图检查等方法,从某集团军中筛选出120例具有急性心血管事件可能的人群进入高危组,同时以年龄作为匹配条件从剩余人群中选择120例进入对照组。比较两组人群在军事训练前后心率、血压和心电图变化,以及血浆中肾上腺素(AD)、一氧化氮(NO)和心型脂肪酸结合蛋白(hFABP)浓度的变化。结果两组受试者运动前心率、血压和各项生化指标相似,无统计学差异(P>0.05);运动后高危组与对照组的心率血压积分别为[(11514.9±180.4)mmHg.次/min,(10989.1±110.5)mmHg.次/min],异常心电图比例分别为50.00%和9.17%;AD分别为(111.1±10.3)ng/L和(101.9±12.5)ng/L,hFABP分别为(659.1±67.2)pg/ml和(639.5±61.4)pg/ml,NO分别为[(108.3±9.7)μmmol/Lvs.(120.6±11.4)μmmol/L],差异有统计学意义(P<0.05)。结论采用血清学检查与问卷调查、查体及心电图相结合的调查方法,更有利于筛选得到军事训练后可能发生急性心血管病事件的高危患者。

Objective To investigate the significant of comprehensive screening methods after adding serological test for high risk population of acute cardiovascular events after military training. Methods A questionnaire （ including items of family history of heart disease, past medical history, risk factors of heart disease and symptoms after exercise ） , physical examinations and electrocardiogram （ ECG ） were used to select 120 cases with possible acute cardiovascular events as high risk group, and at the same time 120 cases were selected as control group taken age as matching condition. The changes of heart rate （ HR ） , blood pressure （ BP ） and ECG, and content of plasma adrenaline （ AD ） , nitric oxide （ NO ） and heart-type fatty acid binding protein （ hFABP ） were compared between two groups before and after military training. Results Before exercise, HR, BP and various biochemical indexes were similar in two groups. After exercise, the integrals of HR and BP in high risk group and control group were, respectively, [ （ 11514.9 ± 180.4 ） mmHg.time/min, （ 10989.1 ± 110.5 ） mmHg.time/min], proportion of abnormal ECG, 50.00% and 9.17%, AD, （ 111.1 ± 10.3 ） ng/L and （ 101.9 ± 12.5 ） ng/L, and NO, [ （ 108.3 ± 9.7 ） μ mmol/L vs. （ 120.6 ± 11.4 ） μ mmol/L, P〈0.05]. Conclusion The methods of serological test, questionnaire, physical examinations and ECG are conductive to screening of high risk population of acute cardiovascular events after military training.