体力活动与初发急性ST段抬高型心肌梗死发病的相关性分析

Corelation between physical activity and primary ST-segment elevantion acute myocardial infarction

目的：评估中国人群体力活动水平与急性心肌梗死之间的关系。方法：进行医院内的病例对照研究,实验组为初诊急性ST段抬高型心肌梗死的患者（129例）,对照组为同期住院的心绞痛及高血压患者（166例）,在年龄上相匹配。采用自行设计的健康状况调查表及修改后的国际体力活动问卷（IPAQ）对两组人群进行调查,内容包括人口学特征、教育水平、生活方式、疾病个人及家族史,将每周进行的不同体力活动所花费的时间转换成代谢当量（MET）。应用logistic回归分析估计不同体力活动与急性ST段抬高型心肌梗死的相关性。结果：进行家务劳动的人患急性心肌梗死的风险明显降低（P=0.045）,调整了多项混杂因素之后,中等强度体力活动为10.6-19h/周（OR=0.44,95%CI=0.21-0.96,P=0.038）时为保护因素,休闲性体力活动为3.6-9.75h/周时,能够降低急性ST段抬高型心肌梗死的发生风险（OR=0.36,95%CI：0.18-0.71,P=0.004）,交通性体力活动方面两组未见显著差异。结论：中等强度的体力活动,例如散步、打羽毛球等是急性心肌梗死的保护因素,应该倡导人们进行适度的体力活动。

Objective：To evaluate physical activity（PA）in relation to ST-segment elevation acute myocardial infarction（STEMI）in Chinese population.Method：We conducted a hospital-based case-control study.The cases in study group had first STEMI（n=129）.The controls（n=166）consisted of patients who had been admitted to the same hospital for angina or hypertension.The controls were matched to the cases in age.All subjects were interviewed by using a self-designed health condition questionnaire and international physical activity questionnaire（IPAQ）,including socio-demographic characteristics,lifestyle habits,detailed medical history and family history.Time spent per week in different physical activities was converted to metabolic equivalents（MET）.The odds ratios（OR）and 95% confidence intervals（CI）were estimated by using Logistic regression models.Result：Housework could decrease the risk of STEMI（P=0.045）.After adjusting for multiple potential confounders,moderate PA10.6-19h/wk（OR=0.44,95%CI=0.21-0.96,P=0.038）was protective for STEMI.When leisure time PA3.6-9.75h/wk,it also had lower risk（OR=0.36,95%CI：0.18-0.71,P=0.004）.Communicational physical activities were not associated with STEMI.Conclusion：Moderate PA,such as walking,play badminton and so on,are protective against STEMI.So we should encourage people to do regular PA.