某部海勤人员及新兵体检心电图检查结果分析及启示

Analysis of electrocardiograms in afloat naval personnel and recruits of a certain naval unit and thoughts about electrocardiogram detection in basic units

目的探讨某部海勤人员(水面舰艇工作生活至少2年以上,均有至少半年海上执行任务经历)和新兵整体心电图检查情况。方法选择2017年在解放军92012部队进行体检的某部海勤官兵及新入伍体检的新兵为研究对象。应用心电图记录仪,对284名海勤人员和137名新兵的心电图基本情况包括心率、PR间期长度、QRS时限、校正的QT间期(corrected QT interval, QTc)及心电图异常进行了统计和分析比较。结果海勤人员的心率慢于当年入伍新兵(P<0.01),在PR间期、QRS时间上较新兵长(P<0.01),在QTc上2者未见差异(P>0.05)。右束支传导阻滞、提早复极的发生率在海勤人员和新兵心电图未见差异(P>0.05)。发现1例重度ST-T异常的图形、1例间歇预激心电图图形。新兵中发现1例频发室性早搏(17 000次/24 h)伴快心率时ST-T下降。其中重度ST-T改变病例经上级医院冠状动脉CT检查和心脏超声检查及运动试验均未发现心脏存在病理改变证据。结论海勤人员心率偏慢,心电图各项异常检出情况与新入伍人员相比未见明显差异,舰上生活对舰员心电图无明显影响。但是2组均有个别心电图异常情况,提示应进一步加强对海勤人员心电图异常检查的检出。各级医院最好有标准来规范无症状ST-T异常人员后续检查流程。

Objective To investigate electrocardiograms(ECGs) of the commissioned and enlisted, who had worked and lived onboard surface naval vessels for at least 2 years and had the experience of sea service for at least half a year, and ECGs of recruits in a naval unit.Methods The electrocardiograms of the 284 commissioned and enlisted and 137 recruits, including heart rate(HR), length of PR interval, QRS duration and corrected QT interval, as well as ECG abnormality, were collected and analyzed by using ECG recorder.Results The heart rate of the commissioned and enlisted was slower than that of the recruits(P<0.01), PR interval and QRS length of the commissioned and enlisted were longer than that of the recruits, and no differences could be seen in QT interval, when comparisons were made between them. However, there were no differences in the incidence of right branch block and early repolarization when comparisons were made between the 2 groups. One case of severely abnormal ECG and one case of intermittent pre-excitation ECG were found in the commissioned and enlisted. In the recruits, there was one case of ECG diagram with frequent ventricular premature beats(17 000/24 h) and ST segment depression at rapid heart rate. Coronary CT examination, cardiac ultrasound examination and maximum exercise examination of the case with severe ST-T abnormity failed to find out any evidence of pathological change of the heart.Conclusion The heart beat of the naval afloat personnel tended to be slower, but there were no significant differences in the rate of abnormal changes in ECGs, as compared with that of the recruits, indicating that life onboard the ship seemed to have no significant impact on the ECGs of the ship crew. However, there were still a few abnormal ECGs in both the commissioned and enlisted and the recruits, suggesting that efforts should be intensified in the detection of abnormal ECGs among the naval afloat personnel. Hospitals at all levels should have related rules to standardize follow-up medical check-ups of those with asymptomatic ST-T diagram.