汉族正常成年人的异常心电图改变及其特征

Characteristics of the abnormal electrocardiogram in normal Han adults

目的调查正常成年人中不同类型异常心电图的发生率及其与性别和年龄之间的关系.方法连续采集在医院体检中心接受常规体检的汉族人群心电图等资料.采用GEMAC 1600心电图机采集,MUSE系统进行心电图自动诊断后人工校正.以60岁为界值将研究对象分为老年组和青年组.结果共1720例纳入研究,其中男性877例(50.9%),老年组94例.心电图诊断异常为33.7%(579例),包括396例(23.0%)冲动起源异常、61例(3.5%)冲动传导异常、35例(2.0%)合并存在冲动起源与传导异常,心电图形态异常125例(7.3%).女性中显著窦性心动过缓、一度房室传导阻滞、左室肥大、电轴左偏的发生率均低于男性[0.1%(1/843)vs 0.8%(7/877),0.2%(2/843)vs 1.4%(12/877),0.2%(2/843)vs 1.0%(9/877),0.9%(8/843)vs 2.2%(19/877),P均<0.05];而S T段异常、T波异常、ST-T异常的发生率均高于男性[1.9%(16/843)vs 0.8%(7/877),3.8%(32/843)vs 1.1%(10/877),0.7%(6/843)vs 1.0%(1/877),P均<0.05].老年人中窦性心动过缓、一度房室传导阻滞、左室肥厚、电轴左偏的发生率均高于年轻人[19.2%(18/94)vs 10.9%(177/1626),4.3%(4/94)v s 0.6%(10/1626),4.3%(4/94)vs 0.43%(7/1626),7.5%(7/94)vs1.2%(20/1626),P均<0.05],而窦性心律不齐发生率较年轻人低[4.3%(4/94)vs 14.2%(230/1626),P=0.002].结论三成以上正常成年人体检心电图可发现异常,女性和老年人的部分异常心电图发生率较高.

Objective To investigate the incidence of different types of abnormal electrocardiogram(ECG)and its relationship with gender and age in normal adults.Methods ECG and health data of Han normal people,which continuously enrolled from routine physical examination in Xinjiang Production and Construction Corps Hospital,were collected.GE MAC 1600 ECG acquisition and MUSE system were used for automatic ECG diagnosis and manual calibration.The enrolled population was divided into the old group and the young group by the year threshold of 60.Results A total of 1720 cases were included in the study,including 877 males(50.9%).There were 579 cases(33.7%)of abnormal ECGs,including 396 cases(23.0%)with abnormal impulse origin,61 cases(3.5%)with abnormal impulse conduction,35 cases(2.0%)with abnormal impulse origin and conduction,and 125 cases(7.3%)with abnormal ECG morphology.In women,the percentage of the significant sinus bradycardia(0.1%vs 0.8%,P=0.035),first degree of atrioventricular block(0.2%vs 1.4%,P=0.007),left ventricular hypertrophy(0.2%vs 1.0%,P=0.031),and left-deviation(0.9%vs 2.2%,P=0.020)were lower than that in men,the per-centage of abnormal ST segment(1.9%vs 0.8%,P=0.024),abnormal T wave(3.8%%vs 1.1%,P〈0.001),abnormal ST-TC0.7%vs 0.1%,P=0.049)were high than men.In the elder,sinus bradycardia(19.2%vs 10.9%,P=0.014),first degree of atrioventricular block(4.3%vs 0.6%,P=0.005),left ventricular hypertrophic(4.3%vs 0.43%,P=0.002),and left deviation(7.5%vs 1.2%,P<0.001)were higher than that in the younger.Sinus arrhythmia(4.3%vs 14.2%,P=0.002)was less common in young adults.Conclusion Abnormal ECG is found on more than 30%of normal adults.and the incidence of the partial abnormal ECG is higher in women and in elderly.