2065例应征入伍男青年心电图分析

ECG analysis of 2065 enlisted male youths

目的分析应征入伍男青年心电图初、复检结果,排除各种不良影响因素所致的功能性改变,避免入伍后不良心脏事件的发生,确保为部队选拔身体、心理素质双优青年。方法回顾性分析2065例应征入伍男青年的心电图检查结果。受检者的年龄18~22(20.0±1.5)岁,按照心电图诊断标准,分析心电图初、复检结果的变化情况。结果在2065例应征入伍男青年中,共检出异常心电图330例,包括窦性心动过速30例(其中合并ST-T改变者13例),窦性心动过缓11例,早搏19例,ST-T改变60例,J点抬高早期复极80例,右心室优势12例,短PR间期56例,心电轴显著偏移10例,一度房室阻滞25例,二度房室阻滞1例,左前分支阻滞6例,房性心律、房性逸搏各2例,完全性右束支阻滞12例,心房颤动1例,心室预激3例。一周后对330例心电图异常者进行复检,其中277例转为合格,包括窦性心动过速28例(其中合并ST-T改变者11例)(93.33%),窦性心动过缓11例(100%),早搏17例(89.47%),ST-T改变56例(93.33%),J点抬高早期复极68例(85.00%),右心室优势11例(91.67%),短PR间期50例(89.29%),心电轴显著偏移8例(80.00%),一度房室阻滞22例(88.00%),左前分支阻滞2例(33.33%),房性心律、房性逸搏各2例(100%);其余复检均不合格。除二度房室阻滞、左前分支阻滞、完全性右束支阻滞、心房颤动、心室预激外,其他初、复检心电图异常项目发生率之间的差异均有统计学意义(均P<0.05)。结论应征入伍男青年体检前,应提前纠正不良生活习惯,保持良好心态。心电图检查医生要耐心地对不合格的心电图予以复检,只有排除功能性改变,方可确定为不合格心电图。

Objective To analyze initial and re-examinations of ECGs among enlisted male youths excluding functional changes due to various adverse influencing factors so as to prevent adverse cardiac events after enlistment and ensure the selection of physically and psychologically qualified candidates for the military.Methods Retrospective analysis was performed in the ECG examination results of 2065 enlisted male youths.The age range of the examines was 18 to 22 years with a mean of(20.0±1.5)years.According to ECG diagnostic criteria,ECG changes of initial and re-examinations were analyzed.Results Among the 2065 enlisted male youths,abnormal ECGs were detected in 330 cases:sinus tachycardia in 30 cases(including 13 cases with concurrent ST-T changes),sinus bradycardia in 11 cases,premature beats in 19 cases,ST-T changes in 60 cases,early repolarization with elevated J point in 80 cases,right ventricular dominance in 12 cases,short PR interval in 56 cases,significant axis deviation in 10 cases,first-degree atrioventricular block in 25 cases,second-degree atrioventricular block in 1 case,left anterior fascicular block in 6 cases,atrial rhythm and atrial escape rhythm in 2 cases each,complete right bundle branch block in 12 cases,atrial fibrillation in 1 case,and ventricular pre-excitation in 3 cases.A week later,re-examination was performed in the 330 cases with abnormal ECGs out of whom 277 cases turned to be normal,including sinus tachycardia(including 11 cases with concurrent ST-T changes)in 28 cases(93.33%),sinus bradycardia in 11 cases(100%),premature beats in 17 cases(89.47%),ST-T changes in 56 cases(93.33%),early repolarization with elevated J point in 68 cases(85.00%),right ventricular dominance in 11 cases(91.67%),short PR interval in 50 cases(89.29%),significant axis deviation in 8 cases(80.00%),first-degree atrioventricular block in 22 cases(88.00%),left anterior fascicular block in 2 cases(33.33%),and atrial rhythm and atrial escape rhythm in 2 cases each(100%);the remaining cases were all unqualified in the re-examination.Except for second-degree atrioventricular block,left anterior fascicular block,complete right bundle branch block,atrial fibrillation and ventricular pre-excitation,there were statistically significant differences in the incidences of other ECG abnormalities between initial and re-examinations(all P<0.05).Conclusion Before physical examinations of enlisted male youths,they should correct unhealthy living habits and keep a positive attitude in advance.ECG physicians should patiently recheck unqualified ECGs to exclude functional changes before confirming unqualified ECG results.