青海省饮茶型氟中毒病区氟骨症患者心电图特征分析

Analysis of electrocardiographic characteristics of patients with skeletal fluorosis in tea type of fluorosis areas in QingHai Province

目的了解青海省饮茶型氟中毒病区氟骨症患者心电图变化及特征,为氟对非骨相组织损伤的精准防控和措施制定提供依据。方法2021年9月1日—15日选取曲麻莱县未诊断出氟骨症的20例为对照组;19例氟骨症患者(包括轻度、中度、重度)为病例组,对两组受检者分别进行心电图和血压检查,并详细询问其饮茶史、心血管病史、骨关节病史;统计方法采用t检验、非参数Mann-Whitney秩和检验及χ^(2)检验。结果两组受检者的年龄、心率、舒张压比较差异无统计学意义(t=1.508、0.118、-1.673,P>0.05);收缩压比较差异有统计学意义(t=-2.170,P<0.05);心电图检查中,病例组心电图异常14例,检出率为73.68%,对照组心电图异常12例,检出率为60.00%。两组受检者在心电图出现异常、心律失常、电轴方向异常、传导阻滞和其他心电图异常表现方面比较,差异均无统计学意义(χ^(2)=0.821、1.642、0.041、0、0.914,均P>0.05);病例组主要出现胸导ST段下移(2例,10.53%),V1-V4导联出现R波递增不良及V2导联R波低小(4例,21.05%);主要参数方面,两组除PR间期差异有统计学意义(Z=2.506,P<0.05)外,QRS、QT、QTc间期差异均无统计学意义(Z=0.897、0.980、1.581,均P>0.05)。结论青海省饮茶型氟中毒病区氟骨症患者血压和心电图异常发生率较高,应加强综合防治措施。

Objective To understand the changes and characteristics of electrocardiograms in patients with skeletal fluorosis in the tea type of fluorosis area of Qinghai Province,and to provide a basis for precise prevention and control of fluorine damage to non-bone tissue and the formulation of measures.Methods From September 1 to 15 in 2021,twenty people with undiagnosed skeletal fluorosis in Qumalai County were selected as the control group.A total of 19 patients with skeletal fluorosis(including mild,moderate and severe)were selected as the case group.Electrocardiogram and blood pressure were examined for both groups of subjects,and they also questioned in detail about the history of tea consumption,cardiovascular disease,and bone and joint disease.The statistical methods used were the t test,the non-parametric Mann-Whitney rank sum test,andχ^(2) test.Results There were no statistically significant differences in comparison of age,heart rate,and diastolic blood pressure between the two groups of subjects(t=1.508,0.118,and-1.673,P>0.05).There was a statistically significant difference in comparison of systolic blood pressure(t=-2.170,P<0.05).In the electrocardiogram examination,there were 14 cases of abnormal electrocardiogram in the case group with a detection rate of 73.68%,and 12 cases of abnormal electrocardiogram in the control group with a detection rate of 60.00%.There were no statistically significant differences in the abnormal electrocardiogram,arrhythmia,abnormal electrical axis direction,conduction block,and other abnormal electrocardiogram between the two groups of subjects(χ^(2)=0.821,1.642,0.041,0,0.914,P>0.05).The case group mainly showed the ST segment downshifted in the chest lead(2 cases,10.53%),and poor R wave increment in leads V1-V4 and low and small R wave in lead V2(4 cases,21.05%)were more frequent.In terms of main parameters,except for the statistically significant difference between the PR interval(Z=2.506,P<0.05),there were no statistically significant differences in QRS,QT,and QTc intervals between the two groups(Z=0.897,0.980,1.581,P>0.05).Conclusion There is a high incidence of blood pressure and electrocardiogram abnormalities in patients with skeletal fluorosis in the tea type of fluorosis area of Qinghai Province,and comprehensive prevention and treatment measures should be strengthened.