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目的阐明健康管理人群的缺血性异常心电图的影响因素及非缺血性异常心电图对重要的缺血性异常心电图的预测价值。方法选择山东多中心健康管理纵向观察队列中至少参加2次体检的个体,排除冠心病及缺血性异常心电图患者,构建随访队列。对随访中发生缺血性异常心电图者与未发生缺血性异常心电图者,比较其基线信息,并筛选影响缺血性异常心电图的危险因素,进一步构建缺血性异常心电图的Cox回归分析模型。结果队列中共纳入45 546例,随访时间1~7年,平均3.24年,随访中共有7 656例出现缺血性异常心电图,发病密度为77.57/1 000人年。缺血性异常心电图发生的主要影响因素是年龄偏高、女性、高收缩压和舒张压、高空腹血糖、白细胞计数高以及非缺血性异常心电图R波高电压。结论本研究探讨导致缺血性异常心电图的危险因素,为制定切实可行的健康干预措施提供了科学依据。
Objective To clarify the influencing factors of ischemic abnormal ECG and the predictive value of non-ischemic abnormal ECG in important ischemic abnormal ECG in healthy management population. Methods Individuals who took part in at least 2 physical examinations in Shandong multicentre health management longitudinal observation cohort were selected and patients with coronary heart disease and ischemic abnormal ECG were excluded to construct a follow-up cohort. During the follow-up, those with ischemic abnormality electrocardiogram and those without ischemic abnormality electrocardiogram were compared with baseline information, and the risk factors of ischemic abnormality electrocardiogram were screened, and the Cox regression model of ischemic abnormal electrocardiogram was further constructed. Results A total of 45 546 patients were enrolled in the cohort. The follow-up duration ranged from 1 to 7 years (mean, 3.24 years). There were 7,656 ischemic abnormal electrocardiograms (ECGs) at a follow-up of 77.57 per 1000 person-years. The main influencing factors of ischemic anomalies were high age, female, high systolic and diastolic blood pressure, high fasting blood glucose, high white blood cell count and non-ischemic abnormal ECG R wave high voltage. Conclusion This study explored the risk factors leading to ischemic anomalies and provided a scientific basis for the development of practical health interventions.