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[目的]观察美国一般人群的尿镉水平与心电图改变的关系,了解镉暴露对心电图的影响。[方法]利用美国第三次国家健康与营养调查(NHANESⅢ)中进行心电图测量,年龄≥40岁的6 889名参与者作为研究对象。采用标准十二导联心电图分析系统记录心电图参数;采用原子吸收光谱法测定尿镉含量。按性别分层,运用多元线性回归分析尿镉水平与心电图改变的关系。[结果]尿镉平均水平为(0.7±0.01)μg/g肌酐,其中男性人群平均(0.6±0.02)μg/g肌酐;女性(0.8±0.02)μg/g肌酐;在男性群体,尿镉水平四分位最高与最低等分相比,多因素调整的心率、PRrr间期、QTrr间期和QRS间期变化及其95%CI分别为1.72(0.05~3.4)次/分,-3.87(-7.3~-0.45)ms,-0.39(-4.09~3.22)ms和-2.64(-4.96~-0.33)ms。在女性群体,尿镉水平最高与最低等分相比,上述相应的心电图参数变化及其95%CI分别为-0.19(-1.72~1.33)次/分,-0.09(-4.13~3.94)ms,1.59(-1.05~4.23)ms和-1.11(-2.68~0.47)ms。[结论]尿镉水平与美国男性一般人群的心电图改变存在一定的关联。
[Objective] To observe the relationship between urinary cadmium levels and electrocardiogram changes in the general population in the United States and to understand the influence of cadmium exposure on electrocardiogram. [Methods] 6 889 participants aged 40 or older underwent electrocardiogram measurement in the Third National Health and Nutrition Examination Survey (NHANES Ⅲ) in the United States. Electrocardiogram parameters were recorded by standard 12-lead electrocardiogram analysis system. Urine and cadmium contents were determined by atomic absorption spectrometry. Stratified by sex, using multiple linear regression analysis of urinary cadmium levels and the relationship between ECG changes. [Results] The average level of urinary cadmium was (0.7 ± 0.01) μg / g creatinine, in which the average male was (0.6 ± 0.02) μg / g creatinine and the female was (0.8 ± 0.02) μg / The multifactorial adjusted heart rate, PRrr interval, QTrr interval and QRS interval and their 95% CIs were 1.72 (0.05 to 3.4) / min and -3.87 (- 7.3 ~ -0.45) ms, -0.39 (-4.09 ~ 3.22) ms and -2.64 (-4.96 ~ -0.33) ms. In the female population, the corresponding changes in ECG parameters and their 95% CIs were -0.19 (-1.72 to 1.33) and -0.09 (-4.13 to 3.94) ms respectively, with the highest and lowest urinary cadmium levels. 1.59 (-1.05 to 4.23) ms and -1.11 (-2.68 to 0.47) ms. [Conclusion] The level of urinary cadmium is related to the change of electrocardiogram in American male general population.