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目的 评估我国北京、广州 35～ 5 4岁工人、农民人群心电图ST T异常与远期死亡、冠心病和脑血管病事件的关系。方法 分析中美心血管病流行病学和危险因素合作研究 1983年、1984年至 2 0 0 0年我国北京、广州 35～ 5 4岁工人、农民样本人群 (除外心绞痛、心肌梗死、脑卒中 )共 92 6 0人的基线调查和随访资料。心电图按标准化方法Minnesota编码 ,终点事件为全病因死亡或首次发生冠心病或脑血管病事件 ,评估ST T异常的影响采用生存分析 (survivalanalysis)和Cox比例风险(proportionalhazards)分析。结果 ST T异常的发现率在广州地区、农村人群、女性人群较高 ,北京地区、城市人群、男性人群较低 ,T波异常明显多于ST段异常。ST T异常组死亡率和冠心病事件发病率依次为 75 9 18/10万和 134 97/10万 ,均高于无异常组的 5 38 5 3/10万和 5 7 93/10万 (P <0 0 5 )。ST T异常组平均生存期 193 8个月 ,发生冠心病事件平均时间为 16 6 6个月 ,均短于无异常组 (P =0 0 2 3和 0 0 18) ;发生脑血管病事件平均时间亦短于无异常组 ,但无统计学差异。ST T异常组死亡和冠心病事件的Cox比例危险度分别为无异常组的 1 6 0倍和 5 34倍 (P =0 0 0 9和 0 0 0 0 ) ,脑血管病事件是无异常组的 1 4 9倍 (P =0 14 3)。以
Objective To evaluate the relationship between ECG STT abnormalities and long-term death, coronary heart disease and cerebrovascular disease in 35 ~ 54 workers and peasants in Beijing and Guangzhou of China. Methods Analysis of Epidemiology and Risk Factors of Cardiovascular Diseases in China and the United States In 1983, from 1984 to 2000, 35-54-year-old laborers and peasants from Beijing and Guangzhou (except angina, myocardial infarction and stroke) A total of 92 6 0 baseline survey and follow-up information. The electrocardiogram was coded by the Minnesota standardized method and the end point was total cause death or first occurrence of coronary heart disease or cerebrovascular disease. Assessments of ST T abnormalities were performed using survivalanalysis and Cox proportional hazards analysis. Results The prevalence of ST T abnormalities in Guangzhou was higher in rural areas than in rural areas. The prevalence of ST T abnormality was higher in Beijing, urban areas and urban areas than in ST. The morbidity rates of ST T abnormal group and CHD were 75 9 18/10 and 134 97/10, respectively, which were higher than 5 38 5 3/10 and 5 7 93/10 (P <0 0 5). The mean survival time of ST-T abnormal group was 193 8 months, and the average duration of coronary heart disease was 16 6 months, both of which were shorter than those without abnormality (P = 0.0023 and 0 018). The average incidence of cerebrovascular disease Time is also shorter than no abnormal group, but no statistical difference. The risk of Cox proportional hazard between death and coronary heart disease in ST T abnormal group was 160 times and 544 times higher than those without abnormalities (P = 0 0 0 9 and 0 0 0 0) respectively. There was no abnormality in patients with cerebrovascular disease 1 4 9 times (P = 0 14 3). To