CAJ | 학술논문

目的研究健康人群正常衰老过程中QT间期的相关因素，为提高健康人群心血管疾病危险评估提供依据。方法2008年从沈阳、郑州、长沙3个城市4000名自我评价健康的城市居民中筛选出年龄≥35岁的1049例健康个体，分为35～44岁、45～54岁、55～64岁、65～74岁组及≥75岁组，进行基本身体状况、血压、血液生化和心脏超声检查，并记录12导联心电图。组间比较采用单因素方差分析，两两比较采用LSD方法；计数资料组间比较采用χ2检验。变量间的相关性利用Pearson相关分析。多元素分析采用多元逐步回归方程。结果 QT 间期65～74岁组（392 ms ±31 ms）及≥75岁组（392 ms ±33 ms）显著高于55～64岁组（381 ms ±34 ms，P＜0．001）。QT间期与左心房容积的相关性最强（r＝0．215，P＜0．001），其次为二尖瓣减速时间（r＝0．161，P＜0．001），与射血分数（γ＝－0．106，P＝0．001）。多元逐步回归方程分析发现，QT间期与年龄（β＝0．249，95％CI：0．122～0．376，P ＜0．001）、性别（β＝8．827，95％CI：5．495～12．159，P＜0．001）、心率（β＝－1．276，95％CI：－1．429～－1．123，P＜0．001）、左心房容积（β＝0．344，95％CI：0．176～0．512，P＜0．001）、二尖瓣减速时间（β＝0．058，95％CI：0．023～0．094，P＜0．001）以及左心室射血分数（β＝－0．335，95％CI：－0．629～－0．041，P＜0．05）独立相关。结论健康人群正常衰老过程中，QT间期与心血管危险因素，年龄、性别、心率、左心室收缩和舒张功能均独立相关。提示QT间期可能有助于改善健康人群心血管危险的预测水平。
목적연구건강인군정상쇠로과정중QT간기적상관인소，위제고건강인군심혈관질병위험평고제공의거。방법2008년종침양、정주、장사3개성시4000명자아평개건강적성시거민중사선출년령≥35세적1049례건강개체，분위35～44세、45～54세、55～64세、65～74세조급≥75세조，진행기본신체상황、혈압、혈액생화화심장초성검사，병기록12도련심전도。조간비교채용단인소방차분석，량량비교채용LSD방법；계수자료조간비교채용χ2검험。변량간적상관성이용Pearson상관분석。다원소분석채용다원축보회귀방정。결과 QT 간기65～74세조（392 ms ±31 ms）급≥75세조（392 ms ±33 ms）현저고우55～64세조（381 ms ±34 ms，P＜0．001）。QT간기여좌심방용적적상관성최강（r＝0．215，P＜0．001），기차위이첨판감속시간（r＝0．161，P＜0．001），여사혈분수（γ＝－0．106，P＝0．001）。다원축보회귀방정분석발현，QT간기여년령（β＝0．249，95％CI：0．122～0．376，P ＜0．001）、성별（β＝8．827，95％CI：5．495～12．159，P＜0．001）、심솔（β＝－1．276，95％CI：－1．429～－1．123，P＜0．001）、좌심방용적（β＝0．344，95％CI：0．176～0．512，P＜0．001）、이첨판감속시간（β＝0．058，95％CI：0．023～0．094，P＜0．001）이급좌심실사혈분수（β＝－0．335，95％CI：－0．629～－0．041，P＜0．05）독립상관。결론건강인군정상쇠로과정중，QT간기여심혈관위험인소，년령、성별、심솔、좌심실수축화서장공능균독립상관。제시QT간기가능유조우개선건강인군심혈관위험적예측수평。
Objective To evaluate the associated factors of QT interval in normal aging process in order to improve the early cardiovascular risk assessment in healthy population.Methods We examined 4 000 apparently healthy community dwelling subjects in three Chinese cities,and 1 049 healthy subjects were recruited and examined.Blood pressure,blood biochemical parameters,and cardiovascular ultrasonography were assessed.Pearson correlation analysis and multiple stepwise regression analysis were used to examine the relationship between QT interval and associated variables.Results The QT intervals of 65-74 years group (392 ms ±31 ms)and ≥75 years group (392 ms ±33 ms)were significantly higher than 55-64 years group (381 ms ±34 ms,P<0.001 ).The strongest correlation was found between QT interval and left atrial volume (r=0.21 5,P <0.001 ),followed by MVE-DT (r =0.1 61 ,P <0.001 ).QT interval was negatively correlated with left ventricular ejection fraction (γ=-0.1 06,P=0.001 ).The stepwise regression analysis found that the QT interval was independently correlated with age (β=0.249,95%CI:0.1 22-0.376,P<0.001 ),gender (β=8.827,95%CI:5.495-1 2.1 59,P <0.001 ),heart rate (β=-1 .276,95%CI:-1 .429-1 .1 23,P<0.001 ),left atria volume (β=0.344,95%CI:0.1 76-0.51 2,P<0.001 ),mitral E wave deceleration time (β=0.058,95%CI:0.023-0.094,P<0.001 ),and left ventricular ejection fraction (β=-0.335,95%CI:-0.629--0.041 ,P<0.05).Conclusion QT interval was independently correlated with traditional cardiovascular risk factors such as age,heart rate,heart systolic and diastolic function in normal aging process of healthy population.It suggested that as noninvasive and easy to evaluated electrocardiographic index,QT interval may help to improve prediction of cardiovascular risk in healthy population.