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2005—2009年新发云南不明原因猝死病区人群临床检查检测指标调查研究

ISSN号：1007-4961
期刊名称：《河北林果研究》
时间：0
分类：R541[医药卫生—心血管疾病;医药卫生—临床医学;医药卫生—内科学] R181.23[医药卫生—流行病学;医药卫生—公共卫生与预防医学]
作者机构：[1]云南省地方病防治所,云南大理671000, [2]中国疾病预防控制中心中国现场流行病学培训项目,北京100050, [3]北京阜外心血管病医院,北京100037
相关基金：云南省科技厅攻关项目（2004NG13）;卫生部科学研究基金项目（WKJ-2003-01-05）;科技部国家重大科技攻关资助项目（2003BA712A11-01）

作者：王跃兵[1], 施国庆[2], 杨林[1], 赵溯[1], 李兆祥[1], 马琳[1], 申涛[2], 张健[3], 曾光[2], 黄文丽[1]

关键词：不明原因猝死, 心电图, 心肌酶, Unexpected sudden death, Electrocardiogram, Myocardial enzyme

中文摘要：

目的研究2005-2009年新发云南不明原因猝死病区人群不同时期的健康状况及变化趋势，为建立和完善病例监测报告标准和诊断标准提供依据，为病因研究提供线索。方法调查新发猝死病区人群和对照人群的心电图、血液生化、血压、脉搏、呼吸、体温、身高、体重等临床检查检测指标，分析各类人群各项指标之间的差异。结果新发猝死病区人群心电图异常检出率、心肌酶异常率和均值表现为急性期：猝死病例〉同发病例〉家庭成员〉同村村民〉邻村村民〉对照人群，猝死病例和同发病例明显高于其他人群；同类人群：急性期〉恢复期，恢复期已降低至对照人群流行期前及流行期间水平；各类人群的基础生命体征检查结果相同。结论心电图和心肌酶是新发猝死病区人群临床检查检测指标中异常改变最为明显的指标，是猝死病例和同发病例区别于其他人群的高风险健康指标，具有明显的“心源性”特点；心电网和心肌酶是制定病例定义、有效干预措施和临床救治措施的重要参考内容，是病情监测指标和猝死事件发生的预警指标，病区环境中可能存在某些致心肌损伤的危险因素，表现为人群心电图发生特异性改变和心肌酶水平异常增高。

英文摘要：

Objective To study health condition of crowds in new area of Yunnan unexpected sudden death （YUSD） from 2005 to 2009, in order to establish and perfect the report and diagnostic criteria, and offer clue for etiologic research. Methods Electrocardiogram （ECG）, blood biochemical indexes, blood pressure, sphygmus, respiratory rate, temperature, height and weight of the studied and control crowd were investigated to carry out comparative analysis of each index among different crowds. Results The relevance ratio of electrocardiogram, the abnormality rate and mean value of myocardial enzyme showed in acute phase, that is, YUSD case 〉 concurrent case 〉 family member 〉 fellow villager 〉 neighbor villager 〉 con- trol population. Those ratios displayed graded decrease. While among the same population, those were acute phase over re- covery phase. The health status in recovery phase was close to that of the level of the control population. The results of basic life signs were the same among different crowds. Conclusions Electrocardiogram and myocardial enzyme were higher abnormal among all clinical examination and detection indexes. Electrocardiogram and myocardial enzyme were specificity indexes to YUSD case and concurrent case, and also important reference to case definition, intervening and cure measure, the important indexes to monitor the state of YUSD and the warning indexes of YUSD events. The myocardial damage factors may exist in the whole natural environment of YUSD areas, showing specific change of electrocardiogram and abnormal in- crease of myocardial enzyme of the crowds.

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