中国全科医学 ›› 2024, Vol. 27 ›› Issue (36): 4534-4539.DOI: 10.12114/j.issn.1007-9572.2024.0061

• 论著 • 上一篇    下一篇

人群房室传导阻滞患病率及危险因素研究:基于开滦队列研究

陶锦涛, 吴寿岭, 赵晓红*()   

  1. 063000 河北省唐山市,华北理工大学附属开滦总医院心内科
  • 收稿日期:2024-02-21 修回日期:2024-05-24 出版日期:2024-12-20 发布日期:2024-09-19
  • 通讯作者: 赵晓红

  • 作者贡献:

    陶锦涛负责研究的构思与设计,研究的实施,进行数据的收集与整理,统计学处理,图、表的绘制与展示;吴寿岭提出主要研究目标,进行论文的修订;赵晓红负责文章的质量控制与审查,对文章整体负责,监督管理。

Prevalence and Risk Factors of Atrioventricular Block in the Population: a Study Based on the Kailuan Cohort

TAO Jintao, WU Shouling, ZHAO Xiaohong*()   

  1. Department of Cardiovascular, Kailuan General Hospital, North China University of Science and Technology, Tangshan 063000, China
  • Received:2024-02-21 Revised:2024-05-24 Published:2024-12-20 Online:2024-09-19
  • Contact: ZHAO Xiaohong

摘要: 背景 房室传导阻滞与心血管疾病患者不良预后相关,而我国相关流行病学数据相对缺乏,筛查并消除房室传导阻滞的危险因素以预防房室传导阻滞的发生是非常重要的。目的 探讨开滦研究人群中房室传导阻滞患病率及危险因素。方法 纳入参加2018—2020年健康体检的开滦集团在职员工及离退休人员作为观察对象,收集参与者的一般资料、既往史和服药史。患者空腹8 h后,于体检当日晨起抽取肘静脉血5 mL用于生化检测,同时进行心电图检查。采用多因素Logistic回归分析探讨影响房室传导阻滞的危险因素并进行敏感性分析。结果 最终纳入观察对象80 859名,平均年龄(53.8±14.9)岁。房室传导阻滞患病率为0.97%(786/80 859),其中一度房室传导阻滞患病率为0.91%(732/80 859),二度及以上房室传导阻滞患病率为0.07%(54/80 859)。房室传导阻滞患者男性比例、年龄、收缩压、空腹血糖、低密度脂蛋白胆固醇、BMI、高血压、糖尿病、饮酒比例、血尿酸、服药、动脉粥样硬化性心血管疾病(ASCVD)比例高于无房室传导阻滞者,舒张压、心率低于无房室传导阻滞者(P<0.05)。进一步将研究对象按照是否患有房室传导阻滞及房室传导阻滞程度,将患者分为无房室传导阻滞组(n=80 073)、一度房室传导阻滞组(n=732)和二度及以上房室传导阻滞组(n=54)。三组研究对象性别、年龄、心率、高血压、BMI、糖尿病、高尿酸血症、高低密度脂蛋白、饮酒、ASCVD比例比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示男性、高龄、高血压、糖尿病、高低密度脂蛋白水平、高尿酸血症、高BMI及饮酒为房室传导阻滞的危险因素,心率增加为房室传导阻滞的保护因素(P<0.05)。结论 开滦人群中房室传导阻滞患病率为0.97%,高龄、男性、高BMI、高血压、糖尿病、高低密度脂蛋白、高尿酸血症及饮酒为房室传导阻滞的危险因素,高心率为房室传导阻滞的保护因素。

关键词: 房室传导阻滞, 患病率, 危险因素, 流行病学, 开滦队列

Abstract:

Background

Atrioventricular block (AVB) is associated with adverse outcomes in patients with cardiovascular diseases, and there is a relative scarcity of epidemiological data in China. Identifying and eliminating risk factors for AVB to prevent its occurrence is of great importance.

Objective

To explore the prevalence and risk factors of AVB in the Kailuan study population.

Methods

Participants who underwent health examinations from 2018 to 2020, consisting of employees and retirees of the Kailuan Group, were included as subjects of observation. General information, medical history, and medication history of the participants were collected. On the day of the physical examination, 5 mL of blood was drawn from the elbow vein after fasting for 8 hours for biochemical tests, and an electrocardiogram was conducted simultaneously. Multivariate Logistic regression analysis was used to explore the risk factors affecting AVB and to perform sensitivity analysis.

Results

A total of 80 859 subjects were included in the final observation, with an average age of (53.8±14.9) years. The prevalence of AVB was 0.97% (786/80 859), with a first-degree AVB prevalence of 0.91% (732/80 859) and a second-degree or higher AVB prevalence of 0.07% (54/80 859). The proportion of male, age, systolic pressure, fasting blood glucose, low-density lipoprotein cholesterol, BMI, hypertension, diabetes, alcohol consumption, blood uric acid, medication use, and atherosclerotic cardiovascular diseases (ASCVD) was higher in AVB patients than in those without AVB, while diastolic pressure and heart rate was lower (P<0.05). Further, the study subjects were divided into three groups according to the presence and degree of AVB: no AVB group (n=80 073), first-degree AVB group (n=732), and second-degree or higher AVB group (n=54). The comparison of gender, age, heart rate, hypertension, BMI, diabetes, hyperuricemia, hyper-low-density lipoprotein, alcohol consumption, and ASCVD among the three groups showed statistically significant differences (P<0.05). Multivariate Logistic regression results showed that male gender, older age, hypertension, diabetes, hyper-low-density lipoprotein, hyperuricemia, Elevated BMI, and alcohol consumption were risk factors for AVB, while an increased heart rate was a protective factor for AVB (P<0.05) .

Conclusion

The prevalence of AVB in the Kailuan population is 0.97%, with older age, male gender, high BMI, hypertension, diabetes, hyper-low-density lipoprotein, hyperuricemia, and alcohol consumption being risk factors for AVB, and a high heart rate being a protective factor for AVB.

Key words: Atrioventricular block, Prevalence, Risk factors, Epidemiology, Kailuan cohort