社区人群J波流行病学调查及冠心病患者J波分析
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摘要
目的对太原市社区居民心电图J波的发生情况进行流行病学调查,为缺血性J波的研究提供基础资料。
方法选择太原市有健康档案的成熟化社区中35岁-75岁的居民4041人,分别记录同步12导联心电图,按照ⅡⅢaVF、V1V2、V3V4、V5V6及ⅠaVL分为五个组来判断J波,并将其分为三个等级：小J波(时程为0.02-0.04s或波幅0.05-0.10mv)、大J波(时程为0.04-0.06s或波幅0.10-0.20mv)和巨大J波(时程>0.06s或波幅>0.20mv)。分别计算并比较全部人群、合并基础疾病人群、不同性别、不同年龄段以及不同导联组中J波的发生情况。
结果全部人群中J波的发生率为18.00%。男女J波的发生率无差异(男17.81%比女18.09%,χ2=0.05,p>0.05)。年龄段在55-64岁的人群中,J波的发生率为20.15%,显著高于其他年龄段(35-44岁14.60%、45-54岁14.73%、65-75岁13.40%,x2=30.02,p<0.001)。合并主要基础疾病(高血压、糖尿病、脑卒中及心绞痛)的人数为1048占全部人群的25.93%,其J波的发生率为22.88%,显著高于无基础疾病人群16.28%(x2=22.95,P<0.001)。小J波在三个等级中所占的比例最高(92.05%)。在六个导联组中,V5V6导联组发生J波的比例最高(34.20%)。
结论太原市J波的自然发生率呈较高水平,与年龄有关,但无性别差异,并且合并基础疾病人群中J波的发生率明显增高；J波级别越低发生比例越高；侧壁发生比例最高。
目的研究冠心病患者心电图缺血性J波的发生特点并探讨其临床意义。
方法回顾性分析2007年1月-2009年10月在山西医科大学第二医院心内科行冠状动脉造影的473例患者的心电图及冠造结果,年龄35-75岁,平均59±11岁,其中男317例,女156例。(一)根据冠心病诊断标准和冠造结果将患者分为冠心病组和非冠心病组,分别对两组患者不同性别、年龄、导联心电图J波的发生情况调查。(二)根据心肌梗死诊断标准将冠心病组患者分为梗死组和心绞痛组(均为不稳定性心绞痛且无心肌梗死),计算两组患者J波发生情况。(三)根据患者住院期间心电图有无J波将冠心病组的患者分为J波组和非J波组,计算两组患者冠状动脉狭窄分数、病变支数及狭窄支的构成比。
结果(一)冠心病组与非冠心病组患者J波发生率差异无统计学意义。冠心病组J波发生率无性别差异(P>0.05),而非冠心病组男性明显高于女性(χ2=3.986,P=0.046<0.05)。在各个年龄段的冠心病患者中,45-54岁的患者所占的比例最高(32.76%)。在所有发生J波的导联组中,ⅡⅢaVF导联比例最高(44.29%)。(二)在所有冠心病患者中,心绞痛组J波的发生率明显高于梗死组(χ2=6.161,P=0.013<0.05)。两组均为小J波所占的比例最高(62.50%和82.61%),但大J波和巨大J波的比例较一般人群升高。(三)在所有冠心病患者中,J波组与非J波组在冠状动脉狭窄计分(3.56±2.88 vs 3.79±3.17,t=0.56,P=0.58>0.05)及病变支数(单支：双支：三支及以上分别为24：19：15 vs 105：70：84,P=0.544>0.05)差异均无统计学意义；在两组患者的所有病变冠脉血管中,均为前降支所占的比例最高。
结论冠心病患者心电图J波发生率与非冠心病患者相比无差异,且45-54岁的患者出现J波比例最高。冠心病不稳定性心绞痛患者(无心肌梗死)J波发生率明显高于心肌梗死患者。心电图有J波的冠心病患者其冠状动脉狭窄分数及病变支数与心电图无J波患者无差异。
Objective Investigating the epidemic status of J wave of ECG in the communities of Taiyuan city in order to provide basic date for studying ischemic J wave.
Methods 4041 subjects ranged from 35 to 75 years old in the maturated communities of Taiyuan city were selected and 12-lead ECG was recorded. The J waves in Five lead-groups:ⅡⅢaVF, V1V2, V3V4, V5V6 and I aVL were insured respectively and classified into three grades:little (time course was 0.02-0.04s or wave amplitude was 0.05-0.10mv), large (time course was 0.04-0.06s or wave amplitude was 0.10-0.20mv) and enormous (time course was >0.06s or wave amplitude was>0.20mv) J waves. The incidence rate of J wave was calculated and compared between gender, age, different leads and basic diseases.
Results The incidence rate of J wave was 18.00% in whole 4041 population. Sex was no difference (malel7.81% vs famale18.09%,χ2=0.05, p>0.05). Age stage ranged from 55 to 64 were 20.15%, which increased significantly than other age stage groups (age stage 35-44 were 14.60%,45-54 were 14.73%,65-75 were 13.40%,χ2=30.02, p<0.001). There were 1048 people complicated with mainly basic diseases (including hypertension, diabetes, stroke and angina pectoris). The incidence rate of J wave in people complicated with mainly basic diseases increased significantly than people without mainly basic diseases (22.88% vs 16.28%,χ2=22.95, p<0.001);The little J waves occupied the highest proportion of 92.05% in all the three grades and J waves in V5V6 lead occupied the highest proportion of 34.20% in all the ECG leads.
Conclusions The natural incidence rate of J wave presented high level in Taiyuan city, associated with age but had no sex difference. Furthermore, The incidence rate of J wave in complicated with mainly basic diseases population increased significantly. The low-grade J waves and lateral wall occupied the highest proportion respectively in all the J waves and ventricular walls.
Objective To investigate the characteristic of ischemia J wave in the patients with coronary heart disease (CHD) and explore its clinical significance.
Methods The ECG data of 473 patients (ranged from 35 to 75 years old, average age 59±11 years old; 317 males,156 famales) who were performed with coronary arteriography (CAG) in the cardiology department of the second hospital of Shanxi medical univeristy were Retrospectively analyzed. (1) According to the results of CAG and clinical diagnosis, the patients were divided into CHD and non-CHD group. The incidence rate of J wave were investigated and compared between gender, age and different leads in the two groups.(2) According to the results of myocardial infarction (MI), the CHD patients were divided into MI and angina group (all were unstable angina and had no MI) and the incidence rate of J wave were compared between the two groups.(3) According to the results of ECG, the CHD patients were divided into J waves and non-J waves group. The score of coronary stenosis, amount and constituent ratio of coronary stenosis branch were calculated and compared between the two groups.
Results (1) The incidence rate of J wave had no significant difference between the CHD and non-CHD group. The incidence rate of J wave had no significant gender difference in the CHD group (P>0.05) while had significant gender difference in the non-CHD group (χ2=3.986, P=0.046<0.05). Age stage ranged from 50 to 69 andⅡⅢaVF lead occupied the highest proportion in all the age stage groups and leads of the patient in CHD group. (2) The incidence rate of J wave in angina group increased significantly than MI group in all the CHD patients (x2 =6.161, P=0.013<0.05). (3) There were no significant difference in score of coronary stenosis (3.56±2.88 vs 3.79±3.17, t=0.56, P=0.58>0.05) and amount of coronary stenosis branch(24:19:15 vs 105:70:84, P=0.544>0.05) between J waves and non-J waves group. The descending anterior branch occupied the highest proportion of 39.82% and 40.54% respectively in all the branches of the two groups.
Conclusion The incidence rate of J wave in CHD group had no significant difference with the non-CHD group and the age ranged from 45-54 years occupied the highest proportion in all CHD patients. The incidence rate of J wave in angina patients (had no MI) increased significantly than MI patients in all CHD patients. The core of coronary stenosis and amount of coronary stenosis branch in patients whose ECG had J waves had no difference with non J waves patient.
方法选择太原市有健康档案的成熟化社区中35岁-75岁的居民4041人,分别记录同步12导联心电图,按照ⅡⅢaVF、V1V2、V3V4、V5V6及ⅠaVL分为五个组来判断J波,并将其分为三个等级：小J波(时程为0.02-0.04s或波幅0.05-0.10mv)、大J波(时程为0.04-0.06s或波幅0.10-0.20mv)和巨大J波(时程>0.06s或波幅>0.20mv)。分别计算并比较全部人群、合并基础疾病人群、不同性别、不同年龄段以及不同导联组中J波的发生情况。
结果全部人群中J波的发生率为18.00%。男女J波的发生率无差异(男17.81%比女18.09%,χ2=0.05,p>0.05)。年龄段在55-64岁的人群中,J波的发生率为20.15%,显著高于其他年龄段(35-44岁14.60%、45-54岁14.73%、65-75岁13.40%,x2=30.02,p<0.001)。合并主要基础疾病(高血压、糖尿病、脑卒中及心绞痛)的人数为1048占全部人群的25.93%,其J波的发生率为22.88%,显著高于无基础疾病人群16.28%(x2=22.95,P<0.001)。小J波在三个等级中所占的比例最高(92.05%)。在六个导联组中,V5V6导联组发生J波的比例最高(34.20%)。
结论太原市J波的自然发生率呈较高水平,与年龄有关,但无性别差异,并且合并基础疾病人群中J波的发生率明显增高；J波级别越低发生比例越高；侧壁发生比例最高。
目的研究冠心病患者心电图缺血性J波的发生特点并探讨其临床意义。
方法回顾性分析2007年1月-2009年10月在山西医科大学第二医院心内科行冠状动脉造影的473例患者的心电图及冠造结果,年龄35-75岁,平均59±11岁,其中男317例,女156例。(一)根据冠心病诊断标准和冠造结果将患者分为冠心病组和非冠心病组,分别对两组患者不同性别、年龄、导联心电图J波的发生情况调查。(二)根据心肌梗死诊断标准将冠心病组患者分为梗死组和心绞痛组(均为不稳定性心绞痛且无心肌梗死),计算两组患者J波发生情况。(三)根据患者住院期间心电图有无J波将冠心病组的患者分为J波组和非J波组,计算两组患者冠状动脉狭窄分数、病变支数及狭窄支的构成比。
结果(一)冠心病组与非冠心病组患者J波发生率差异无统计学意义。冠心病组J波发生率无性别差异(P>0.05),而非冠心病组男性明显高于女性(χ2=3.986,P=0.046<0.05)。在各个年龄段的冠心病患者中,45-54岁的患者所占的比例最高(32.76%)。在所有发生J波的导联组中,ⅡⅢaVF导联比例最高(44.29%)。(二)在所有冠心病患者中,心绞痛组J波的发生率明显高于梗死组(χ2=6.161,P=0.013<0.05)。两组均为小J波所占的比例最高(62.50%和82.61%),但大J波和巨大J波的比例较一般人群升高。(三)在所有冠心病患者中,J波组与非J波组在冠状动脉狭窄计分(3.56±2.88 vs 3.79±3.17,t=0.56,P=0.58>0.05)及病变支数(单支：双支：三支及以上分别为24：19：15 vs 105：70：84,P=0.544>0.05)差异均无统计学意义；在两组患者的所有病变冠脉血管中,均为前降支所占的比例最高。
结论冠心病患者心电图J波发生率与非冠心病患者相比无差异,且45-54岁的患者出现J波比例最高。冠心病不稳定性心绞痛患者(无心肌梗死)J波发生率明显高于心肌梗死患者。心电图有J波的冠心病患者其冠状动脉狭窄分数及病变支数与心电图无J波患者无差异。
Objective Investigating the epidemic status of J wave of ECG in the communities of Taiyuan city in order to provide basic date for studying ischemic J wave.
Methods 4041 subjects ranged from 35 to 75 years old in the maturated communities of Taiyuan city were selected and 12-lead ECG was recorded. The J waves in Five lead-groups:ⅡⅢaVF, V1V2, V3V4, V5V6 and I aVL were insured respectively and classified into three grades:little (time course was 0.02-0.04s or wave amplitude was 0.05-0.10mv), large (time course was 0.04-0.06s or wave amplitude was 0.10-0.20mv) and enormous (time course was >0.06s or wave amplitude was>0.20mv) J waves. The incidence rate of J wave was calculated and compared between gender, age, different leads and basic diseases.
Results The incidence rate of J wave was 18.00% in whole 4041 population. Sex was no difference (malel7.81% vs famale18.09%,χ2=0.05, p>0.05). Age stage ranged from 55 to 64 were 20.15%, which increased significantly than other age stage groups (age stage 35-44 were 14.60%,45-54 were 14.73%,65-75 were 13.40%,χ2=30.02, p<0.001). There were 1048 people complicated with mainly basic diseases (including hypertension, diabetes, stroke and angina pectoris). The incidence rate of J wave in people complicated with mainly basic diseases increased significantly than people without mainly basic diseases (22.88% vs 16.28%,χ2=22.95, p<0.001);The little J waves occupied the highest proportion of 92.05% in all the three grades and J waves in V5V6 lead occupied the highest proportion of 34.20% in all the ECG leads.
Conclusions The natural incidence rate of J wave presented high level in Taiyuan city, associated with age but had no sex difference. Furthermore, The incidence rate of J wave in complicated with mainly basic diseases population increased significantly. The low-grade J waves and lateral wall occupied the highest proportion respectively in all the J waves and ventricular walls.
Objective To investigate the characteristic of ischemia J wave in the patients with coronary heart disease (CHD) and explore its clinical significance.
Methods The ECG data of 473 patients (ranged from 35 to 75 years old, average age 59±11 years old; 317 males,156 famales) who were performed with coronary arteriography (CAG) in the cardiology department of the second hospital of Shanxi medical univeristy were Retrospectively analyzed. (1) According to the results of CAG and clinical diagnosis, the patients were divided into CHD and non-CHD group. The incidence rate of J wave were investigated and compared between gender, age and different leads in the two groups.(2) According to the results of myocardial infarction (MI), the CHD patients were divided into MI and angina group (all were unstable angina and had no MI) and the incidence rate of J wave were compared between the two groups.(3) According to the results of ECG, the CHD patients were divided into J waves and non-J waves group. The score of coronary stenosis, amount and constituent ratio of coronary stenosis branch were calculated and compared between the two groups.
Results (1) The incidence rate of J wave had no significant difference between the CHD and non-CHD group. The incidence rate of J wave had no significant gender difference in the CHD group (P>0.05) while had significant gender difference in the non-CHD group (χ2=3.986, P=0.046<0.05). Age stage ranged from 50 to 69 andⅡⅢaVF lead occupied the highest proportion in all the age stage groups and leads of the patient in CHD group. (2) The incidence rate of J wave in angina group increased significantly than MI group in all the CHD patients (x2 =6.161, P=0.013<0.05). (3) There were no significant difference in score of coronary stenosis (3.56±2.88 vs 3.79±3.17, t=0.56, P=0.58>0.05) and amount of coronary stenosis branch(24:19:15 vs 105:70:84, P=0.544>0.05) between J waves and non-J waves group. The descending anterior branch occupied the highest proportion of 39.82% and 40.54% respectively in all the branches of the two groups.
Conclusion The incidence rate of J wave in CHD group had no significant difference with the non-CHD group and the age ranged from 45-54 years occupied the highest proportion in all CHD patients. The incidence rate of J wave in angina patients (had no MI) increased significantly than MI patients in all CHD patients. The core of coronary stenosis and amount of coronary stenosis branch in patients whose ECG had J waves had no difference with non J waves patient.
引文
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[3]王红宇,杨钦丁,郭五一.急性心肌梗死患者J波的临床研究.山西医药杂志.2003,32(3)：192-193.
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