稳定性冠心病患者地震前后动态心电图比较
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摘要
目的:分析地震后引起心血管疾病的可能性及其机制。方法:将60例稳定性冠心病患者分为地震组30例及对照组30例,并设定14:28为时间基点。以动态心电图方式连续监测基点前后4h两组人群在心率、频发室性心律失常及心肌缺血事件检出率的变化。结果:地震组在震后的各项指标与震前及对照组比较有明显增高,差异有显著统计学意义(P<0.01)。结论:地震可增加心血管疾病的风险,其机制可能与创伤后应激障碍有关,应采取积极措施控制震后心血管疾病的发生。
Objective To analyze the possibility of earthquake inducing cardiovascular diseases(CVD) and its mechanism.Methods 60 patients with stable coronary artery diseases were divided into earthquake group(n = 30) and control group(n = 30).The time of 28 past 14 was set as the base time point.Heart rates,and the frequencies of frequently ventricular arrhythmia and myocardial ischemia were continuously monitored by Holter(dynamic electrocardiography) 4 hours before and after the base time point.Results As compared with control group and before earthquake,all index in patients after earthquake were increased obviously(P < 0.01).Conclusion The risks of CVD would be increased after earthquake.The mechanism might be associated with post traumatic stress disorder.
Objective To analyze the possibility of earthquake inducing cardiovascular diseases(CVD) and its mechanism.Methods 60 patients with stable coronary artery diseases were divided into earthquake group(n = 30) and control group(n = 30).The time of 28 past 14 was set as the base time point.Heart rates,and the frequencies of frequently ventricular arrhythmia and myocardial ischemia were continuously monitored by Holter(dynamic electrocardiography) 4 hours before and after the base time point.Results As compared with control group and before earthquake,all index in patients after earthquake were increased obviously(P < 0.01).Conclusion The risks of CVD would be increased after earthquake.The mechanism might be associated with post traumatic stress disorder.
引文
[1]中华医学会心血管分会.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
[2]郭继鸿,张萍.动态心电图学[M].北京:人民卫生出版社,2003:1166-1174.
[3]Schultz C H,Koenig K L,Lewis R J.Implications of hospital evacuation after the Northridge,California,earthquake[J].New Engl J Med,2003,348(14):1349-1355.
[4]Miller A C,Arquilla B.Chronic diseases and natural hazards:impact of disasters on diabetic,renal,and cardiac patients[J].Prehosp Disaster Med,2008,23(2):185-194.
[5]赵丞智,汪向东,高岚.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.
[6]Kubzansky L D,Koenen K C,Spiro A3rd,et al.Prospective studyof post traumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study[J].Arch Gen Psychiatry,2007,64(1):109-116.
[7]Wiedemar L,Schmid J P,Müller J,et al.Prevalence and predictors of post traumatic stress disorder in patients with acute myocardial infarction[J].Heart Lung,2008,37(2):113-121.
[8]Blechert J,Michael T,Grossman P,et al.Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder[J].Psychosom Med,2007,69(9):935-943.
[9]Grisk O,Rettig R.Interactions between the sympathetic nervous system and the kidneys in arterial hypertension[J].Cardiovasc Res,2004,61(2):238-246
[10]Kop W J,Aderson D V.The relationship between PTSD and arrhythmia[J].Ital Heart J,2001,21(12):890-891.
[11]Kinzie J D,Riley C,McFarland B,et al.High prevalence rates of diabetes and hypertension among refugee psychiatric patients[J].J Nerv Ment Dis,2008,196(2):108-112.
[12]Doerfler L A,Paraskos J A.Post-traumatic stress disorder in patients with coronary artery disease:screening and management implications[J].Can J Cardiol,2005,21(8):689-697.
[2]郭继鸿,张萍.动态心电图学[M].北京:人民卫生出版社,2003:1166-1174.
[3]Schultz C H,Koenig K L,Lewis R J.Implications of hospital evacuation after the Northridge,California,earthquake[J].New Engl J Med,2003,348(14):1349-1355.
[4]Miller A C,Arquilla B.Chronic diseases and natural hazards:impact of disasters on diabetic,renal,and cardiac patients[J].Prehosp Disaster Med,2008,23(2):185-194.
[5]赵丞智,汪向东,高岚.张北尚义地震后创伤后应激障碍随访研究[J].中国心理卫生杂志,2000,14(6):361-363.
[6]Kubzansky L D,Koenen K C,Spiro A3rd,et al.Prospective studyof post traumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study[J].Arch Gen Psychiatry,2007,64(1):109-116.
[7]Wiedemar L,Schmid J P,Müller J,et al.Prevalence and predictors of post traumatic stress disorder in patients with acute myocardial infarction[J].Heart Lung,2008,37(2):113-121.
[8]Blechert J,Michael T,Grossman P,et al.Autonomic and respiratory characteristics of posttraumatic stress disorder and panic disorder[J].Psychosom Med,2007,69(9):935-943.
[9]Grisk O,Rettig R.Interactions between the sympathetic nervous system and the kidneys in arterial hypertension[J].Cardiovasc Res,2004,61(2):238-246
[10]Kop W J,Aderson D V.The relationship between PTSD and arrhythmia[J].Ital Heart J,2001,21(12):890-891.
[11]Kinzie J D,Riley C,McFarland B,et al.High prevalence rates of diabetes and hypertension among refugee psychiatric patients[J].J Nerv Ment Dis,2008,196(2):108-112.
[12]Doerfler L A,Paraskos J A.Post-traumatic stress disorder in patients with coronary artery disease:screening and management implications[J].Can J Cardiol,2005,21(8):689-697.
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