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目的:探讨珠海市社区65岁以上老年人代谢综合征流行病学及其与心电图P波间期离散度(Pwd)、QT间期离散度(QTd)的关系。方法:选择珠海市湾仔社区65岁以上的本地居民为研究对象,登记居民的健康资料、体格检查以及生化项目实验室检查数据。同时记录标准12导联心电图,测量P波间期、Pwd、QT间期(QT)、QTd,计算校正的QT间期(QTc)、校正的QT间期离散度(QTcd),计算胰岛素抵抗指数(HOMA-IR)。结果:完成筛查的65岁以上老年居民385例,代谢综合征的患病率为30.13%。排除75例可能对心电图有影响的情况后,共310例纳入本研究。其中69例诊断为代谢综合征,纳入代谢综合征组(MS组),余下241例纳入非代谢综合征组(NMS组)。MS组在性别、高血压患病率、腹型肥胖比例、体质指数、血糖、空腹胰岛素、血脂、尿酸、超敏C反应蛋白、胰岛素抵抗、收缩压方面与NMS组相比有显著差异,两组在年龄、舒张压方面比较差异无统计学意义(P>0.05)。在心电图方面,MS组的心率、Pwd、QTc、QTd、QTcd明显高于NMS组(P<0.05或<0.001),而两组QT间期的比较无统计学差异(P>0.05)。结论:患代谢综合征的老年居民可表现出心电图Pwd、QTc、QTd、QTcd明显延长,需重视对这部分人群心电图的检测及心律失常的预防。
Objective: To investigate the epidemiology of metabolic syndrome in the elderly over 65 years old in community of Zhuhai City and its relationship with Pwd and QTd of electrocardiogram. Methods: Local residents over the age of 65 in Wanzai community of Zhuhai were selected as study subjects, and their health information, physical examination and biochemical laboratory data were checked. At the same time, standard 12-lead electrocardiogram was recorded and P-wave interval, Pwd, QT interval, QTd, QTc, QTcd and QTcd were calculated. Insulin resistance index (HOMA-IR). Results: 385 elderly residents over the age of 65 completed screening, the prevalence of metabolic syndrome was 30.13%. After excluding 75 cases that may affect the ECG, a total of 310 cases were included in the study. Among them, 69 cases were diagnosed as metabolic syndrome and were included in the metabolic syndrome group (MS group), and the remaining 241 cases were included in the non-metabolic syndrome group (NMS group). There was a significant difference between MS group and NMS group in terms of gender, prevalence of hypertension, abdominal obesity, body mass index, blood glucose, fasting insulin, blood lipid, uric acid, high sensitivity C-reactive protein, insulin resistance and systolic blood pressure. There was no significant difference in age and diastolic blood pressure between the two groups (P> 0.05). In ECG, heart rate, Pwd, QTc, QTd and QTcd in MS group were significantly higher than those in NMS group (P <0.05 or <0.001). There was no significant difference in QT interval between the two groups (P> 0.05). Conclusion: Elderly residents with metabolic syndrome can show Pwd, QTc, QTd and QTcd of electrocardiogram significantly prolonged, and the electrocardiogram detection and arrhythmia prevention should be emphasized in this part of the population.