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目的探讨工人脱离职业性噪声接触后的心电图变化。方法在进行《广州生物库队列研究》时,第一阶段收集10413名年龄在≥50岁居民的一般资料、体格检查和实验室检查结果。受检者70%为女性,50%以上年龄在60～69岁;受检者中有2120名(21.0%)曾经接触职业性噪声,但均已脱离接触且为退休或离岗者;用上海惠普有限公司制造的MAC-CS多导联心电图机进行12导联的心电图检查;噪声职业接触史通过问卷采集,心电图由2名中级以上具有诊断资格的医师进行独立诊断。结果(1)心电图异常检出率女性为82.4%,明显高于男性的79.1%;不论男性或女性,心电图异常检出率随年龄增加而上升(P=0.000),女性随文化程度增高而明显下降(P=0.000),但无论男女,脱离职业性噪声接触后,其心电图异常检出率与从未职业性噪声接触者比较,差异无统计学意义(P>0.05);(2)比较曾经有职业性噪声接触与非接触者心电图异常的分类,在校正年龄因素和文化程度后,心律失常、心电轴偏移、房或室肥厚、ST-T改变、心肌劳损、冠状动脉综合征等比较,差异无统计学意义(P>0.05)。结论脱离职业性噪声接触后的工人心电图异常检出率未见明显高于非职业性噪音接触者。
Objective To investigate the changes of ECG after occupational noise exposure. Methods During the “Guangzhou Biological Repository Cohort Study”, the first phase collected the general information, physical examination and laboratory test results of 10413 residents aged 50 or older. 70% of the subjects were women, over 50% were aged 60-69 years; 2120 (21.0%) of the subjects had been exposed to occupational noise, but all of them were out of contact and were retired or left their posts; Hewlett-Packard Co., Ltd. made MAC-CS multi-lead ECG machine for 12-lead ECG; noise occupational exposure history was collected by questionnaire, ECG by more than two intermediate diagnosis of qualified physicians independent diagnosis. Results (1) The detection rate of abnormal electrocardiogram was 82.4% in women, which was significantly higher than 79.1% in men. The detection rate of abnormal ECG increased with age (P = 0.000) in both males and females, and the females increased with the education level (P = 0.000). However, there was no significant difference in the detection rate of ECG abnormalities between men and women after exposure to occupational noise (P> 0.05); (2) There are occupational noise exposure and non-contact ECG abnormalities in the classification, age and cultural factors in the correction of age, arrhythmia, cardiac axis offset, atrioventricular or hypertrophy, ST-T changes, myocardial strain, coronary syndromes The difference was not statistically significant (P> 0.05). Conclusion The detection rate of ECG abnormalities after occupational noise exposure is not significantly higher than that of non-occupational noise exposure.