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目的采用Meta分析方法对高温作业所致工人心电图异常改变进行系统评价。方法计算机检索中国知网CNKI全文数据库、维普数据库、万方数据库和中国生物医学文献数据库,查找1990年至2009年5月公开发表的研究高温作业和心电图异常关系的回顾性队列研究。按照纳入与排除标准选择文献、评价质量和提取数据,而后采用RevMan 4.2.2软件进行Meta分析。结果共纳入20个研究。Meta分析结果显示,高温组心电图异常率明显高于对照组,其差异有统计学意义[OR=2.76,95%CI(2.37,3.20),P<0.00001]。高温作业对工人心电图的左室高电压[OR=3.49,95%CI(2.83,4.31),P<0.00001]、窦性心律过缓[OR=2.83,95%CI(2.33,3.43),P<0.00001]、ST-T段改变[OR=2.63,95%CI(1.48,4.68),P=0.00010]有显著影响,说明左室高电压、窦性心律过速、窦性心律过缓、ST-T段改变等异常心电图改变是监测高温工作人员心血管疾病的敏感指标。结论高温作业会使工人的心电图异常率显著高于对照组,应加强对高温作业工人的健康监测和劳动保护。
Objective To evaluate the abnormal changes of electrocardiogram in workers exposed to high temperature by Meta analysis. Methods A retrospective cohort study was conducted on CNKI full-text database, VIP database, Wanfang database and Chinese biomedical literature database from 1990 to May 2009. The literature was selected according to the inclusion and exclusion criteria, the quality was evaluated and the data extracted, followed by a Meta-analysis using RevMan 4.2.2 software. Results A total of 20 studies were included. The results of Meta analysis showed that the abnormal rate of electrocardiogram in high temperature group was significantly higher than that of the control group (OR = 2.76, 95% CI 2.37, 3.20, P <0.00001). The left ventricular high voltage (OR = 3.49, 95% CI 2.83, 4.31, P <0.00001), sinus bradycardia (OR 2.83, 95% CI 2.33, 3.43, P < 0.00001], ST-T segment change [OR = 2.63,95% CI (1.48,4.68), P = 0.00010], indicating that left ventricular hypertrophy, sinus rhythm, sinus arrhythmia, ST- Abnormal ECG changes such as T-segment changes are sensitive indicators of cardiovascular disease monitoring in high-temperature workers. Conclusion High-temperature operation will make workers abnormal ECG rate was significantly higher than the control group should strengthen the health monitoring of workers at high temperatures and labor protection.