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目的通过总结云南不明原因猝死高发地区人群的心电图特征,发现其规律并为进一步的病因学研究提供线索。方法自2005年9月至2006年7月间,对云南的不明原因猝死高发区(宁蒗、鹤庆、大姚)的三个自然村年龄为15～45岁的居民进行12导联静息心电图普查,以云南大理地区人群作为对照人群。共普查人群338例,男性175例,女性163例,平均年龄(33.4±11.7)岁。记录所有普查者的一般状况及疾病家族史。单盲法测量心电图各指标。结果猝死高发区与对照地区人群一样,常见心律失常发生率均低,仅见于个别居民。大姚地区左室高电压发生率(34.6%)显著高于其他地区(P 均<0.01)。上述三个猝死高发区人群的 QTc 较对照地区显著延长[分别为(428.92±25.71)ms、(440.67±28.03)ms、(417.70±24.00)ms 与(386.80±27.22)ms,P 均<0.05];U 波出现率仅鹤庆地区显著高于对照地区(P<0.05);QUc 上述各地区均显著高于对照地区[分别为(613.67±37.34)ms、(597.19±46.47)ms、(608.59±39.59)ms 与(589.33±41.27)ms,P 均<0.01];U 波呈宽大、高电压并与 T 波融合特征性表现;在7例有猝死家族史者中,6例有 U 波,4例呈猝死高发区特征性改变。结论云南省不明原因猝死高危人群心电图呈 QT 间期延长和 U 波特征性改变,提示可能存在潜在的心肌复极异常内因。
OBJECTIVE: To summarize the electrocardiographic features of people with sudden death in areas of unknown cause in Yunnan Province and to find out the regularity and to provide clues for further etiological studies. Methods From September 2005 to July 2006, 12-lead resting electrocardiogram (ECG) was performed on residents aged 15-45 in three natural villages with high incidence of unexplained sudden death (Ninglang, Heqing and Dayao) in Yunnan Province. Census, Dali Prefecture in Yunnan Province as a control population. A total of 338 people surveyed the crowd, 175 males and 163 females, mean age (33.4 ± 11.7) years. Record the general status of all census providers and family history of illness. Single-blind measurement of ECG indicators. Results In the areas with high incidence of sudden death as well as those in the control area, the incidence of common arrhythmia was low, only seen in individual residents. The incidence of left ventricular high voltage in Dayao (34.6%) was significantly higher than that in other regions (all P <0.01). The QTc of the above three areas with high incidence of sudden death were significantly longer than that of the control area [(428.92 ± 25.71) ms, (440.67 ± 28.03) ms, (417.70 ± 24.00) ms and (386.80 ± 27.22) ms, respectively ; The incidence of U wave in Heqing area was significantly higher than that in control area (P <0.05); the areas above QUc were significantly higher than those in control area [(613.67 ± 37.34) ms, (597.19 ± 46.47) ms and (608.59 ± 39.59) ms and (589.33 ± 41.27) ms respectively, P <0.01]. U wave was characterized by large and high voltage and fusion with T wave. Of the seven patients with a family history of sudden death, 6 had U waves, 4 Cases of sudden changes in the characteristics of high incidence of sudden death. Conclusion Electrocardiogram of people at high risk of unexplained sudden death in Yunnan Province showed QT prolongation and U wave characteristic changes, suggesting that there may be potential intrinsic cause of myocardial repolarization abnormalities.