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目的探讨长期高强度噪声环境对机务人员心电图的影响,为防治可能造成的不良心血管事件提供参考。方法以708名机务人员为观察组,与体检同步进行静息12导联心电图普查,记录心律、心率、P-QRS-T形态变化。以某研究生院356名男性研究生作为对照组。同时在机务人员内部以外场工作年限分为初级(1～5年)、中级(6～12年)、高级(13年以上)三组,进行组间比较。结果观察组平均心率、平均QTc均高于对照组(74.6±5.8 vs 71.3±5.3,0.40±0.03 vs 0.38±0.02,P<0.05),束支阻滞、ST下移、T波改变、QT延长、早期复极变异(early reporlarization variation,ERV)检出率明显高于对照组(6.1%vs 2.2%,12.3%vs 7.9%,7.5%vs 3.7%,3.2%vs 1.1%,8.5%vs 4.5%,P<0.05);组间比较发现,初级组平均心率最高(76.2±6.9),而高级组的平均QTc最长(0.42±0.04)、ERV检出率最高(15.1%)。观察组服役期间未发生不良心血管事件。结论长期高强度噪声暴露可以对机务人员的心电图造成影响,但尚未发现与不良心血管事件有关,是否与本组对象较年轻有关,尚需深入的研究与长期的随访观察。
Objective To explore the long-term high-intensity noise environment on the crew ECG, for the prevention and treatment of adverse cardiovascular events may provide a reference. Methods A total of 708 crew members were employed as the observation group. The 12-lead electrocardiogram (ECG) was performed simultaneously with the physical examination. The changes of heart rhythm, heart rate and P-QRS-T were recorded. A graduate school of 356 male graduate students as a control group. At the same time, the working hours inside the crew are divided into three groups: primary (1-5 years), intermediate (6-12 years) and advanced (13+ years). Results The average heart rate and mean QTc in observation group were significantly higher than those in control group (74.6 ± 5.8 vs 71.3 ± 5.3, 0.40 ± 0.03 vs 0.38 ± 0.02, P <0.05), bundle branch block, ST down, T wave change and QT prolongation The detection rate of early reporlarization variation (ERV) was significantly higher than that of the control group (6.1% vs 2.2%, 12.3% vs 7.9%, 7.5% vs 3.7%, 3.2% vs 1.1%, 8.5% vs 4.5% , P <0.05). The average heart rate of the primary group was the highest (76.2 ± 6.9), while that of the advanced group was the highest (0.42 ± 0.04) and the highest was the rate of ERV (15.1%). No adverse cardiovascular events occurred during the observation period. Conclusion Long-term high-intensity noise exposure may affect the electrocardiogram of the crew. However, it has not been found to be related to adverse cardiovascular events and is related to younger subjects in this group. Further studies and long-term follow-up studies are still needed.