西藏地区正常藏族人群心脏形态及瓣膜关闭不全相关因素分析

摘要

Objective: To explore the correlation factors for cardiac morphology and valvular regurgitation in normal Tibetan population at high altitude area. Methods: Based onTibetan permanent resident population, a 4-stage cluster random sampling was conducted to drawn normal Tibetan subjects. Personal information and medical history were collected; physical parameters including blood and urine tests, ECG, chest X-ray and echocardiography were examined; cardiac morphology and valvular stenosis and regurgitation were detected. Canonical correlation study and Logistic regression analysis were performed to investigate the correlation factors for cardiac structure and function. Results: A population of 4 688 in Tibetan area were involved and 1 820 normal subjects were studied including 694 from Lhasa, 575 from Naqu, 286 from Nyingchi and 265 from Shigatse area. Canonical correlation analysis revealed that in normal Tibetan population, the major relevant physiological parameters for measuring right ventricle were age, blood oxygen saturation and body weight; for left ventricle were body weight, age and height; gender had no real differences. Logistic regression analysis presented that body weight, pulse and blood oxygen saturation were negatively related to mild tricuspid regurgitation; age was positively related to mild mitral and aortic regurgitations, all P<0.01. Conclusion: Age and body weight were the correlation factors for cardiac morphology and mild valvular regurgitation in normal Tibetan population at high altitude area, which should be alert in heart disease investigation.%目的:探讨高原环境下正常藏族人群心脏形态及瓣膜关闭不全的相关因素.方法: 以西藏地区常住人口为总体,采用分层四阶段随机抽样方法抽取调查对象,在所有调查人群中筛选正常藏族人群.收集调查对象的个人信息、病史、行体格检查、实验室(血尿)检查、心电图、X线胸片及超声心动图检查,包括径线测量及瓣膜功能评价.采用典型相关及逻辑回归的方法分析正常藏族人群心脏结构、瓣膜功能相关因素.结果:西藏地区共4688人参加调查,获得正常藏族人群共计1820人,其中拉萨地区694人、那曲地区575人、林芝地区286人、日喀则地区265 人.典型相关分析发现,正常藏族人群右心室测量主要相关生理学指标为年龄、血氧饱和度、体重,男女差异不大;左心室测量主要相关生理学指标为:体重、年龄、身高,同样性别差异较小.通过回归分析发现,体重、脉搏、血氧饱和度是轻度三尖瓣关闭不全的负相关因素;年龄是轻度二尖瓣、主动脉瓣关闭不全的正相关因素(P均<0.01).结论:在高原地区藏族人群中,年龄、体重是心脏形态、瓣膜轻度关闭不全相关因素,在心脏疾病分析中应重视其作用.