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世界核心医学期刊文摘（心脏病学分册） 2006年第5期2卷 47-48页

作者： Straus S.M.j.M kors j.a De Bruin M.L. B.H.Ch. Stricker 王亭忠 Department of Epidemiology and Biostatistics Erasmus Medical Center P.O. Box 1738 3000 DR Rotterdam NetherlandsDr.

OBjECTIVES: This study sought to investigate whether prolongation of the heart rate-corrected QT(QTc) interval is a risk factor for sudden cardiac death in the general population. BACKGROUND: In developed countries, sudden cardiac death is a major cause of cardiovascular mortality. Prolongation of the QTc interval has been associated with ventricular arrhythmias, but in most population-based studies no consistent association was found between QTc prolongation and total or cardiovascular mortality. Only very few of these studies specifically addressed sudden cardiac death. METHODS: This study was conducted as part of the Rotterdam Study, a prospective population- based cohort study that comprises 3,105 men and 4,878 women aged 55 years and older. The QTc interval on the electrocardiogram was determined during the baseline visit(1990 to 1993) and the first follow-up examination(1993 to 1995). The association between a prolonged QTc interval and sudden cardiac death was estimated using Cox proportional hazards analysis. RESULTS: During an average follow-up period of 6.7 years(standard deviation, 2.3 years) 125 patients died of sudden cardiac death. An abnormally prolonged QTc interval(>450 ms in men, >470 ms in women) was associated with a threefold increased risk of sudden cardiac death(hazard ratio, 2.5; 95% confidence interval, 1.3 to 4.7), after adjustment for age, gender, body mass index, hypertension, cholesterol/high-density lipoprotein ratio, diabetes mellitus, myocardial infarction, heart failure, and heart rate. In patients with an age below the median of 68 years, the corresponding relative risk was 8.0(95% confidence interval 2.1 to 31.3). CONCLUSIONS: Abnormal QTc prolongation on the electrocardiogram should be viewed as an independent risk factor for sudden cardiac death.

关键词： QTc间期延长心脏性猝死老年人群风险分析室性心律失常疾病死亡危险因素心率校正普通人群发达国家

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计算机明尼苏达编码与人工编码比较及其评价

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中华心律失常学杂志 1998年第2期2卷 92-95页

作者：吴杰 j.a kors G.Herpen Z.Zhang R.j Prineas 同济医科大学附属同济医院心内科 430030 荷兰Erasmus大学医学信息研究所美国Miami大学公共卫生和流行病学研究所

目的介绍一种计算机明尼苏达编码系统,并报告计算机编码与人工编码性能的比较结果。方法随机选择300例有各种编码形态的心电图,分别独立由计算机和人工进行编码并与参考标准编码比较,计算两者编码的准确率以及检测不同编码分类的敏感性... 详细信息

目的介绍一种计算机明尼苏达编码系统,并报告计算机编码与人工编码性能的比较结果。方法随机选择300例有各种编码形态的心电图,分别独立由计算机和人工进行编码并与参考标准编码比较,计算两者编码的准确率以及检测不同编码分类的敏感性和特异性。结果研究结果显示在所有的编码分类上计算机编码的准确率以及敏感性和特异性优于或相当于人工编码。结论本研究表明计算机编码是一项有价值的编码方式,可以辅助或替代人工编码。

关键词：人工心电图计算机编码特异性敏感性辅助研究结果参考标准准确率评价

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年龄≥55岁的男性和女性中显性与未诊断心肌梗死的发生率:鹿特丹研究

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世界核心医学期刊文摘（心脏病学分册） 2006年第8期2卷 26-27页

作者： De Torbal A. Boersma E. kors j.a. j.C.M. Witteman 王睿 Department of Epidemiology and Biostatistics Erasmus MC PO Box 1738 3000 DR Rotterdam Netherlands

Aims: Contemporary data on the incidence of unrecognized myocardial infarction(MI) among subjects aged 55 and older are limited. Methods and results: We studied the incidence of recognized and unrecognized MI in the Rotterdam Study, a population-based cohort of men and women aged 55 and older. The baseline examination was performed during 1990-93, with follow-up examinations during 1994- 95, and 1997-2000. Baseline and follow-up 12-lead ECGs were analysed by the Modular ECG Analysis System. The 5148 participants who had no evidence of prevalent infarction were the subjects for analysis. Incident recognized infarction was defined as the occurrence of a fatal or non-fatal event coded as 121 according to the International Classification of Diseases, 10th edition. A repeat ECG was available in 4187 subjects. An unrecognized infarction was considered to have occurred if there was electrocardiographic evidence in the absence of a clinically recognized event. During a median follow-up of 6.4 years, 141 incident recognized infarctions occurred and the incidence rate of this event was 5.0 per 1000 person years. The incidence was higher in men(8.4) than in women(3.1). The incidence rate of unrecognized infarction was 3.8 per 1000 person years. Men(4.2) and women(3.6) had approximately similar incidence. Hence, the proportion of unrecognized infarction was lower in men(33% ) than in women(54% ). This difference in proportion of unrecognized infarctions was independent of age. Conclusion: A high proportion of incident MIs remains clinically unrecognized. As a history of MI is associated with an increased risk of repeat cardiovascular complications, our data suggest a need for periodical electrocardiographic screening to recognize(prevalent) infarctions and to install effective preventive treatment in those aged 55 and older.

关键词：心肌梗死发生率鹿特丹显性女性男性年龄 12导联心电图未诊断

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