正常成年人静息及双重自主神经阻断后ST段高度的年龄和性别差异。
Age and gender difference in ST height at rest and after double autonomic blockade in normal adults.
作者信息
Endres Susanne, Mayuga Kenneth A, de Cristofaro Alessandro, Taneja Taresh, Goldberger Jeffrey J, Kadish Alan H
机构信息
Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
出版信息
Ann Noninvasive Electrocardiol. 2006 Jul;11(3):253-8. doi: 10.1111/j.1542-474X.2006.00112.x.
BACKGROUND
ST elevation is commonly seen in young, healthy men. The exact mechanisms that cause ST height to be greater in young men are not yet completely understood. The purpose of the present study was to determine whether autonomic tone is responsible for age and gender differences in ST height.
METHODS
Gender and age differences in ST height were studied at rest and after double autonomic blockade (DAB) with atropine and propranolol. Fifty healthy men and women were included (16 men, 14 women, age 23-32 years; 9 men, 11 women, age 65-79 years). Twelve-lead ECGs were registered at rest and after DAB. Leads II and V(1)-V(4) were chosen for analysis. ST height (in mm) was measured manually at the J-point, and 40 ms and 80 ms after the J-point. Values were corrected for QRS amplitude.
RESULTS
Gender and age differences in ST height were seen in both rest and DAB data. Men had greater ST height compared to women at J-point, 40 and 80 ms after the J-point (P < or = 0.0001), and younger subjects had greater ST height than older subjects at J-point (P = 0.0140), 40 and 80 ms after the J-point (P < or = 0.0001). DAB did not change ST height at J-point or at 40 ms, but increased ST height at 80 ms. Women had less of an increase in ST height following DAB than men did.
CONCLUSIONS
ST elevation in the absence of structural or electrical heart disease is mainly seen in young men. Age and gender difference persist after DAB and thus are not due to differences in autonomic tone.
背景
ST段抬高常见于年轻健康男性。导致年轻男性ST段抬高幅度更大的确切机制尚未完全明确。本研究的目的是确定自主神经张力是否是ST段抬高幅度存在年龄和性别差异的原因。
方法
研究了静息状态下以及使用阿托品和普萘洛尔进行双重自主神经阻滞（DAB）后ST段抬高幅度的性别和年龄差异。纳入了50名健康男性和女性（16名男性，14名女性，年龄23 - 32岁；9名男性，11名女性，年龄65 - 79岁）。在静息状态和DAB后记录12导联心电图。选择Ⅱ导联和V(1)-V(4)导联进行分析。在J点、J点后40毫秒和80毫秒手动测量ST段抬高幅度（以毫米为单位）。数值根据QRS波幅进行校正。
结果
静息状态和DAB数据中均观察到ST段抬高幅度的性别和年龄差异。在J点、J点后40毫秒和80毫秒，男性的ST段抬高幅度大于女性（P≤0.0001），在J点较年轻受试者的ST段抬高幅度大于年长受试者（P = 0.0140），在J点后40毫秒和80毫秒也是如此（P≤0.0001）。DAB并未改变J点或40毫秒时的ST段抬高幅度，但增加了80毫秒时的ST段抬高幅度。DAB后女性ST段抬高幅度的增加少于男性。
结论
在无结构性或电性心脏病的情况下，ST段抬高主要见于年轻男性。DAB后年龄和性别差异仍然存在，因此并非由自主神经张力差异所致。
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