Szlachcic Yaga, Carrothers LeeAnne, Adkins Rodney, Waters Robert
Rancho Los Amigos National Rehabilitation Center, Downey, California, USA.
J Spinal Cord Med. 2007;30(5):473-6. doi: 10.1080/10790268.2007.11754580.
Cardiovascular risk factors are common in individuals with chronic spinal cord injury (SCI), and their prevalence increases with age. The actual prevalence of overt cardiovascular disease (CVD) in this population has not been well established.
Electrocardiograms (ECGs) were examined for abnormalities in 43 individuals with abnormal lipid profiles being followed in the outpatient SCI clinic of our institution. The mean age of the study population of predominantly men was 43 +/- 9.9 years and the mean duration of injury 16.6 +/- 8 years.
ECG abnormalities were common and present in 60.5% of participants. ST-T wave abnormalities were the most commonly observed (35%). Evidence of previous myocardial infarction was present in 7% of all individuals and in 12% of those with ECG abnormalities. The only clinical parameter differentiating the group with normal vs abnormal ECG was the duration of injury (19.5 +/- 8 y vs 12 +/- 5 y; P = 0.0026). Analysis of variance showed that injury duration was the sole predictor of abnormal ECG with 68% accuracy (P = 0.006). Among those with ECG abnormalities, although no significant differences were detected between those with and without evidence of previous myocardial infarction, mean total cholesterol and low-density lipoprotein were higher, and mean high-density lipoprotein was lower. Mean age and injury duration were greater in those with evidence of previous myocardial infarction.
Although age is an important risk factor for CVD in the population of individuals without disabilities, injury duration is at least as important as age in those with SCI. Our findings support the recommendation that individuals with SCI and abnormal lipids should be screened for CVD regardless of age.
心血管危险因素在慢性脊髓损伤（SCI）患者中很常见，且其患病率随年龄增长而增加。该人群中明显心血管疾病（CVD）的实际患病率尚未完全明确。
在我们机构的门诊SCI诊所，对43名血脂异常患者的心电图（ECG）进行异常检查。研究人群以男性为主，平均年龄为43±9.9岁，平均损伤时长为16.6±8年。
ECG异常很常见，60.5%的参与者存在该情况。ST-T波异常最为常见（35%）。所有个体中有7%曾有心肌梗死迹象，在ECG异常者中这一比例为12%。区分ECG正常与异常组的唯一临床参数是损伤时长（19.5±8年 vs 12±5年；P = 0.0026）。方差分析表明，损伤时长是ECG异常的唯一预测因素，准确率为68%（P = 0.006）。在ECG异常者中，尽管有无心肌梗死迹象者之间未检测到显著差异，但总胆固醇和低密度脂蛋白均值较高，高密度脂蛋白均值较低。有心肌梗死迹象者的平均年龄和损伤时长更大。
虽然年龄是无残疾人群中CVD的重要危险因素，但在SCI患者中，损伤时长至少与年龄同样重要。我们的研究结果支持以下建议：无论年龄如何，SCI且血脂异常的患者都应接受CVD筛查。
