Akhtar M, Dham S K
Senior Adviser (Medicine), No. 7 Air Force Hospital, Kanpur Cantt - 208 004.
Professor and Head, Department of Medicine, Armed Forces Medical College, Pune 411 040.
Med J Armed Forces India. 1995 Jul;51(3):173-179. doi: 10.1016/S0377-1237(17)30960-7. Epub 2017 Jun 26.
Two hundred and fifty seven service personnel with established diagnosis of (a) silent ischaemia (40.47%) (b) Q-infarction (25.68%) and (c) non-Q-infarction (33.85%) along with 50 age-matched controls were subjected to stress tests before and after identification and control of risk factors. Lack of exercise (63.0%), dietetic indiscretion (47.4%) and cigarette smoking (40.4%) were the main risk factors. Hypercholesterolaemia (22.1%), alcohol over-indulgence (17.1%), positive family history (16.3%), diabetes mellitus (9.7%) and hypertension (6.2%) were other contributing factors. Clustering or multiplicity of risk factors was seen in 61.1% cases. All patients were advised for control of risk factors along with necessary specific therapy wherever indicated. Initial stress test was positive in 83.3% of the total and on repetition, after 4 years, the positivity dropped to 45.9% with a rate of improvement of 44.9%. Patients with silent ischaemia showed the maximum improvement (57.8%) following the risk factor intervention. Only 4 cases (1.56%) showed deterioration with reinfarction during the 4-year follow up.
257名已确诊患有以下疾病的服务人员：(a) 无症状性缺血（40.47%）、(b) Q波梗死（25.68%）和(c) 非Q波梗死（33.85%），以及50名年龄匹配的对照组人员，在识别和控制危险因素前后接受了压力测试。缺乏运动（63.0%）、饮食无节制（47.4%）和吸烟（40.4%）是主要危险因素。高胆固醇血症（22.1%）、酗酒（17.1%）、家族史阳性（16.3%）、糖尿病（9.7%）和高血压（6.2%）是其他促成因素。61.1%的病例存在危险因素聚集或多重性。所有患者均被建议控制危险因素，并在必要时进行必要的特异性治疗。初始压力测试中，总阳性率为83.3%，4年后重复测试时，阳性率降至45.9%，改善率为44.9%。无症状性缺血患者在危险因素干预后改善最大（57.8%）。在4年随访期间，只有4例（1.56%）出现病情恶化并再次梗死。
