广州成年人群心率分布及死亡和心脑血管病危险度分析  

Heart rate distribution of adult population in Guangzhou and proportional hazard analysis of heart rate to death and attack of cadio-cerebrovascular diseases

作　　者：吴勇[1] 饶栩栩[1] 刘小清[1] 麦劲壮[1] 连子斌[1] 高向民[1] 郭成业[1] 邓木兰[1] 

机构地区：[1]广东省人民医院广东省心血管病研究所流行病研究室,广州510100

出　　处：《岭南心血管病杂志》2005年第6期424-427,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的分析社区中成年健康人群心率分布,评估不同心率时死亡和心脑血管病的危险度,对传统成人正常心率范围(60～100次/分)提出评议。方法采用中美心血管病流行病学和危险因素合作研究对广州工农人群的调查。基线调查1983～1984年,1987～1988年复查,1991年开始每2年1次终点事件随访,平均随访16.2年。心率以体检时心电图记录明尼苏达编码测定。终点事件包括全死因死亡或首次冠心病或脑血管病事件。用SAS软件作统计分析,分析基线调查人群除外患有心脑血管病、糖尿病和各种慢性病者。用Cox比例风险(proportionalhazards)分析评估心率对死亡和对心脑血管事件的关系。结果调查广州城乡35岁以上自然人群共4570名,纳入分析的“健康者”3493名(男1694名,女1799名),心率(68±11)次/分,其中男性(66±11)次/分,女性(69±10)次/分;心率的第5分位数百分数男性和女性分别为51次/分和54次/分;95百分位数男性和女性分别为85次/分和88次/分。年龄与心率的单相关分析表明心率与年龄有轻度负相关,但仅在女性有统计学意义。Cox比例风险分析显示较高的心率有较高的总死亡率和心脑血管病事件风险。以心率60～89次/分为基准组,心率在50～59次/分减少总死亡率[优势比(oddsradio,OR)0.90]和心脑血管病事件(OR0.63),而心率90～99次/分和大于100次/分增加总死亡率(OR1.85和1.12)和心脑血管病事件(OR2.12和1.02)。结论在一定范围内心率偏慢较心动过速或心率偏快好,死亡和心脑血管病发病的危险性较低。Objectives Through the study on heart rate （HR） distribution of the healthy adult population to evaluate the proportional hazards of HR to death of total causes and the attack of cardio-cerebrovascular events, and to criticize the traditional normal range of 60-100 beats per minute （bpm） of HR in adults. Methods The analyzed data were from The PRC-USA collaborative study of cardiovascular epidemiology in Guangzhou urban and rural study populations. The baseline survey was carried out in 1983 and 1984, and re-screened in 1987 and 1988. Follow up visits for endpoint events were performed once every 2 years since 1991. The total follow up period was 16.2 years on average from the baseline to the year of 2000. The participants with cardiocerebrovascular diseases, diabetes and various chronic diseases were excluded from analysis. HR was measured through 3 R-R intervals of 12 lead resting electrocardiogram after double blind code of Minnesota Code. Endpoint events included total cause of death, first attack of coronary event and cerebrovascular event. SAS software was used for the analysis. Cox proportional hazards model was used to evaluate the impact of HR on total death and cardiocerebrovascular events. Results A total of 4570 men and women aged 35-55 years from Guangzhou urban and rural areas were investigated. Among 3493 ＂healthy adults＂ （ men 1 694, women 1 799）, the mean of HR was （ 68 ± 11 ） bpm [ men （ 66 ± 11 ） bpm, women （ 69 ± 10） bpm ] ; The 5th percentile of the HR was 51 bpm and 54 bpm,and the 95th percentile was 85 bpm and 88 bpm,for male and female respectively. Simple correlation analysis showed that there was a negative relationship between age and HR. But only in female showed statistical significant. Cox proportional hazards analysis showed that there was a trend of higher eardiocerebrovaseular events and ＇all cause of death with higher HR. Compared with the HR between 60-89 bpm, the risk of death （OR=0.70 and 0.90） and events （OR=0.47 and 0.63） decreased wh

关 键 词：心率 死亡率 心血管病 脑血管病 广州地区 成年人 危险度 

分 类 号：R54[医药卫生—心血管疾病] R743[医药卫生—内科学]