老年代谢综合征患者静息心率增加与靶器官损害的相关性  

Study on the relationship between the resting heart rate and target organ damage in elderly patients with metabolic syndrome

作　　者：丁向东[1] 刘平[1] 魏国[1] 刘雅斐[1] 倪一虹[1] 

机构地区：[1]山东大学第二医院内分泌科,济南市250033

出　　处：《中华老年医学杂志》2008年第12期905-908,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨老年代谢综合征患者静息心率（RHR）与靶器官损害的关系。方法人选老年代谢综合征患者264例，按RHR水平分为4组：RHR1组：RHR〈65次／min46例；RHR2组：65次／min≤RHR〈75次／min77例；RHR3组：75次／min≤RHR〈85次／min89例；RHR4组：RHR≥85次／min52例。对人选患者检查心电图、超声心动图、颈动脉超声、肌酐清除率（Ccr）及尿微量白蛋白。结果（1）RHR4组的颈动脉内膜厚度、颈动脉内径、左心室重量指数及尿微量白蛋白定量均高于RHR1、RHR2和RHR3组（P〈0．05或P〈0．01），左心室射血分数、Ccr均小于RHR1、RHR2和RHR3组（均为P〈0．01）；（2）RHR与颈动脉内膜厚度、颈动脉内径、左心室重量指数及尿微量白蛋白定量呈正相关（r分别为0．33、0．23、0．61、0．58，均为P〈0．01），与左心室射血分数、Ccr呈负相关（r分别为-0．59、-0．51，均为P〈0．01）；（3）非条件Logistic回归分析结果显示，RHR和脉压对心肌肥厚、冠心病、心力衰竭、脑卒中和肾功能损害都有不同程度的影响（P〈0．05或P〈0．01），其中除心力衰竭外，脉压较RHR的作用更大。结论RHR可能是老年代谢综合征患者靶器官损害的独立危险因素，控制RHR对于老年代谢综合征的发生、发展具有重要意义。Objective To investigate the relationship between the resting heart rate （RHR） and target organ damage （TOD） in elderly patients with metabolic syndrome （MS）. Methods 264 elderly patients with MS were divided into four groups according to the level of RHR： RHR1 group, RHR〈65 beats/minute （bpm） （46 cases） ; RHR2 group, 65≤RHR〈75 bpm （77 cases）; RHR3 group, 75 bpm≤RHR（85 bpm （89 eases）; RHR4 group, RHR≥85 bpm （52 eases ）. Electrocardiography, echocardiography, carotid ultrasonography, creatinine clearance rate （Ccr） and quantitative assay of 24 hours＇ albuminuria were performed. Results （1） Compared with RHR1, RHR2 and RHR3 groups, RHR4 group showed higher levels of carotid intima-mediai thickness （IMT）, carotid arterial diameter （CAD）, left ventricular mass index （LVMI） and albuminuria（P〈 0.05 or P〈0.01）, and lower levels of left ventricular ejection fraction （LVEF） and Cer （all P〈 0.01）. （2） The IMT, CAD, LVMI and albuminuria were positively correlated with RHR （r=0. 33, 0.23, 0.61, 0.58, respectively, all P〈0.01）. However, the LVEF and Cer were negatively correlated with RHR （r = - 0.59, - 0.51, all P〈0.01）. （8） Logistic multivariate analysis showed that RHR and pulse pressure （PP） had effects on myocardial hypertrophy, coronary heart disease, heart failure, cerebral stroke and renal dysfunction（P〈0.05 or P〈0.01）. Except heart failure, PP played a more important role than RHR. Conclusions RHR may be an independent risk factors for TOD in elderly patients with MS,and RHR regulation is important for the development of MS in the elderly.

关 键 词：代谢综合征X 心率 心脏病 脑血管意外 

分 类 号：R686[医药卫生—骨科学]