心率与全因死亡及冠心病事件关系的队列人群研究  

Association between heart rate and all-cause death and coronary event in the Chinese cohort： 16 years follow up results

作　　者：麦劲壮[1] 赵连成[2] 刘小清[1] 武阳丰[3] 饶栩栩[1] 高向民[1] 吴勇[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510080 [2]中国医学科学院北京协和医学院阜外心血管病医院流行病研究室 [3]北京大学公共卫生学院

出　　处：《中华心血管病杂志》2009年第8期750-753,共4页Chinese Journal of Cardiology

摘　　要：目的了解中国成年健康人群心率的分布状况，评估不同心率水平与死亡和冠心病事件的关系。方法资料来源于中美心肺血管病流行病学合作研究。研究人群为北京和广州的工人和农民人群，入选时年龄范围为35～59岁。从1983和1984年开始进行基线调查，每2年进行1次终点事件随访，2005年结束研究。以12导联静息心电图连续5个RR间期计算心率。终点事件包括全因死亡及冠心病首发事件。结果进行资料分析的人群共9856名，其中男性4805名，女性5051名。平均随访16．2年。静息时平均心率男性为67．9次/min，女性为71．6次/min（P〈0．01）。随着年龄的增加，男女性的心率均显著增加。队列人群中发生全因死亡1523例，冠心病事件200例。Cox回归分析显示，在控制年龄、血糖、血清总胆固醇、甘油三酯、体质指数、收缩压和舒张压后，以心率60-89次／min为对照组，心率〈50次／min、50～59次／min、90—99次／min和≥100次／min组的全因死亡相对危险度（95％可信区间）依次为0．76（0．49—1．17）、0．87（0．75～1．02）、1．33（1．06～1．68）和1．48（1．03—2．14）。心率与冠心病事件无明显相关（P〉0．05）。结论心率≥90次／min的人群发生全因死亡的危险明显增加。Objective To evaluate the association between resting heart rate （HR） and all-cause death and coronary heart disease （CHD） events in the Chinese cohort. Methods Data were obtained from the PRC-USA Cooperative Study on Cardiovascular and Cardiopulmonary Epidemiology. Baseline screen surveys were conducted in 1983 and 1984 from people aged 35 to 59 years living in urban or rural areas of Beijing and Guangzhou. Follow-up visits were performed for end point events of all-cause death and first CHD events every two years till 2005. Resting HR was determined from 5 consecutive intervals between R waves on the 12-lead electrocardiogram. Results A total of 9856 （4805 males） people were included in the study and the mean follow up duration was 16. 2 years. There were 1523 deaths, including 200 CHD events during the follow up period. Mean resting HR was 67.9 beat per minute（bpm） in men and 71.6 bpm in women respectively which had a trend to increase with aging. Cox Proportional Hazards model indicated the relative risk of all-cause death increased constantly with the increase of HR percentile after control of age, fasting glucose, serum cholesterol, serum triglyceride, body mass index, systolic blood pressure and diastolic blood pressure. With HR 60-89 bpm as control group, the relative risk and 95% confidence interval in group HR 〈 50 bpm,50-59 bpm, 90-99 bpm and ≥ 100 bpm were 0. 76 （0.49-1.17）, 0. 87 （0. 75-1.02 ）, 1.33 （ 1.06-1.68 ）, 1.48 （ 1.03-2. 14） respectively. However there was no significant correlation between HR and CHD events in studied population. Conclusion The risk of total death increased significantly in people with HR≥90 bpm suggesting higher resting heart rate might be an independent risk factor for all-cause death in the Chinese population.

关 键 词：心率 死亡 冠状动脉疾病 队列研究 

分 类 号：R686[医药卫生—骨科学]