中老年人静息心率升高与动脉硬化的相关性研究  

Correlation of elevated resting heart rate with atherosclerosis in middle-aged and elderly people

作　　者：季宗文 王本远 孙继超[3] 孙婉婉[3] 徐佰慧[3] 徐瑜[3] 陆洁莉[3] 毕宇芳[3] 徐敏[3] 

机构地区：[1]兖矿集团总医院内分泌科 [2]即墨市人民医院内分泌科 [3]上海交通大学医学院附属瑞金医院内分泌代谢病科上海市内分泌代谢病临床医学中心上海市内分泌代谢病研究所,上海200025

出　　处：《内科理论与实践》2014年第1期55-58,共4页Journal of Internal Medicine Concepts & Practice

基　　金：上海市卫生局课题(项目编号:2011293)

摘　　要：目的：研究中老年人静息心率升高与动脉硬化的相关性。方法：在上海市嘉定区选取2519名年龄40岁以上的居民进行问卷调查、体格检查、生化检测以及肱-踝动脉脉搏波传导速度（ba-PWV）的测量。以ba—PWV上四分位定义为动脉硬化。以ba-PWV作为应变量。采用多重线性回归模型．分析心率及其他传统危险因素与ba-PWV的相关性。同时。将人群按心率四分位值分成4组，以心率上四分位组作为对照，采用多重Logistic回归模型分析其余3组人群动脉硬化的患病风险。结果：按心率四分位分组为≤73次／min组、74～81次／min组、82～90次／min组、≥91次／min组;ba-PWV与心率呈显著正相关（r=0．23，P〈0．0001），在多重线性回归中，心率对ba-PWV仍然有很好的相关性（标准β=0．17，P〈0．0001）。在心率四分位组间，随着心率水平的增高，动脉硬化的患病率也随之增高，从上四分位组到下四分位组，动脉硬化的患病率依次为15．5％、20．9％、24．5％和39．9％。多重Logistic回归分析显示，在校正了其他传统危险因素后，心率≥91次／min组人群的动脉硬化患病风险是心率≤73次／min组人群的4．36倍[比值比（0R1=4．36，95％可信区间（CI）：2．98～6．38]0结论：中老年人静息心率升高与动脉硬化独立相关。Objective To investigate the correlation of elevated resting heart rate （RHR） with atherosclerosis. Meth- ods In this study 2 519 people aged 40 years or older in Shanghai Jiading district were enrolled. Questionnaire results, anthropometric and biochemical measurements were taken from each of the participants. The braehial- ankle pulse wave velocity （ba-PWV） was measured to define atherosclerosis. And we defined the highest quartile of ba-PWV as atheroscle- rosis. Firstly, multiple linear regression model was used to analyze the association of RHR and other conventional risk fac- tors with ba-PWV. Then the study population were categorized into 4 groups according to quartiles of RHR （beats/min） （≤ 73, 74-81, 82-90, ≤91）. Logistic regression model analysis was performed to estimate the odds ratios （OR） of quartile 2, 3 or 4 of RHR in comparison with quartile 1 as reference. Results Ba-PWV was positively associated with RHR （r=0.23, P〈0.000 1）. In multiple linear regression model, RHR was significantly associated with ba-PWV （standardized β=0.17, P〈 0.000 1）. The prevalence of atherosclerosis was increased stepwisely from quartile 1 to quartile 4： 15.5%, 20.9%, 24.5% to 39.9%, respectively. After adjusted for other conventional risk factors, people with RHR≥91 beats/min conferred a 4.36 fold [OR=4.36, 95% confidence interval （CI）： 2.98-6.38] of risk of atherosclerosis as compared with people with RHR≤73 beats/min. Conclusions Elevated RHR is an independent association factor of atherosclerosis.

关 键 词：静息心率 动脉硬化 动脉脉搏波传导速度 

分 类 号：R543.5[医药卫生—心血管疾病]