中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2008年
12期
905-908
,共4页
丁向东%刘平%魏国%刘雅斐%倪一虹
丁嚮東%劉平%魏國%劉雅斐%倪一虹
정향동%류평%위국%류아비%예일홍
代谢综合征X%心率%心脏病%脑血管意外
代謝綜閤徵X%心率%心髒病%腦血管意外
대사종합정X%심솔%심장병%뇌혈관의외
Metabolic syndrome X%Heart rate%Heart diseases%Cerebrovascular accident
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 入选老年代谢综合征患者264例,按RHR水平分为4组:RHRl组;RHR<65次/min 46例;RHR2组:65次/min≤RHR<75次/min 77例;RHR3组:75次/min≤RHR<85次/min 89例;RHR4组:RHR≥85次/min 52例.对入选患者检查心电图、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、左心事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.
目的 探討老年代謝綜閤徵患者靜息心率(RHR)與靶器官損害的關繫. 方法 入選老年代謝綜閤徵患者264例,按RHR水平分為4組:RHRl組;RHR<65次/min 46例;RHR2組:65次/min≤RHR<75次/min 77例;RHR3組:75次/min≤RHR<85次/min 89例;RHR4組:RHR≥85次/min 52例.對入選患者檢查心電圖、超聲心動圖、頸動脈超聲、肌酐清除率(Ccr)及尿微量白蛋白. 結果 (1)RHR4組的頸動脈內膜厚度、頸動脈內徑、左心室重量指數及尿微量白蛋白定量均高于RHR1、RHR2和RHR3組(P<0.05或P<0.01),左心室射血分數、Ccr均小于RHR1、RHR2和RHR3組(均為P<0.01);(2)RHR與頸動脈內膜厚度、頸動脈內徑、左心事重量指數及尿微量白蛋白定量呈正相關(r分彆為0.33、0.23、0.61、0.58,均為P<0.01),與左心室射血分數、Ccr呈負相關(r分彆為-0.59、-0.51,均為P<0.01);(3)非條件Logistic迴歸分析結果 顯示,RHR和脈壓對心肌肥厚、冠心病、心力衰竭、腦卒中和腎功能損害都有不同程度的影響(P<0.05或P<0.01),其中除心力衰竭外,脈壓較RHR的作用更大. 結論 RHR可能是老年代謝綜閤徵患者靶器官損害的獨立危險因素,控製RHR對于老年代謝綜閤徵的髮生、髮展具有重要意義.
목적 탐토노년대사종합정환자정식심솔(RHR)여파기관손해적관계. 방법 입선노년대사종합정환자264례,안RHR수평분위4조:RHRl조;RHR<65차/min 46례;RHR2조:65차/min≤RHR<75차/min 77례;RHR3조:75차/min≤RHR<85차/min 89례;RHR4조:RHR≥85차/min 52례.대입선환자검사심전도、초성심동도、경동맥초성、기항청제솔(Ccr)급뇨미량백단백. 결과 (1)RHR4조적경동맥내막후도、경동맥내경、좌심실중량지수급뇨미량백단백정량균고우RHR1、RHR2화RHR3조(P<0.05혹P<0.01),좌심실사혈분수、Ccr균소우RHR1、RHR2화RHR3조(균위P<0.01);(2)RHR여경동맥내막후도、경동맥내경、좌심사중량지수급뇨미량백단백정량정정상관(r분별위0.33、0.23、0.61、0.58,균위P<0.01),여좌심실사혈분수、Ccr정부상관(r분별위-0.59、-0.51,균위P<0.01);(3)비조건Logistic회귀분석결과 현시,RHR화맥압대심기비후、관심병、심력쇠갈、뇌졸중화신공능손해도유불동정도적영향(P<0.05혹P<0.01),기중제심력쇠갈외,맥압교RHR적작용경대. 결론 RHR가능시노년대사종합정환자파기관손해적독립위험인소,공제RHR대우노년대사종합정적발생、발전구유중요의의.
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 cases);RHR4 group, RHR≥85 bpm (52 cases).Electrocardiography, echocardiography, carotid uhrasonography, crcatinine 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-medial 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 Ccr (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 Ccr were negatively correlated with RHR (r=-0.59, -0.51, all P<0.01). (3) 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. Coneinsions 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.
