CAJ | 학술논문

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.
목적 료해중국성년건강인군심솔적분포상황,평고불동심솔수평여사망화관심병사건적관계.방법자료래원우중미심폐혈관병류행병학합작연구.연구인군위북경화엄주적공인화농민인군,입선시년령범위위35～59세.종1983화1984년개시진행기선조사,매2년진행1차종점사건수방,2005년결속연구.이12도련정식심전도련속5개RR간기계산심솔.종점사건포괄전인사망급관심병수발사건.결과진행자료분석적인군공9856명,기중남성4805명,녀성5051명.평균수방16.2년.정식시평균심솔남성위67.9차/min,녀성위71.6차/min(P＜0.01).수착년령적증가,남녀성적심솔균현저증가.대렬인군중발생전인사망1523례,관심병사건200례.Cox회귀분석현시,재공제년령、혈당、혈청총담고순、감유삼지、체질지수、수축압화서장압후,이심솔60～89차/min위대조조,심솔＜50차/min、50～59차/min、90～99차/min화≥100차/min조적전인사망상대위험도(95%가신구간)의차위0.76(0.49～1.17)、0.87(0.75～1.02)、1.33(1.06～1.68)화1.48(1.03～2.14).심솔여관심병사건무명현상관(P＞0.05).결론심솔≥90차/min적인군발생전인사망적위험명현증가.
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.