中老年人群高静息心率对颈动脉斑块检出率的影响

摘要

Objective To explore the effect of high resting heart rate (RHR) on the detection rate of carotid artery plaque in elderly population.Methods From June 2010 to June 2011,a total of 5 852 participants randomly selected and recruited from 101 510 workers of a Tangshan Kailuan Company in this cohort study.All the information was obtained through unified questionnaires.Blood tests and RHR were measured and color-ultrasound performed to detect the carotid artery plaque.All the subjects were divided into groups according to RHR,with ≤ 80 bpm/min as low RHR group and ＞80 bpm/min as high RHR group.The detection rates of carotid artery plaque were compared between the two groups after stratification on both gender and age.Single and multiple factors logistic regression analyses were used to analyze the factors related to carotid artery plaques.Results 1) The detection rate of carotid artery plaque in high RHR group was higher than that of low RHR group (48.9％ vs.41.5％,P＜0.001).Between the high or low RHR groups,the detection rates of carotid artery plaque were 58.7％ and 52.1％ in males,26.9％ and 25.1％ in females.2) The detection rates of carotid artery plaque increased with age:19.5％,42.9％,67.6％ and 86.5％ in ＜ 50,50-,60-and ≥ 70year olds.They were 25.1％,50.0％,70.5％ and 87.5％ in the high RHR group and,18.5％,41.8％,60.7％ and 86.3％ in the low RHR group.3) After adjustment for influence factors related to carotid artery plaque,the risk on carotid artery in high RHR group had an increase of 22.6％,when compared with that of the low RHR group.The OR value was 1.226(95％CI:1.018-1.477).Conclusion High RHR could increase the risk of carotid artery plaque.%目的 探讨中老年人群高静息心率对颈动脉斑块检出率的影响.方法 2010年6月至2011年6月在健康体检职工中随机分层抽取5 852人作为观察对象,进行统一血液生化、静息心率及颈动脉超声检查,其中5 440人符合人选标准,最后有5 280人纳入统计分析,根据静息心率水平分为≤80次/分(低静息心率组)和＞80次/分(高静息心率组),比较性别、年龄分层后颈动脉斑块的检出率,采用单因素和多因素logistic回归分析颈动脉斑块的影响因素.结果 (1)高静息心率组颈动脉斑块检出率高于低静息心率组(48.9％vs.41.5％,P＜0.001);按性别分层后,男性高、低静息心率组颈动脉斑块检出率分别为58.7％和52.1％,女性分别为26.9％和25.1％.(2)随着年龄增长,颈动脉斑块检出率逐渐升高,年龄＜50、50～、60～、≥70岁人群颈动脉斑块检出率分别为19.5％、42.9％、67.6％、86.5％,高静息心率组颈动脉斑块检出率分别为25.1％、50.0％、70.5％、87.5％,低静息心率组颈动脉斑块检出率分别为18.5％、41.8％、60.7％、86.3％.(3)校正影响颈动脉斑块的多因素logistic回归分析,显示高静息心率组发生颈动脉斑块的风险比低静息心率组增加22.6％(OR=1.226,95％CI:1.018 ～ 1.477).结论 高静息心率能增加颈动脉斑块的发生风险.