在线办公
期刊论坛
主 管
中国人民解放军总医院
主 办
中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
编 辑
中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
传真:010-66936756
E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
闻静,王蔚华,陈卫平,刘健.24 h平均心率对老年冠心病患者全因死亡的影响[J].中华老年多器官疾病杂志,2019,18(4):285~289
24 h平均心率对老年冠心病患者全因死亡的影响
Impact of average heart rate over 24-hour on all-cause death in elderly patients with coronary heart disease
投稿时间:2018-11-26  
DOI:10.11915/j.issn.1671-5403.2019.04.058
中文关键词:  老年人;冠心病;平均心率;全因死亡
英文关键词:aged; coronary disease; average heart rate; all-cause death
基金项目:
作者单位E-mail
闻静 北京市海淀医院老年内科,北京 100080 wen_6k@sina.com 
王蔚华 北京市海淀医院老年内科,北京 100080  
陈卫平 北京市海淀医院老年内科,北京 100080  
刘健 北京市海淀医院心功能室,北京 100080  
摘要点击次数: 138
全文下载次数: 199
中文摘要:
      目的 探讨24 h平均心率(AHR)对老年冠心病(CHD)患者全因死亡的影响。方法 连续入选2010年6月至2012年6月在北京市海淀医院老年内科住院的老年CHD患者262例。根据出院前24 h动态心电图(holter)检查,以24 h AHR 75次/min为切点分为24 h AHR≥75次/min组71例和24 h AHR<75次/min组191例。对入选患者进行随访,2010年12月1日开始,每6个月进行一次,至2016年6月31日结束,以全因死亡为主要研究终点。收集并比较患者出院前24 h的基线资料、化验指标,以及随访期间的死亡原因。采用SPSS 19.0软件对数据进行分析。根据数据类型,组间比较采用t检验、Wilcoxon秩和检验或χ2检验。组间累计生存率分析采用Kaplan-Meier生存曲线。采用多因素Cox比例风险模型评价随访期间CHD患者全因死亡的各种可能危险因素。结果 入选患者中位随访40.7个月,患者资料完整。与24 h AHR<75次/min组比较,24 h AHR≥75次/min组患者白细胞计数、低密度脂蛋白胆固醇和尿微量白蛋白显著升高,差异有统计学意义(P<0.05)。随访期间患者总死亡率为6.87%(18/262)。与24 h AHR<75次/min组比较,24 h AHR≥75次/min组患者全因死亡率[15.49%(11/71) vs 3.66%(7/191),P=0.002]、CHD死亡率[9.86%(7/71) vs 1.57%(3/191),P=0.005]均显著升高,差异有统计学意义。Kaplan-Meier生存分析显示,24 h AHR≥75次/min组患者累计生存率显著低于24 h AHR<75次/min组(P=0.001)。多因素Cox比例风险模型分析显示,校正混杂因素后,24 h AHR≥75次/min(HR=4.604,95%CI 1.343~15.784;P=0.015)和吸烟(HR=3.943,95%CI 1.009~15.412;P=0.049)是老年CHD患者全因死亡的独立危险因素。结论 24 h AHR≥75次/min的老年CHD患者全因死亡率明显升高,通过控制24 h AHR和戒烟可能会降低老年CHD患者全因死亡率。
英文摘要:
      Objective To investigate the effect of 24-hour average heart rate (AHR) on all-cause mortality in elderly patients with coronary heart disease (CHD). Methods A total of 262 elderly CHD patients admitted in our hospital from June 2010 to June 2012 were recruited in this study. According to the results of 24-hour ambulatory electrocardiography (Holter examination) before discharge, they were divided into 24 h AHR≥75 times/min group (n=71) and 24 h AHR<75 times/min group (n=191) at the cut point of 75 times/min. The follow-up was carried out from December 1,0 to June 31,6, at an interval of 6 months, with all-cause death as the main endpoint. Their baseline data and laboratory indicators 24 h before discharge and causes of death during follow-up were collected and compared. SPSS statistics 19.0 was used to analyze the data. According to the data type, Student′s t test, Wilcoxon rank sum test and Chi-sqaure test were used for comparison between groups. Kaplan-Meier survival curve was plotted to analyze the cumulative survival rate between groups. Multivariate Cox proportional hazard model was applied to evaluate the risk factors of all-cause mortality in CHD patients during follow-up. Results The median period of follow-up was 40.7 months, and whole data of these patients were collected. Compared with the 24 h AHR<75 times/min group, the 24 h AHR≥75 times/min group had signifi-cantly higher white blood cell count, serum level of low-density lipoprotein cholesterol and urinary content of microalbumin (P<0.05). The total mortality rate during follow-up was 6.87%(18/262). [JP+1]The all-cause mortality rate [15.49%(11/71) vs 3.66%(7/191); P=0.002] and CHD mortality [9.86%(7/71) vs 1.57%(3/191); P=0.005] was obviously increased in the 24 h AHR≥75 times/min group than the 24 h AHR<75 times/min group. Kaplan-Meier survival analysis showed that the cumulative survival rate of patients with 24 h AHR≥75 times/min was statistically lower than that of the patients with 24 h AHR<75 times/min (P=0.001). Multivariate Cox proportional hazard model analysis showed that after adjustment for confounding factors, 24 h AHR≥75 times/min (HR=4.604, 95%CI 1.343-15.784; P=0.015) and smoking (HR=3.943,5%CI 1.009-15.412; P=0.049) were determined as independent risk factors for all-cause death in the elderly CHD patients. Conclusion The all-cause mortality is significantly increased in the elderly CHD patients with 24 h AHR≥75 times/min. So, the mortality may be reduced by controlling 24 h AHR and quitting smoking.
查看全文    下载PDF阅读器
关闭