摘要
目的：分析老年冠心病合并糖尿病患者的静息心率（RHR）控制水平与血糖水平的相关性，为老年冠心病患者二级预防的有效实施提供参考。方法入选在2011年4~7月全国21个省市165家医院门诊就诊的老年冠心病合并糖尿病患者（≥60岁）1336例，收集入选患者的一般临床资料及实验室检查指标，按照患者RHR控制水平将患者分为3组：Ⅰ组（RHR〈70次/min，n=372）、Ⅱ组（RHR：70~79次/min，n=533）、Ⅲ组（RHR≥80次/min，n=431）；记录各组相关临床资料及血糖控制情况，比较各组血糖控制目标或达标情况的差异，分析RHR与血糖指标的相关性，并利用二分类非条件Logistic回归方程探讨不同RHR控制水平与血糖控制或达标情况的关系。结果Ⅰ组、Ⅱ组、Ⅲ组患者在总体人群、男性、女性患者中HbA1c水平均存在统计学差异（F=15.436，24.270，12.340，P〈0.05），从Ⅰ组到Ⅲ组HbA1c水平依次增升高；3组患者亦在总体人群、男性、女性患者中的血糖达标率存在统计学差异（χ2=13.471，6.752，6.522，P〈0.05），Ⅲ组的血糖达标率均低于Ⅰ组；Pearson相关分析分析显示， RHR分别与空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1C）呈正相关（r=0.058，0.085，0.084，P〈0.05），多元线性回归分析提示RHR分别与FPG、2 hPG、HbA1C呈独立正相关（β=0.075，0.018，0.099，P〈0.05）；多因素Logistic回归方程显示，与RHR〈70次/min比较，RHR≥80次/min在总体人群、男性、女性患者中血糖未达标的风险值（OR）分别为1.99（95%CI∶1.23~2.37，P〈0.05）、1.81（（95%CI∶1.17~2.77，P〈0.05）、2.18（95%CI∶1.12~3.74，P〈0.05）。结论 RHR增高可能与老年冠心病合并糖尿病患者血糖增高呈正相关，可能增加了患者血糖不达标的发生风险，临床应当积极控制此类高危患者的RHR水平，以利于患者血糖控制及促进冠心病二�
Objective To explore the correlation between resting heart rate （RHR） and blood glucose level in elderly patients with coronary heart disease （CHD） complicated by diabetes mellitus. Methods Between April and July, 2011, a total of 1336 outpatients over 60 years of age recruited from 165 hospitals were asked to complete a questionnaire and received blood glucose and RHR examination. According to baseline RHR, the patients were divided into 3 groups with HRH 〈70 min- 1 （group I, 372 cases）, between 70 and 79 min-1 （group II, 533 cases）, and ≥80 min-1 （group III, 431cases） for analysis of the relationships of RHR with blood glucose control rate. Results HbA1c levels in the total, male and female patients differed significantly among the 3 groups （F=15.436, 15.436, and 24.270, respectively, P〈0.05）, and increased in the order from group I to group III. Blood glucose control rate in the total, male and female patients also differed significantly among the 3 groups （χ2=13.471, 6.752, and 6.522, respectively, P〈0.05）, and was significantly lower in group III than in group I （P〈0.05）. RHR was found to positively correlate with FPG, 2 hPG and HbA1c by Pearson correlation analysis （r=0.058, 0.085, and 0.058, respectively; P〈0.05） and multiple linear regression analysis （β=0.075, 0.075, and 0.018, respectively; P〈0.05）. Multivariable logistic regression equationshowed that compared with patients with RHR 〈70 min-1, the total, male and female patients with RHR ≥80 min-1 had OR values of blood glucose control failure of 1.99 （95%CI：1.23-2.37, P〈0.05）, 1.81 （95%CI：1.17-2.77, P〈0.05）, and 2.18 （95%CI：1.12-3.74, P〈0.05）, respectively. Conclusions RHR in elderly CHD patients with MD is positively correlated with their blood glucose level, and an increased RHR is associated with an increased risk of poor blood glucose control. Rigorous RHR control in such high-risk patients may prove beneficial for both blood glucose control and secondary preventio
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2016年第5期609-616,共8页
Journal of Southern Medical University
基金
国家重点基础研究发展计划(973)项目(2012CB517503)~~
关键词
冠心病
门诊患者
糖尿病
静息心率
血糖达标率
coronary heart disease
outpatients
diabetes mellitus
resting heart rate
blood sugar success rate
