我国急性心肌梗死患者心率水平与病死率关系的Meta分析

【目的】采用Meta分析的方法确定我国人群心率水平对急性心肌梗死（AMI）患者病死率的影响，为AMI临床治疗的选择提供参考依据。【方法】全面收集国内发表的有关AMI患者静息心率与病死率关系的流行病学研究资料，对符合条件的所有研究结果利用RevMan软件进行固定效应模型和随机效应模型的Meta分析。计算AMI患者心率慢组（〈80次／分钟）和相对心率快组（〉80次／分钟）发生死亡的相对危险（RR），评价心率快慢对AMI患者生存的影响，并用漏斗图分析发表性偏倚。【结果】符合纳入标准的共11篇文献，总样本量3484例。其中心率慢组2389例，死亡198例；心率快组1095例，死亡226例；合并RR=0．33，95％可信区间是（0．27～0．40）。漏斗图分析提示不存在发表性偏倚。【结论】AMI患者心率水平与病死率之间存在关联。AMI后心率增快者死亡危险增加，心率可能作为评估AMI患者预后的指标之一。

Relationship Between Heart Rate and the Fatality of Patients with Acute Myocardial Infarction in China

[Objective]To determine the influence of heart rate level of Chinese people on the fatality of patients with acute myocardial infarction（AMI） by using meta analysis so as to provide a reference for elinical treatment of AMI. [Methods]A comprehensive collection of epidemiological literatures about the relationship between resting heart rate and fatality of AMI patients published in our country was carried out. All research results in accordance with the condition were taken for meta analysis by using RevMan software with fixed effect model and random effect model. The relative risk（RR） of death in AMI patients of slow heart rate group （〈80 times per second） to quick heart rate group（〉80 times per second） was calculated. The influence of heart rate level on the survival of AMI patients was evaluated. The publication bias was analyzed by funnel plot. [Results]Eleven literatures were enrolled in the standard. The total samples were 3484 patients. Among them, 2389 patients were slow heart rate, and 1095 patients were quick heart rate, and 198 patients died. The RR was 0.33, and 95 % confidence interval was 0.27-0.40. Funnel plot analysis showed no publication bias. [Conclusion]There is a correlation between heart rate level and fatality in AMI patients. The risk of death in AMI patients with quick heart rate is increased. Heart rate may be a forecasting marker to assess the prognosis of AMI.