绝经后女性静息心率与冠状动脉钙化相关性研究

目的研究静息心率(RHR)与冠状动脉钙化(CAC)的相关性。方法以2010年1月~2012年10月西安市自愿参与此项健康研究的1535例绝经后女性作为研究对象,根据不同的RHR分为四组:<70次/min组(对照组)、70~79次/min组、80~89次/min组、≥90次/min组。电话随访1年后,对进入最终分析的1021例女性,应用CS2000全息同步12导动态心电分析CAC水平,并对糖尿病、高血压患者比率、三酰甘油(TG)及总胆固醇(TC)水平进行检测,使用化学发光法检测了血浆同型半胱氨酸(Hcy)和叶酸(FA)水平。结果数据分析显示,CAC面积随着RHR加快而增大,RHR≥90次/min组CAC>0患者比率约为76.5%,显著高于<70次/min组(39.9%)、70~79次/min组(38.5%)、80~89次/min组(51.7%),差异均有统计学意义(P<0.05);血管钙化患者统计显示,随着RHR加快,血管钙化数逐渐增多,且≥90次/min组钙化血管支数为2和3的患者所占比率(29.0%、32.1%)约为钙化血管支数为1(15.4%)的患者的2倍;绝经后女性RHR≥90次/min组糖尿病、高血压患者比率(41.9%、72.2%)和TG[(4.82±1.03)mmol/L]、TC[(2.97±0.64)mmol/L]水平明显高于其他各组,差异有统计学意义(P<0.05)。此外结果证实,血浆Hcy水平为随着RHR加快而升高,同时FA逐渐降低,分析显示Hcy和FA同为CAC的危险因素(RR=2.05、0.95,P<0.05)。结论本研究证实绝经后女性RHR越快,CAC的危险性越高,并可能通过调节Hcy和FA的水平来实现的,因此本文将为临床上动脉粥样硬化的预测提供新的靶向研究方向。

Investigate of correlations between resting heart rate and coronary artery calcification in postmenopausal women

Objective To explore the association between resting heart rate（RHR） and coronary artery calcification（CAC） in postmenopausal women. Methods A single-center registry strategy was used and 1535 postmenopausal women voluntarily participated in this study from January 2010 to October 2012 in Xi＇an City were as study objects, and they were divided into four gmups ： RHR： 70 times/min group（control group）, 70-79 times/min group, 80-89 times/min group, and ≥ 90 times/min group. After one year followed up by telephone, the CAC of 1021 women entered into the final analysis, and was estimated by holographic synchronous 12 lead holter. Then the ratio of diabetes, hypertension, triacylglycerol（TG） and total cholesterol（TC） level of each group was tested. Levels of Hcy and FA were analyzed by the method of Chemiluminescence. Results The statistical analysis showed that the area of CAC was gradually upregulated with the increasing ratio of RHR, and the ratio of patients with CAC 0 was about 76.5% in patientes of RHR ≥ 90 times/min group, significantly higher than the ratio of the 70 times/min group（39.9%）; 70-79 times/min group（38.5%）; 80-89 times/min group（51.7%）, indicated an obvious correlation between baseline RHR and CAC（P 0.05）. Statistics of vascular calcification in patients showed that the number of vascular calcification increased along with the quickening of RHR. Moreover, the ratio of patients in ≥ 90 times/min group with 2（29.0%） and 3（32.1%）vascular calcification were almost double the rate of patients with 1 vascular calcification（15.4%）. Further analysis confirmed that the ratio of diabetes, hypertension, TG and TC level in ≥ 90 times/min group [41.9%, 72.2%,（4.82±1.03） mmol/L,（2.97±0.64） mmol/L] were significantly higher than other groups（P 0.05）. Beside, the results showed that the level of Hcy was increased with the quickening of RHR, and the level of FA was decreased simultaneously. Further analysis showed that Hcy and FA were risk factors of CAC（RR=2.05, 0.95,P 0.05）. Conclusion postmenopausal women with an elevated RHR have a significantly higher odds for the presence of calcified CAC, and may be regulated by Hcy and FA levels. Therefore, this study may provide a new target for clinical stuty of atherosclerosis.