心率与急性心肌梗死心源性休克发生率的关系

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）患者心源性休克发生率的影响。方法全面收集国内发表的有关AMI患者静息心率与心源性休克关系的文献，对符合条件的所有研究结果利用Rev Man软件进行固定效应模型和随机效应模型的Meta分析。计算AMI患者心率慢组相对心率快组发生心源性休克的危险（RR），评价心率快慢对AMI患者心源性休克发生的影响，并用漏斗图分析发表偏倚。结果符合纳入标准的共5篇文献，总样本量586例。其中心率慢组295例，发生心源性休克24例；心率快组291例，发生心源性休克38例；合并RR=0．63，95％可信区间是（0．39—1．00）。漏斗图分析提示不存在发表偏倚。结论AMI患者心率水平与心源性休克发生之间存在关联，AMI后心率增快者发生心源性休克危险增加，减慢心率可能减少心源性休克发生的风险。

Relationship between heart rate and incidence rate of acute myocardial infarction cardiogenic shock I

Objective To determine the influence of heart rate on cardiac shock incidence in chinese population with acute myocardial infarction by Meta analysis. Methods Published a comprehensive collection of domestic resting literature a-bout AMI patients with cardiogenic shock the heart rate relationship,fixed effects model and random effects model of Meta-anal- ysis for the results of all studies using RevMan software qualifying. Calculated the eardiogenie shock occurs relative risk （RR） of slow heart rate group and rapid heart rate group in patients with AMI, evaluated cardiogenic shock occurs impact of patients with heart rate speed for AMI and analyzed the publication bias using funnel plots, and analyzed of publication bias using fun- nel plots. Results Met the inclusion criteria of five documents ,the total sample size of 586 cases. Which slow heart rate group 295 cases,24 cases of cardiogenic shock occurs;rapid heart rate group 291 cases,38 cases of eardiogenic shock occurs;com-bined RR = 0.63,95% confidence interval （0.39-1.00）. Funnel plot analysis suggests there is no publication bias. Con-clusion There is a correlation between heart rate level and cardiac shock occurrence in AMI patients. Cardiac shock is im-paired in heart rate quick patients. Slow down the heart rate may reduce the risk of cardiac shock.