代谢综合征患者静息心率与靶器官损害的相关性分析研究

Correlation between Resting Heart Rate and Target Organs Damage in Patients with Metabolic Syndrome

目的探讨代谢综合征(MS)患者静息心率(RHR)与靶器官损害的关系。方法入选96例MS患者,按RHR频率不同分为3组:RHR1组:RHR<70次/min;RHR2组:70～80次/min;RHR3组:RHR>80次/min。所有研究对象测量身高、体质量、腰围、血压,采静脉血测定空腹总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),靶器官损害测定:(1)超声心动图检查(ultrasonic cardiogram,UCG):主要测量左室舒张末期内径(Dd)、左室收缩末期内径(Ds)、室间隔舒张末期厚度(IVST)、左室后壁舒张末期厚度(LVPWT)和左室射血分数(EF),并计算左室质量指数(LVMI)。(2)颈动脉超声检测其内膜中层厚度(IMT)和颈总动脉分叉处内颈(CAD)。(3)测量尿微量清蛋白及常规生化测定肌酐(Cr),计算出24h尿微量清蛋白排泄率(UAE)和内生肌酐清除率(CCr)。结果 (1)3组患者年龄、腰围、体质指数(BMI)比较,差异无统计学意义(P>0.05);(2)收缩压、TC、TG、FPG、LDL-C、空腹血浆胰岛素浓度(FINS)、胰岛素抵抗指数(HOMA-IR)随着RHR增加而增高;(3)随着RHR增加,LVMI增加,EF明显降低。RHR与LVMI呈正相关,与EF呈负相关;(4)随着RHR的增加,IMT和CAD增大,RHR与IMT和CAD呈正相关;(5)RHR与UAE呈正相关,与CCr呈负相关;(6)多元线性回归分析显示:RHR增快与靶器官损害存在线性关系,Logistic回归结果显示:RHR是MS患者靶器官损害的危险因素。结论 MS患者随着RHR的增加,与血压升高、血脂紊乱、胰岛素抵抗程度加重有关,RHR增加是代谢综合征患者靶器官损害的重要危险因素。

Objective This study was to investigate the relationship between resting heat rate and and damage of target organs in patients with Metabolic Syndrome.Methods 96 patients with Metabolic Syndrome were divided into three groups according to the level of resting heart rate,RHR 1 group:RHR<70beats/minute (bpm)(36 cases);RHR 2 group:70 bpm-<RHR<80 bpm(35 cases);RHR 3 group:RHR >80 bpm (25 cases).All patients were to assay blood pressure,fasting total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C),low-desity lipoprotein Cholesterol (LDL-C),plasma glucose (FPG),fasting insulin (FINS),were measured.target organ damage were test:All patients were observed by Color Doppler echocardiography.The intima-media thickness,Left ventricular diastole period end point,left ventricle inner diameter,left ventricular posterior wall thickness and inter-ventricular septum thickness were measured,then calculated left ventricular mass index according to Dereveux formula.All patients were observed by Color Doppler ultrasonography.The inner diameter of the common carotid artery(CCA) 、the intima-media thickness were measured.Urinary albumin excretion was also detected.Results (1) There were no significant differences in the levels of age,waist circumference and BMI in the three groups patients (P>0.01);(2) Higher lever of SP、TC、TG、FPG、LDL-C、FINS、HOMA-IR was associate with higher RHR;(3) with the higher lever RHR Higher LVMI,lower EF;RHR was positive correlated to LVMI and was negative correlated to EF;(4) with the higher lever RHR Higher IMT and CAD;RHR was positive correlated to IMT and CAD;(5) RHR was positive correlated to UAE and was negative correlated to CCr;(6) multiple linear regression show RHR and target organ damage existence linear correlation in patient with metabolic syndrome.Logistic regression show RHR is one of the important risk factors of target organ damage in patient with metabolic syndrome.Conclusion Higher lever of SP、disorder of Lipid metabolism and Nsulin Resistance was associate with higher RHR with higher RHR,higher RHR is the important factors of target organ damage in patient with metabolic syndrome.