静息心率与老年慢性心力衰竭预后的相关性分析

Study on correlation between resting heart rate and prognosis in senile patients with chronic heart failure

目的探讨老年慢性心力衰竭（CHF）患者入院时静息心率与其心功能及预后的相关性。方法选择213例老年CHF患者，按入院时静息心率（治疗前心率）分为3组：CHF 1组（静息心率48～79次／min），CHF 2组（静息心率80～99次／min），CHF3组（静息心率100～140次／min）。并在循证医学标准治疗的基础上，对其入院、出院时及随访的心功能及预后进行分析。结果老年CHF患者入院时的静息心率与出院时的疗效（相关系数-0．163；P=0．017）、随访疗效（相关系数-0．161；P=0．019）显著负相关；与总死亡率（相关系数0．162；P=0．018）显著正相关。亚组分析显示：CHF1组、2组、3组间总有效率分别为92．7％、77．5％、73．2％；1组与2、3组间比较差异有统计学意义（P=0．011；P=0．007）。总死亡率分别为7．3％、22．5％、26.8％；1组与2、3组间比较差异有统计学意义（P=0．017；P=0．009），2、3组间比较差异无统计学意义。结论静息心率可作为判断老年CHF治疗效果和预后的预测指标之一。

Objective To study correlation between resting heart rate（RHR）on admission to prognosis of heart function in senile patients with chronic heart failure（CHF）. Methods Two hundred thirteen senile cases of CHF were studied ,on the base of therapy of Evidence-Based Medicine. RHR and prognosis of heart function on admission ,discharge ,follow-up data were analyzed. According to the resting heart rate （RHR）they were divided into three groups：the first group （RHR 48-79 beats per minute）, the second group（RHR 80-99 beats per minute）and the third group（RHR 100-140 beats per minute）. Results There was negative correlation between the RHR and the curative effect（Spearman Correlation -0.163 ;P=0.017）, （Spearman Correlation -0.161 ;P=0.019 ）, but there was significant positive correlation compared with the total death rate（Spearman Correlation 0.162;P=0.018）. Subgroup analvsis showed the total effective rate in the three groups was 92.7% ,77.5% ,73.2% ,the first group was significant higher compared with the second and third group （P=0.011 ;P=0.007）. The total death rate was 7.3% ,22.5% ,26.8% ;there was significant difference between the first group and the 2nd,the 3rd group（P=0.017;P=0.009）,no significant difference in the 2nd and the 3rd group. Conclusions The RHR can be considered as one of the indexes to forecast the treatment effectiveness and prognosis in senile patients with CHF.