静息心率对急性冠状动脉综合征患者预后的评估

Prognostic Value of Resting Heart Rate in Patients with Acute Coronary Syndrome

【目的】探讨静息心率水平对急性冠状动脉综合征（Acs）患者预后的影响。【方法】入选本院2004年1月至2008年9月ACS（STEMI、NSTEMI、UA）患者265例，根据患者入院时静息心率（RHR）分为：RHR1组：60次／min≤RHR〈70次／min；RHR2组：70次／min≤RHR〈80次／min；RHR3组：80次／min≤RHR〈90次／min；RHR4组：RHR≥90次／min。以稳定性心绞痛（SAP）及健康体检组为对照组，分析静息心率与ACS及合并症、预后之间的关系。【结果】ACS组静息心率显著高于正常组[（82．66±8．34）次／minVS（71．48±8．49）次／min，P〈0．05]，合并糖尿病或高血压的ACS患者平均心率快于无合并症者（P〈0．05）。ACS患者RHR≥90次／min，随着心率增快其发生再发心绞痛及复合心血管事件显著高于RHR〈90次／min患者（P〈0．05）。【结论】RHR增快与ACS病情及预后有关，可作为评估ACS病情及预后的预测指标。

[Objective] To explore the prognostic value of resting heart rate （RHR） in patients with acute coronary syndrome（ACS）. [Methods] A total of 265 patients of acute coronary syndrome admitted to hospi tals consecutively from Jan. 2004 to Sep. 2008 were divided into four groups according to the levels of RHR. RHR1 group was 60 beats/rain （bpm） ≤ RHR 〈70 beats/min. RHR2 group was 70bpm≤RHR（80bpm. RHR3 group was 80bpm≤RHR（90bpm. RHR4 group was RHR≥90bpm. Patients with stable angina pectoris and healthy people during the same period were in control group. The relationship between RHR and complication and prognosis of ACS was analyzed. [Results] RHR in ACS group was significantly higher than that in normal group （82.66±8.34bpmvs71.48±8.49bpm, p〈0.05）. RHR in ACS patients complicated with diabetes mellitus or hypertension was higher than those with no complication （p〈0.05）. Patients with RHR≥90bpm had significantly higher levels of recurrent ischemia angina and combined cardiovascular events as compared with those with RHR〈90bpm（ P 〈0.05） during the follow up. [Conclusion]High resting heart rate is associated with the progression and prognoses of ACS, and it may be a predictor to estimate the state of ACS and prognosis.