心率与心肌梗死患者再梗死率的关系

Impact of Heart Rate on Reinfarction Incidence in Patients with Myocardial Infarction in China

目的采用meta分析（metaanalysis）的方法确定我国人群心率与急性心肌梗死（acutemyocardiainfarc—tion，AMl）患者再梗死率的关系，为临床预防再梗死提供参考依据。方法全面收集国内发表的有关AMI患者心率与再梗死关系的文献，对符合条件的研究结果进行meta分析。计算AMI患者心率慢组相对心率快组发生再梗死的相对危险度（relativerisk，RR），评价心率与再梗死的关系。结果符合纳入标准的共9篇文献，总样本量2314例。其中心率慢组1211例，发生再梗死59例；心率快组1103例，发生再梗死154例；RR=0．31，95％可信区间（0．24～0．42）。漏斗图分析提示不存在发表性偏倚。结论AMI后心率增快者发生再梗死危险增加，减慢心率能减少再梗死发生的风险。

Objective To determine the influence of heart rate on reinfarction incidence in Chinese population with acute myocardial infarction （AMI） by meta analysis. Methods A comprehensive collection of the domestically published literatures on the relationship between resting heart rate and reinfarction in AMI patients was carried out. Meta analysis was performed by using RevMan software. The relative risk （RR） of reinfarction risk of AMI patients in slow heart rate group relative to quick heart rate group was calculated, and the relationship between heart rate and reinfarction was evalu- ated. Results Nine articles were included. The total sample size was 2 314, among whom 1 211 were in slow heart rate group including 59 cases with reinfarction, and 1 103 were in quick heart rate group including 154 cases with reinfarction. RR was 0. 31, and 950/00 confidence interval was （0. 24 - 0. 42）. Funnel plot analysis showed no presence of publication bi- as. Conclusion The increase of heart rate after AMI will increase the occurrence rate of reinfarction. Slowing down the heart rate may reduce the risk of reinfarction.