[1]邵俊丽.静息心率与脑卒中关系的研究[J].医学信息,2018,(16):16-20.[doi:10.3969/j.issn.1006-1959.2018.16.006]
 SHAO Jun-li.Research on Relationship between Resting Heart Rate and Stroke[J].Medical Information,2018,(16):16-20.[doi:10.3969/j.issn.1006-1959.2018.16.006]
点击复制

静息心率与脑卒中关系的研究()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
期数:
2018年16期
页码:
16-20
栏目:
综述
出版日期:
2018-08-15

文章信息/Info

Title:
Research on Relationship between Resting Heart Rate and Stroke
文章编号:
1006-1959(2018)16-0016-05
作者:
邵俊丽
江苏无锡长江康复医院医疗康复科,江苏 无锡 214002
Author(s):
SHAO Jun-li
Department of Medical Rehabilitation,Changjiang Rehabilitation Hospital,Wuxi 214002,Jiangsu,China
关键词:
静息心率脑卒中β受体阻滞剂
Keywords:
Key words:Resting heart rateStrokeβ receptor blockers
分类号:
R743.3
DOI:
10.3969/j.issn.1006-1959.2018.16.006
文献标志码:
A
摘要:
静息心率与脑卒中相关危险因素,包括高血压、脂代谢异常、糖尿病、颈动脉粥样硬化性疾病等各方面均密切相关。机制在于交感神经过度激活,改变血压的昼夜节律、血流剪切力升高长期作用、颈动脉内-中膜的增厚相关、血管的内皮功能受损、各种炎症标志物、血管内斑块的形成等。治疗上,各大指南共识在原发疾病的基础上均确定了目标心率。β受体阻滞剂在降压治疗的同时可减慢心率,但要注意应个体化处理。静息心率是高血压患者预后的独立预测因子,降低静息心率可减少脑卒中的发生率及远期预后。
Abstract:
Abstract:Resting heart rate is closely related to stroke-related risk factors,including hypertension,dyslipidemia,diabetes,carotid atherosclerosis and so on.The mechanism lies in over-activation of the sympathetic nerve,changing the circadian rhythm of blood pressure,long-term effect of elevated blood flow shear stress,thickening of the carotid intima-media,impaired vascular endothelial function,various inflammatory markers,formation of intravascular plaques and so on.In terms of treatment,it is agreed that the target heart rate is determined on the basis of primary diseases.β receptor blockers can slow down heart rate while lowering blood pressure, but individual treatment should be paid attention to.Resting heart rate is an independent predictor of prognosis in patients with hypertension.Decreasing resting heart rate can reduce the incidence of stroke and long-term prognosis.

参考文献/References:

[1]黄元铸.心率与心血管病危险性[J].中华心血管病杂志,2005,33(4):388-390.
[2]Gillman MW,Kannel WB,Belanger A.Influence of heart rate on mortality among persons with hypertension:The Framingham Study[J].Am Heart J,1993,125(4):1148-1154.
[3]Palatini P,Thijs L,Staessen JA,et al.Predictive value of clinic and ambulatory heart rate for mortality in elderly subjects with systolic hypertension[J].Arch Intern Med,2002,162(20):2313-2321.
[4]Paul L,Hastie CE,Li WS,et al.Resting heart rate pattern during follow-up and mortality in hypertensive patients[J].Hypertension,2010,55(2):567-574.
[5]Okin PM,Kjeldsen SE,Julius S.All-cause and cardiovascular mortality in relation to changing heart rate during treatment of hypertensive patients with electrocardiographic left ventricular hypertrophy[J].Eur Heart J,2010,31(18):2271-2279.
[6]Julius S,Palatini P,Kjeldsen SE,et al.Usefulness of heart rate to predict cardiac events in treated patients with high-risk systemic hypertension[J].Am J Cardiol,2012,109(5):685-692.
[7]孙宁玲,王鸿懿,霍勇.我国高血压专病门诊患者血压控制及糖代谢调查现状分析[J].中华内科杂志,2013,52(8):654-658.
[8]马斌,王瑞英.静息心率与心血管疾病的研究进展[J].心血管病学进展,2006,27(s1):90-92.
[9]高竞生,刘小雪,王安心,等.静息心率与新发高血压的关系[J].中华高血压杂志,2014,22(4):347-352.
[10]Fox K,Ford I,Steg PG,et al.Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction(BEAUTIFUL):a randomised,double-blind,placebo-controlled trial[J].Lancet,2008,372(9641):807-816.
[11]鲁燕,王瑞英,许志红.高血压病人静息心率与血管内皮功能的相关性研究[J].中西医结合心脑血管病杂志,2011,09(2):137-138.
[12]李波,纳志英,张红珊,等.老年高血压患者静息心率与心率变异性及动态血压的相关研究[J].中国心血管病研究,2011,09(1):18-20.
[13]Menown IBA,Davies S,Gupta S,et al.Resting Heart Rate and Outcomes in Patients with Cardiovascular Disease:Where Do We Currently Stand[J].Cardiovascular Therapeutics,2013,31(4):215-223.
[14]韩硕,张一径,张学颖,等.静息心率与代谢综合征相关性研究[J].中国实用内科杂志,2015(6):540-541.
[15]王亚蓉,张丕德,韦建瑞,等.原发性高血压患者静息心率与血脂及靶器官损害的相关性研究[J].广东药学院学报,2006,22(3):328-330.
[16]王增武,陈祚,王馨,等.西藏新疆地区静息心率和血脂、血糖的关系研究[J].心脑血管病防治,2017,17(2):89-92.
[17]Carnethon MR,Golden SH,Folsom AR,et al.Prospective investigation of autonomic nervous system function and the development of type 2 diabetes:the Atherosclerosis Risk In Communities study,1987-1998[J].Circulation,2003,107(17):2190-2195.
[18]李燕来,马艳庆,孙继超,等.静息心率升高对中老年人群患糖尿病的风险研究[J].中国实用内科杂志,2014(9):900-903.
[19]马庆华,辛柏青,马亚娜,等.老年人静息心率过快与糖尿病发病关系的队列研究[J].中国初级卫生保健,2014,28(10):77-79.
[20]Yang Z,Xu B,Lu J,et al.Autonomic test by EZSCAN in the screening for prediabetes and diabetes[J].PLoS One,2013,8(2):e56480.
[21]Carnethon MR,Prineas RJ,Temprosa M,et al.The Association Among Autonomic Nervous System Function,Incident Diabetes,and Intervention Arm in the Diabetes Prevention Program[J].Diabetes Care,2006,29(4):914-919.
[22]Emdin M,Gastaldelli A,Muscelli E,et al.Hyperinsulinemia and Autonomic Nervous System Dysfunction in Obesity Effects of Weight Loss[J].Circulation,2001,103(4):513-519.
[23]王盼盼,李玉倩,刘晓田,等.静息心率与2型糖尿病发病风险的Meta分析[J].中华疾病控制杂志,2017,21(3):245-249.
[24]刘俊,姚欢.高血压病患者颈动脉内膜中层厚度与静息心率的关系[J].中国医师进修杂志,2005,28(19):39-42.
[25]Hildenbrand FF,Fauchère I,Huber LC,et al.A low resting heart rate at diagnosis predicts favourable long-term outcome in pulmonary arterial and chronic thromboembolic pulmonary hypertension.A prospective observational study[J].Respiratory Research,2012,13(1):76.
[26]张小琴,郁晖丽,秦磊,等.高血压患者静息心率与血压昼夜节律的相关性[J].临床心电学杂志,2012,21(4):260-262.
[27]秦磊,张小琴,郑雪梅,等.静息心率与高血压颈动脉内膜厚度的相关性[J].临床心电学杂志,2011,20(1):27-29.
[28]侯文静,王晓飞,孙晓燕,等.中老年高血压患者静息心率与颈动脉粥样硬化的相关性[J].实用医学杂志,2017,33(18):3040-3044.
[29]黄宇玲,王志军,刘雪梅,等.静息心率与中老年人群颈动脉斑块检出率的关系[J].中华高血压杂志,2014(9):841-846.
[30]Custodis F,Schirmer SH,Baumhkel M,et al.Vascular pathophysiology in response to increased heart rate[J].Journal of the American College of Cardiology,2010,56(24):1973-1983.
[31]Palatini P,Julius S.The physiological determinants and risk correlations of elevated heart rate[J].American Journal of Hypertension,1999,12(S1):3S-8S.
[32]Castagno D,Skali H,Takeuchi M,et al.Association of Heart Rate and Outcomes in a Broad Spectrum of Patients With Chronic Heart Failure:Results From the CHARM(Candesartan in Heart Failure:Assessment of Reduction in Mortality and morbidity)Program[J].Journal of the American College of Cardiology,2012,59(20):1785-1795.
[33]Dominguez-Rodriguez A,Blanco-Palacios G,Abreu-Gonzalez P.Increased heart rate and atherosclerosis:potential implications of ivabradine therapy[J].World J Cardiol,2011,3(4):101-104.
[34]Woodward M,Webster R,Murakami Y,et al.The association between resting heart rate,cardiovascular disease and mortality:evidence from 112,680 men and women in 12 cohorts[J].Eur J Prev Cardiol,2014,21(6):719-726.
[35]Whelton SP,Blankstein R,Al-Mallah MH,et al.Association of resting heart rate with carotid and aortic arterial stiffness:multi-ethnic study of atherosclerosis[J].Hypertension,2013,62(3):477-484.
[36]鲁燕,王瑞英,许志红.高血压病人静息心率与血管内皮功能的相关性研究[J].中西医结合心脑血管病杂志,2011,09(2):137-138.
[37]Rogowski O,Shapira I,Shirom A,et al.Heart rate and microinflammation in men:a relevant atherothrombotic link[J].Heart,2007,93(8):940-944.
[38]Bhm M,Reil JC,Danchin N,et al.Association of heart rate with microalbuminuria in cardiovascular risk patients:data from I-SEARCH[J].Journal of Hypertension,2008,26(1):18.
[39]Custodis F,Baumhkel M,Schlimmer N,et al.Heart Rate Reduction by Ivabradine Reduces Oxidative Stress,Improves Endothelial Function,and Prevents Atherosclerosis in Apolipoprotein E-Deficient Mice[J].Circulation,2008,117(18):2377-2387.
[40]Baumhkel M,Custodis F,Schlimmer N,et al.Heart rate reduction with ivabradine improves erectile dysfunction in parallel to decrease in atherosclerotic plaque load in ApoE-knockout mice[J].Atherosclerosis,2010,212(1):55-62.
[41]Heidland UE,Strauer BE.Left Ventricular Muscle Mass and Elevated Heart Rate Are Associated With Coronary Plaque Disruption[J].Circulation,2001,104(13):1477-1482.
[42]Taylor AJ,Al-Saadi N,Abdel-Aty H,et al.Elective percutaneous coronary intervention immediately impairs resting microvascular perfusion assessed by cardiac magnetic resonance imaging[J].American Heart Journal,2006,151(4):1-7.
[43]郭宝玉,李建红.血压昼夜节律与心率变异对脑卒中患者的影响[J].临床医药实践,2014,23(3):200-201.
[44]刘小英,侯玉立,彭瑞华,等.心率减速力及心率变异对脑卒中患者的临床意义[J].中国药物与临床,2014,14(4):516-517.
[45]Tochikubo O,Mizushima S,Watanabe J,et al.Base heart rate during sleep in hypertensive and normotensive subjects[J].Journal of Hypertension,2001,19(6):1131-1137.
[46]丁立,何国厚,李承晏.静息心率与脑梗死患者颈动脉内-中膜厚度的关系[J].湖北医药学院学报,2010,29(1):22-24.
[47]唐文红,张琴,陈晓婕,等.脑梗死患者静息心率与颈动脉病变相关性分析[J].广东医学,2011,32(19):2531-2533.
[48]孙宁玲,霍勇,黄峻.中国高血压患者心率现状调查[J].中华高血压杂志,2015(10):934-939.
[49]Tomlinson B,Dalal JJ,Huang J,et al.The role of β-blockers in the management of hypertension:An Asian perspective[J].Current Medical Research and Opinion,2011,27(5):1021-1033.
[50]Park BJ,Lee HR,Shim JY,et al.Association between resting heart rate and arterial stiffness in Korean adults[J].Archives of Cardiovascular Diseases,2010,103(103):246-252.
[51]王文.血压患者目标心率是<70还是<80次/min?[J].中华高血压杂志,2014,22(6):507-510.
[52]Chiang CE,Wang TD,Ueng KC,et al.2015 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension[J].Journal of the Chinese Medical Association,2015,78(1):1-47.
[53]杨庆华,章茹.倍他乐克联合他汀类药物治疗颈动脉粥样硬化的疗效观察[J].实用心脑肺血管病杂志,2014,22(3):34-35.
[54]冯颖青,李勇,张宇清,等.β受体阻滞剂在高血压应用中的专家指导建议[J].慢性病学杂志,2013,5(11):58-66.
[55]Ding FH,Li Y,Li LH,et al.Impact of heart rate on central hemo-dynamics and stroke:a Meta-analysis of β-blocker trials[J].Am J Hypertens,2013,26(1):118-125.
[56]沈法荣.β受体阻滞剂临床选择:我们应该关注什么?[J].中华高血压杂志,2012,20(7):619-621.
[57]Bangalore S,Sawhney S,Messerli FH.Relation of beta-blocker-induced heart rate lowering and cardioprotection in hypertension[J].Journal of the American College of Cardiology,2008,52(18):1482-1489.
[58]Fongemie J,Felix-Getzik E.A review of nebivolol pharmacology and clinical evi-dence[J].Drugs,2015,75(12):1349-1371.
[59]Park KH,Park WJ.Endothelial dysfunction:clinical implications in cardiovascu-lar disease and therapeutic approaches[J].J Korean Med Sci,2015,30(9):1213-1225.
[60]Howlett JG.Nebivolol:vasodilator properties and evidence for relevance in treatment of cardiovascular disease[J].Canadian Journal of Cardiology,2014,30(5):29-37.
[61]Hildenbrand FF,Fauchère I,Huber LC,et al.A low resting heart rate at diagnosis predicts favourable long-term outcome in pulmonary arterial and chronic thromboembolic pulmonary hypertension.A prospective observational study[J].Respiratory Research,2012,13(1):76.
[62]Bhm M,Cotton D,Foster L,et al.Impact of resting heart rate on mortality,disability and cognitive decline in patients after ischaemic stroke[J].European Heart Journal,2012,33(22):2804.
[63]Kjeldsen SE,Okin PM.High resting heart rate predicts mortality,disability,and cognitive decline in patients after ischaemic stroke:time for additional selective I(f) channel inhibitor trials?[J].European Heart Journal,2012,33(22):2761-2763.
[64]石义永,何宏梅,林传鸿,等.静息心率对缺血性脑卒中患者预后的影响[J].中国医药导报,2016,13(20):115-119.
[65]Black HR,Elliott WJ,Granditis G,et al.Principal results of the controlled onset verapamil investigation of cardiovascular end points(CONVINCE)trial[J].JAMA,2003,12(4):2073-2082.
[66]曾进胜,黄如训,苏镇培.实验性高血压所致的脑卒中与静息心率的关系[J].中华高血压杂志,1997(4):004.

相似文献/References:

[1]尹美丽.早期康复护理对脑卒中临床疗效及偏瘫肢体功能的影响分析[J].医学信息,2018,(05):167.[doi:10.3969/j.issn.1006-1959.2018.05.061]
 YIN Mei-li.Effect of Early Rehabilitation Nursing on Clinical Effect of Stroke and Limb Function of Hemiplegia[J].Medical Information,2018,(16):167.[doi:10.3969/j.issn.1006-1959.2018.05.061]
[2]杨立丹,吴 敬,王学军.调神益髓针刺法结合康复训练治疗脑卒中后 平衡功能障碍的临床分析[J].医学信息,2018,(07):143.[doi:10.3969/j.issn.1006-1959.2018.07.049]
 YANG Li-dan,WU Jing,WANG Xue-jun.Clinical Analysis of Treatment of Balance Dysfunction after Stroke by Acupuncture of Regulating Spirit and Supplementing Pulp Combined with Rehabilitation Training[J].Medical Information,2018,(16):143.[doi:10.3969/j.issn.1006-1959.2018.07.049]
[3]王晓强,张艳军,贾 琎,等.早期康复介入与脑卒中合并代谢综合征患者并发症的关系[J].医学信息,2018,(08):96.[doi:10.3969/j.issn.1006-1959.2018.08.030]
 WANG Xiao-qiang,ZHANG Yan-jun,JIA Jin,et al.Relationship between Early Rehabilitation Intervention and Complications in Stroke Patients with Metabolic Syndrome[J].Medical Information,2018,(16):96.[doi:10.3969/j.issn.1006-1959.2018.08.030]
[4]李娅娜,曹 岚,徐 影,等.四肢联动联合虚拟现实训练对脑卒中恢复期患者 下肢功能与平衡功能的影响[J].医学信息,2018,(14):107.[doi:10.3969/j.issn.1006-1959.2018.14.031]
 LI Ya-na,CAO Lan,XU Ying,et al.Effects of Limb Linkage and Virtual Reality Training on Lower Limb Function and Balance Function in Stroke Patients during Convalescence[J].Medical Information,2018,(16):107.[doi:10.3969/j.issn.1006-1959.2018.14.031]
[5]张怀祥,段晓宇.脑梗死后认知障碍的病理学机制、相关危险因素及治疗[J].医学信息,2018,(16):21.[doi:10.3969/j.issn.1006-1959.2018.16.007]
 ZHANG Huai-xiang,DUAN Xiao-yu.Pathological Mechanism,Related Risk Factors and Treatment of Cognitive Impairment after Cerebral Infarction[J].Medical Information,2018,(16):21.[doi:10.3969/j.issn.1006-1959.2018.16.007]
[6]平兴团,赵富强,杨 飞,等.家庭康复管理对卒中患者运动功能恢复的远期影响[J].医学信息,2018,(16):66.[doi:10.3969/j.issn.1006-1959.2018.16.018]
 PING Xing-tuan,ZHAO Fu-qiang,YANG Fei,et al.Long-term Effects of Family Rehabilitation Management on Recovery of Motor Function in Stroke Patients[J].Medical Information,2018,(16):66.[doi:10.3969/j.issn.1006-1959.2018.16.018]
[7]刘 萍,傅继红.30°斜坡式自动充气枕在鼻饲脑卒中 患者体位管理的可行性研究[J].医学信息,2018,(17):170.[doi:10.3969/j.issn.1006-1959.2018.17.054]
 LIU Ping,FU Ji-hong.Feasibility Study on the Position Management of 30°Slope Automatic Inflatable Pillow in Patients with Nasal Feeding Stroke[J].Medical Information,2018,(16):170.[doi:10.3969/j.issn.1006-1959.2018.17.054]
[8]赵富强,平兴团,杨 飞,等.重心重塑训练对Pusher综合征的疗效观察[J].医学信息,2018,(20):94.[doi:10.3969/j.issn.1006-1959.2018.20.027]
 ZHAO Fu-qiang,PING Xing-tuan,YANG Fei,et al.Therapeutic Effect of Center of Gravity Remodeling Training on Pusher Syndrome[J].Medical Information,2018,(16):94.[doi:10.3969/j.issn.1006-1959.2018.20.027]
[9]包娜娜,刘 超.高频重复经颅磁刺激对后遗症期脑卒中后吞咽功能障碍的疗效观察[J].医学信息,2018,(22):104.[doi:10.3969/j.issn.1006-1959.2018.22.028]
 BAO Na-na,LIU Chao.Therapeutic Effect of High Frequency Repetitive Transcranial Magnetic Stimulation on Deglutition Disorders after Sequelae Stroke[J].Medical Information,2018,(16):104.[doi:10.3969/j.issn.1006-1959.2018.22.028]
[10]王 瑜,方勇斌.吞咽治疗仪治疗脑卒中后吞咽障碍的临床研究[J].医学信息,2018,(22):115.[doi:10.3969/j.issn.1006-1959.2018.22.032]
 WANG Yu,FANG Yong-bin.Clinical Study of Swallowing Therapy Apparatus in Treating Dysphagia after Stroke[J].Medical Information,2018,(16):115.[doi:10.3969/j.issn.1006-1959.2018.22.032]

更新日期/Last Update: 2018-08-15