中国血液净化 ›› 2012, Vol. 11 ›› Issue (05): 259-262.doi: 10.3969/j.issn.1671-4091.2012.05.00

• 临床研究 • 上一篇    下一篇

血液透析频率对终末期肾病患者心率变异性的影响

陈晓婉 沈 阳 李 智   

  1. 广东省潮州市潮州医院
  • 收稿日期:2011-11-28 修回日期:1900-01-01 出版日期:2012-05-12 发布日期:2012-05-12
  • 通讯作者: 李智 lizhi519@126.com

Impact of hemodialysis frequency on heart rate variability in patients with end stage of renal disease

CHEN Xiao-wan, SHEN Yang, LI Zhi   

  • Received:2011-11-28 Revised:1900-01-01 Online:2012-05-12 Published:2012-05-12

摘要: 摘要目的探讨终末期肾病患者不同血液透析频率对心率变异性(HRV)的影响及血液透析前后心率变异性的变化。 方法 收集规律透析患者107例,根据透析频率将患者分为1次/2d(Q2d组,共40例)、1次/3d(Q3d组,共37例)及1次/4d(Q4d组,共30例),3组患者透析前后各HRV指标并进行对比分析。 结果 3组患者透析后各HRV指标均出现升高,以Q2d组及Q3d组升高明显[Q2d:相邻RR间期相差>50ms的个数占总心跳次数的百分比(PNN50)7.01±3.21 比 6.19±2.56 P0.05,24h,全部正常RR间期的标准差(SDNN)135.11±21.98 比105.29±20.78 P0.01,相邻RR间期差值均方的平方根(RMSSD)80.78±17.96比 67.66±16.87 P0.01, 24h内每5min的RR间期平均值的标准差119.22±23.41 比 108.32±21.20 P0.05,全部相邻RR间期之差的标准差(SDSD)77.38±17.78 比 68.29±18.48 P0.05];Q3d:SDNN 128.65±23.79 比 101.32±19.88 P0.01,RMSSD 74.69±16.56 比 65.36±15.19 P0.05,SDANN 116.33±21.01 比105.54±21.07 P0.05,SDSD 73.19±17.33 比 65.17±16.08 P0.05;Q4d:SDNN 107.16±20.04 比 90.86±19.54 P0.05,RMSSD 66.74±17.82 比 58.63±15.88 P0.05),透析前、后3组患者间的方差分析结果显示组间的差别有统计学意义(透析前:PNN50、SDNN、RMSSD、SDANN、SDSD的F值分别为2.96、   3.65、3.09、3.34、2.90,P<0.05;透析后:PNN50、SDNN、RMSSD、SDANN、SDSD的F值分别为2.96、3.65、3.09、3.34、2.90,P<0.05),且随着透析次数减少HRV有降低趋势。 结论 长期充分的血液透析可能有助于心脏自主神经功能的改善。

关键词: 终末期肾病, 血液透析, 心率变异性

Abstract: AbstractAims To explore the impact of hemodialysis and hemodialysis frequency on heart rate variability (HRV) in patients with end stage renal disease.  Methods A total of 107 patients treated with regular hemodialysis were enrolled in this study. They were assigned into 3 groups according to the hemodialysis frequency: Q2d group (once every 2 days), Q3d group (once every 3 days) and Q4d group (once every 4 days). The parameters of HRV were compared between the 3 groups. Results The parameters of HRV were increase after hemodialysis in all patients (P0.05), especially in Q2d and Q3d groups (P0.01). Analysis of variance showed that there were significant differences in HRV parameters between the 3 groups before and after hemodialysis (P0.05). HRV tended downwards when hemodialysis frequency decreased.  Conclusions Long term and adequate hemodialysis may be useful for the improvement of heart autonomic function.

Key words: End stage of renal disease, Hemodialysis, Heart rate variability