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慢性肾衰血液透析患者心率变异性及其影响因素分析(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第4期
页码:
285-287
栏目:
论著
出版日期:
2001-07-01

文章信息/Info

Title:
Determinants of heart rate variability in chronic hemodialysis patients
作者:
朱　军1;  赵正辉1;  王跃民2;  王汉民1;  陈　威1
第四军医大学: 1. 西京医院肾内科; 2. 基础部生理学教研室, 陕西西安710032
Author(s):
ZHU Jun1;  ZHAO Zheng-hwi1; WANG Yao-min2; WANG Han-min1;  CHEN Wei1
1. Department of Nephrology, Xijing Hospital; 2. Department of Physiology, Fourth Military Medical University, Xi’an Shaanxi 710032, China
关键词:
血液透析;  心率变异性;  自主神经功能障碍
Keywords:
hemodialysis;  heart rate variability;  autonomic dysfunction
分类号:
R540. 41　
DOI:
-
文献标识码:
A
摘要:
目的 分析慢性血液透析患者的心率变异性(HRV)及其影响因素。方法 观察了80 例接受慢性血液透析治疗的患者。血液透析开始前记录24 h 动态心电图, 采用R2R 间期的标准差(SDNN ) 作为HRV 的指标。采用多元回归法, 对年龄、性别、透析前体重指数、缺血性心肌病、糖尿病肾病、吸烟、累积进行血液透析的时间、透析前平均血压、血细胞比容(Hct)、血浆尿素氮水平(BUN )、转换酶抑制剂(ACEI) 和B2受体阻滞剂的使用等12 个可能影响SDNN的独立因素进行了分析。结果 老年(P<0. 01) , 原发病为糖尿病肾病(P<0. 01) ,Hct 降低(P=0. 0122) , 透析前体重指数增加(P=0. 0132) , 长期进行血透的患者(P=0. 0201) 及吸烟者(P=0. 0345) 与SDNN 的降低呈明显的相关性。结论 除已证明的因素外, 慢性血液透析患者的肾性贫血、透析前体重指数及累计进行血液透析的时间也是患者心率变异性的独立影响因素.
Abstract:
AIM To clarify determinants of heart rate variability in hemodialysis patients,METHODS We evaluated 80 patients receiving chronic hemodialysis. Ambulatory electro-cardiogram was recorded for 24 h from the beginning of hemodialysis. Standard deviation of the normal R-R interval (SDNN ) was used as a marker of heart rate variability. Multiple regression analysis was performed to select independent variables associated with SDNN from the following 12 variables: age, sex, body mass index before hemodialysis, presence of ischemic heart disease, diabetic nephropathy as primary renal disease, smoking, duration of hemodialysis, mean blood pressure before hemodialysis, use of beta blockers, use of angiotensin-converting enzyme inhibitors, hematocrit, and blood urea nitrogen. RESULTS Older age (P<0. 01) , presence of diabetic nephropathy as primary renal disease (P<0. 01) , lower hematocrit (P=0. 0122) ,larger body mass index before hemodialysis (P=0. 0132) , longer duration of hemodialysis (P=0. 0201) , and smoking (P=0. 0345) were associated with reduced SDNN. CONCLUSION In hemodialysis patients, SDNN as a marker of cardiac autonomic modulation was associated with hematocrit, body mass index, and duration of hemodialysis, in addition to previously reported variables.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-02-26.
更新日期/Last Update: 2001-07-01