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慢性肾衰血液透析患者血浆儿茶酚胺水平及其心率变异性分析(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第4期
页码:
288-289，292
栏目:
论著
出版日期:
2001-07-01

文章信息/Info

Title:
Plasma catecholamines level and analysis of heart rate variability in patients with chronic renal failure on hemodialysis
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:
慢性肾衰;  血液透析;  自主神经系统;  心率变异性;  儿茶酚胺
Keywords:
chronic renal failure;  hemodialysis;  autonomic nervous system;  heart rate variability; catecholamines
分类号:
R540. 41　
DOI:
-
文献标识码:
A
摘要:
目的 观察心透患者血浆儿茶酚胺水平与心率变异性, 并探讨两者的相关性。方法 测定慢性肾衰血透患者血浆儿茶酚胺水平及记录24 h 动态心电图, 分析其心率变异性。结果 慢性肾衰血液透析患者血浆多巴胺和去甲肾上腺素水平较对照组明显升高(分别为P < 0. 01 和P ≤0. 05) ; 心率变异性时域指标SDNN , SDANN , SDNN index 及rMSSD 均较对照组明显降低(P < 0. 01) ; 血浆多巴胺水平与HRV 呈明显的负相关(SDNN: r= - 0. 45, P≤0. 01; SDANN: r=-0. 43, P≤0. 01; SDNN index: r=-0. 51, P<0. 01; rMSSD: r=-0. 49, P<0. 01) , 血浆去甲肾上腺素水平亦呈类似的相关性。结论 尿毒症心脏交感神经病变以血浆儿茶酚胺水平升高和心率变异性降低为特点, 提示交感神经作用代偿性增强.
Abstract:
AIM To characterize uremic cardiac autonomic neuropathy. METHODS We measured plasma catecholamines and analyzed the 24-hour heart rate variability (HRV) in 45 patients with chronic renal failure on hemodialysis and in 16 controls. Time-domain measures were calculated. RESUITS Compared with controls, plasmadopamine and norepinephrine levels were elevated (P<0. 01 and P≤0. 05, respectively) , all the time-domain measures of HRV were reduced in the patients (P<0. 01) , and the plasma concent ration of dopamine showed a significant negative correlation with all four measures of HRV (SDNN: r=-0. 45, P≤0. 01; SDANN: r=-0143, P≤0. 01; SDNN index: r=-0. 51, P<0. 001; rMSSD: r=-0. 49, P<0. 01). Plasma norepinephrine also showed a similar correlation. CONCLOSION Uremic cardiac autonomic neuropathy may be characterized by high plasm a levels of dopamine and norepinephrine, andreduced HRV , suggesting cardiac sympathetic overactivity.

参考文献/References

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[3] 朱　军, 赵正辉, 王跃民, 等. 慢性肾衰血液透析患者心率变异性及其影响因素分析[J]. 心脏杂志, 2001, 13(4): 285- 287.

[4] Takahashi H, Matsuo S, Toriyama T, et al. Autonomic dysfunction in hemodialysis patients with persistent hypotension[J]. Nephron, 1996, 72 (3): 418-423.

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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