On-line血液透析滤过对维持性血液透析患者心率变异性的影响

The effect of on-line hemodiafiltration on heart rate variability in maintenance hemodialysis patients

目的探讨On-line血液透析滤过技术对维持性血液透析患者心率变异性(HRV)的影响。方法 50例维持性血液透析(MHD)患者随机分为常规血液透析治疗组(HD组)和On-line血液透析滤过治疗组(OL-HDF组),每组各25例。患者每周行3次、每次4 h的血液透析治疗或OL-HDF,治疗24个月。比较两组常规的实验室检查和24h动态心电图监测结果。结果治疗24个月后,OL-HDF组的β2-微球蛋白(β2-MG)由基线值30.1±7.2 mg/dl降至21.7±6.1 mg/dl(P<0.05),HD组的β2-MG则无明显下降。OL-HDF组HRV的时域性和频域性指标均值高于基线值(P<0.05),HD组的HRV指标则无显著性变化(P>0.05)。结论与普通血液透析比较,OL-HDF能更好地改善MHD患者的HRV,改善自主神经功能。

Objective To investigate the effects of On - 1 ine hemodiafiltration on heart rate viability of maintenance hemodialysis （MHD） patients. Methods Fifty chronic HD patients were divided into conventional HD and OL - HDF groups. They received regular high - flux HD or OL - HDF for4 - hour sessions, three times a week. Time - and frequency - domain measures of the 24 h HRV were analyzed every 6 months for 24 months. Routine laboratory tests and the parameter of 24 h Holter monitoring electrocardiogram were compared between the two groups. Results There was no difference in the baseline characteristics. After 24 months of treatment, {32 - microglobulin concentration decreased （from 30.1± 7.2 mg/dl to 21.7 ± 6.1 mg/dl, P 〈 0.05 ） in the OL - HDF group, while there was no change in the HD group. In the HRV analysis, Time - and frequency - domain HRV parameters increased significantly compared with base line in the OL - HDF group natural （ P 〈 0.05 ）. However, there was no change in the HD group （ P 〉 O. 05 ）. Conclusion This study shows that OL - HDF improved autonomic nervous system dysfunc- tion compared with HD group in chronic HD patients.