肾脏病患者心率变异性的临床观察

Clinical analysis on heart rate variability in patients with renal diseases

目的 :用心率变异性 (HRV)分析技术观察肾脏病及肾功不全患者的HRV指标变化。方法 :用 2 4h动态心电图分析HRV的时域指标。观察肾功正常的肾病患者 2 6例 ,肾功不全患者 34例 ,正常对照 34例。结果 :肾功正常肾病组RRI 76 3.0 5±10 4.2 1、SD 12 2 .48± 39.82、SDAIDX 111.87± 40 .6 0 ,均显著低于正常组 ,P <0 .0 5 ;肾功不全组六项指标均明显低于正常对照组 ,SD 76 .0 9± 37.70 ,SDAIDX 6 7.74± 34.47,SDIDX 2 9.5 9± 15 .37,及rMSSD 17.85± 9.35显著低于肾功正常组。结论 :肾脏病患者在肾功正常期即有自主神经功能损伤 ,以交感神经活动受损为主 ,肾功不全患者交感神经及迷走神经功能均受损。

Objective:[WT5BZ]To analyze heart rate variability(HRV) in patients with renal diseases or renal failure.[WT5HZ]Methods:[WT5BZ]HRV time domain indices of 24 renal diseases patients with normal renal function (NRF group),34 with renal failure(RF group) and 42 healthy subjects (HS group)were analyzed using 24-hour ambulatory electrocardiogram recording.[WT5HZ]Results:[WT5BZ]RR interval(RRI),standard deviation of all normal RR intervals(SD) and standard deviation of the average normal RR interval for 5-minute segments(SDAIDX) in NRF group were markedly lower than those in HS group.All of the six HRV indices in RF group were significantly lower than those in HS group.SD,SDAIDX,mean of standard deviation of all normal RR intervals for 5-minute segments (SDIDX) and root mean square succesive difference(rMSSD)were markedly reduced as compared with those of NRF group.[WT5HZ]Conclusion:[WT5BZ]Autonomic(mainly the sympathetic)dysfunction appeared in patients with renal diseases even in normal renal function stage and worsen in patients with renal failure(both sympathetic and parasympathetic dysfunction). [WT5HZ]