肾衰患者血液透析前后HRV变化及意义

The change and significance of hemodialysis on heart rate variability in patients with end stage of renal dysfunction

目的探讨终末期肾衰患者血液透析前后心率变异性(HRV)的变化及意义。方法对267例终末期慢性肾衰规律血液透析患者和60例健康人行24小时动态心电图检查,分析两组血液透析前后终末期肾衰患者的HRV改变。HRV时域指标包括正常RR间期标准差(SDNN),5min平均RR间期标准差(SDANN)等。结果正常健康组的HRV有明显的昼夜变化规律,HRV夜间大于白天;终末期肾衰患者的HRV明显低于健康组,其昼夜节律性消失,但透析后HRV指标明显改善。结论终末期肾衰患者的HRV与健康人相比有显著的变化,其迷走神经张力减退和HRV昼夜节律性消失。血液透析可提高终末期肾衰患者HRV并改善肾衰患者受损的植物神经功能。

Objective To study the change and significance of hemodialysis on heart rate variability （HRV） in patients with end stage of renal dysfunction. Methods A total of 267 patients with end stage of renal dysfunction and 60 normal persons were examined with 24-hour dynamic electrocardiography and their HRV between two groups including before and after hemodialysis were analysed. HRV measurement included standard deviation of normal RR intervals （SDNN）, 5-minute average normal RR intervals （SDANN） and so on. Results The HRV of normal persons had obviously changing regularity from day to night. HRV on night was more than that of day. The HRV of patients with end stage renal dysfunction was obviously lower than normal persons and the regularity between day and night has lost, the vagus nerve activity also decreased. These changes were improve after hemodialysis. Conclusions The HRV of patients with end stage of renal dysfunction has obviously change than normal persons group. The vagus nerve activity decreased and the regularity of day to night lost. The hemodialysis can increase the HRV of patients with end stage renal dysfunction and improve heart autonomic function