QTcd及心率变异性对老年MHD患者心血管不良事件的影响分析

Effect of the QT Interval Dispersion and Heart Rate Variability on Main Adverse Cardiovascular Events in Old Patients with Maintenance Hemodialysis

目的:探讨校正QT间期离散度(QTcd)及心率变异性(HRV)对维持性血液透析(MHD)老年患者主要心血管不良事件(MACE)的预测价值。方法:选取深圳市第二人民医院2014年1月至2017年1月行MHD的147例老年患者为研究对象,随访1年,根据是否发生MACE分为MACE组和非MACE组,对两组患者的QTcd及HRV各参数进行观察比较。结果:MHD老年患者随访1年MACE发生率为34.7%,MACE组年龄、透析龄均较非MACE组高,差异具有统计学意义(P<0.05);MACE组QTcd显著高于非MACE组,HRV各参数均显著低于非MACE组,差异具有统计学意义(P<0.05);多元回归分析结果显示透析龄、QTcd及HRV各参数是老年MHD患者发生MACE的独立危险因素,差异具有统计学意义(P<0.05)。结论:QTcd及HRV各参数能较好地预测MHD老年患者的MACE发生。

Objective To investigate the predictive value of the adjusted QT interval dispersion（QTcd） and heart rate variability（HRV） on main adverse cardiovascular events（MACE） in old patients with maintenance hemodialysis（MHD）. Methods Patients with MHD in Shenzhen second people＇s hospital hemodialysis center during Jan, 2014 to Jan, 2017 were recruited in this study, and follow at least 1 year, to divide patients into MACE group and non-MACE group according to patients event of MACE, and compare the QTcd and HRV between these two groups. Results 34.7% of old MHD patients with MACE,compared to non-MACE group,the MACE group were order and with longer dialysis age（P〈0.05）, and with higher QTcd（P〈0.05） but signifi cantly lower HRV（P〈0.05）. In addition,the dialysis age, QTcd and HRV were independent risk factors for old MHD patients with MACE in multiple logistic analysis（P〈0.05）. Conclusion QTcd and HRV may do good to predict MACE in old patients with MHD.