维持性血液透析患者24小时动态心电图分析

The 24 hours holter monitoring electrocardiogram analysis of maintenance hemodialysis patients

目的 研究维持性血液透析患者的心率变异性、心律失常情况。方法 使用美国产Century2 0 0 0型心电分析仪进行 2 4小时心率变异 ,心律失常分析 ,并与对照组比较 ,采用时域指标 ,观察其变化特点 ,同时根据透析前后尿素氮计算Kt/V。结果 32例维持性血液透析患者与正常对照组 4 0例自主神经张力的所有指标如SDNN、SDANN、rMSDD、PNN5 0有差异 ;维持性血液透析患者中大于 6 0岁 14例与小于 6 0岁组在总的张力水平指标SDNN及反映交感神经张力的指标SDANN有差异 ,但反映副交感神经张力的指标rMS DD、PNN5 0两组没有差异 ,而两组KT/V没有差异。心律失常发生方面 ,32例维持性血液透析患者与 4 0例对照组在室性期前收缩上有差异 ,室上性心动过速、房性心动过速无差异。 32例透析患者中大于 6 0岁 14例与小于 6 0岁 18例在室性期前收缩、房性心动过速有差异 ,室上性心动过速无差异。结论 维持性透析患者存在自主神经功能受损 ,老年透析患者与低龄透析患者存在交感神经张力的差别 ,副交感神经张力没有差别。

Objective To study the heart rate variability(HRV)and the cardiac arrhythmia condition in the patients of maintenance hemodialysis.Methods Thirty two maintenance hemodialysis patients were studied, Kt/V of pro-and post-dialysis were calculated accordiang to boold ureanitragen. The HRV and arrhythmia of these patients were compared with the control group.Results There was significant difference of the autonomic nerve tension index such as SDNN?SDANN?rMSDD?PNN50 between the maintenance hemodialysis patients and the 40 control patients.And there was difference in the goneral tension level SDNN and SDANN which reflected the sympathetic nerve tension between 14 patients older than 60 and the patients younger than 60,but there was no difference between the index of rMSDD and PNN50 which reflected Parasympathetic nerve tension,and there was no difference in the value of Kt/v.To the arrhythmia,there was difference in the ventricular premature beats between 32 maintenance hemodialysis patients and 40 control patients,but there was no difference in the supra-ventricular premature beats and atrial tachycardia.In 32 maintenance hemodialysis patients,there was difference in the ventricular premature beats and atrial tachycardia between 14 patients older than 60 and 18 patients younger than 60,but no difference in the supra-ventricular premature beats.Conclusion There is autonomic nerve function damage in the maintenance hemodialysis patients, and there is difference in the sympathetic nerve tension between older and younger maintenance hemodialysis patients.