血液透析患者心电图ST-T改变的影响因素分析

Analysis of Influencing Factors of ST-T Changes in Electrocardiogram in Hemodialysis Patients

目的:分析血液透析(hemodialysis, HD)患者心电图ST-T改变的影响因素。方法:回顾性分析2021年1月至2023年3月于陕西省人民医院住院的HD患者的临床资料、实验室结果及人体成分指标。同期进行心电图检查,根据心电图结果分为ST-T正常组、ST-T异常组。比较两组间各临床指标的差异,分析各临床指标与ST-T改变的关系。对心电图ST-T改变有影响的因素进行多因素Logistic回归分析。结果:纳入75例患者中,ST-T改变组患者占总体的60%。两组间合并糖尿病、血肌酐、血尿素氮、血磷、前白蛋白、N端脑钠肽前体、高敏肌钙蛋白、肌酸激酶同工酶及相位角与心电图ST-T改变相关,差异有统计学意义(P < 0.05),将上述因素带入Logistic回归模型,结果显示血尿素氮(OR = 1.125, 95% CI: 1.009~1.254, P = 0.033)是动态心电图ST-T改变的独立危险因素。结论:心电图ST-T改变广泛存在于HD患者,高尿素氮是HD患者心电图ST-T改变的独立危险因素。

Objective: To analyze the influencing factors of ECG ST-T changes in hemodialysis (hemodialysis, HD) patients. Methods: Clinical data, laboratory results and human composition indexes of HD patients hospitalized in Shaanxi Provincial People’s Hospital from January 2021 to March 2023 were retro-spectively analyzed. An electrocardiogram was performed at the same time, and it was divided into ST-T normal group and ST-T abnormal group according to the ECG results. The difference in each clinical index was compared between the two groups, and the relationship between each clinical index and the ST-T change was analyzed. Multivariate Logistic regression analysis of the factors af-fecting ECG ST-T changes. Results: Among the 75 patients included, the patients in the ST-T change group accounted for 60% of the total. Between the two groups, combined diabetes mellitus, blood creatinine, blood urea nitrogen, blood phosphorus, prealbumin, brain natriuretic peptide, highly sensitive troponin, creatine kinase isoenzyme and phase angle were correlated with ST-T changes, with a statistically significant difference (P < 0.05), these factors into the Logistic regression model showed that blood urea nitrogen (OR = 1.125, 95% CI: 1.009~1.254, P = 0.033) was an independent risk factor for Holter ST-T changes. Conclusion: ST-T is widely found in HD patients, and high BUN is an independent risk factor for ECG ST-T changes in HD patients.