腹膜透析所致消化道症状与心率变异性相关性研究  

Strong association between heart rate variability and gastrointestinal symptoms in peritoneal dialysis patients

作　　者：黎丽娴[1,2] 唐雯[1] 陈伯钧[2] 汪涛[1] 

机构地区：[1]北京大学第三医院肾内科,北京100191 [2]广东省中医院大学城医院急诊科,广州510120

出　　处：《中国实用内科杂志》2010年第10期901-903,共3页Chinese Journal of Practical Internal Medicine

基　　金：北京市科技计划项目(D09050704310905);国家自然科学基金(30900681);北京大学第三医院中青年骨干基金;种子基金资助

摘　　要：目的探讨腹膜透析患者消化道症状与心率变异性(HRV)的关系。方法采取横断面研究,选取2007年5月至9月就诊于北京大学第三医院腹透中心的77例患者,根据消化道症状临床评分,把患者分为有消化道症状与无消化道症状两组,检测患者心率变异性情况,并收集患者的一般资料、临床生化指标、透析充分性指标,探讨影响腹膜透析患者消化道症状的可能因素。结果腹膜透析患者有消化道症状组各HRV时域指标均比无消化道症状组低,窦性R-R间期标准差(SDNN)[(33.08±37.71)ms和(51.12±45.93)ms,P<0.05]、相邻正常R-R间期差值的均方根(RMSSD)[(33.53±46.81)ms和(66.44±71.76)ms,P<0.05]、全程相邻R-R间期长度之差的标准差(SDSD)[(47.22±66.12)ms和(93.83±101.39)ms,P<0.05]、相差>50 ms的相邻R-R间期占R-R间期总数的百分比(PNN50)[(4.93±13.24)%和(17.53±25.77)%,P<0.05]。相关分析显示,消化道症状情况与HRV时域指标中的SDNN、RMSSD、SDSD、PNN50及尿素氮呈负相关(P均<0.05)。Logistic回归分析显示,RMSSD、尿素氮是腹膜透析患者出现消化道症状的影响因素。结论腹膜透析患者消化道症状出现,可能与自主神经损伤,交感与副交感神经的平衡遭到破坏,导致胃肠功能紊乱有关。Objective To analyze the possible relationship between heart rate variability （HRV） and Gastrointestinal Symptoms in Peritoneal Dialysis Patients. Methods In this Cross-Sectional Studies, we enrolled 77 continuous ambulatory peritoneal dialysis patients. Patients were divided into two groups according to their gastrointestinal symptoms （GI） （ with GI and without GI symptoms）. HRV were tested by standard method. Patients＇ clinical data were also collected. Results HRV time domain indices in the group with GI symptoms was lower than the group without GI symptoms, SDNN [ （ 33.08 ± 37. 71 ） ms vs （ 51.12 ± 45.93 ） ms,P 〈 0. 05 ], RMSSD [ （33.53 ± 46. 81 ） ms vs（66. 44 ±71.76） ms,P 〈0.05] ,SDSD[ （47. 22 ±66. 12） ms vs（93. 83 ± 101.39） ms,P 〈0. 05 ], PNN50 [ （4. 93 ± 13.24 ） % vs （ 17.53 ± 25.77 ） %, P 〈 0. 05 ]. Patients GI symptoms were negatively correlated with SDNN, SDSD, RMSSD, PNN50 （ P 〈 0. 05 ）. Logistic regression analysis showed that RMSSD, urea nitrogen were the independent risk factor for GI symptoms in PD patients. Conclusion GI symptoms in PD patients were independently associated with abnormality of sympathetic-vagal imbalance.

关 键 词：腹膜透析 消化道症状 心率变异性 

分 类 号：R5[医药卫生—内科学]