慢性肾功能衰竭患者窦性心率震荡分析  

Analysis of heart rate turbulence in patients with chronic renal failure

作　　者：林茴[1] 卓伟明[2] 袁丽萍[3] 

机构地区：[1]深圳市广东医学院附属福田人民医院心功能科,广东深圳518000 [2]广东省人民医院(广东省医学科学院)心功能科,广州510080 [3]深圳市广东医学院附属福田人民医院肾内科,广东深圳518000

出　　处：《岭南心血管病杂志》2015年第4期510-512,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨慢性肾功能衰竭患者窦性心率震荡(heart rate turbulence,HRT)的变化及其临床意义。方法选择发生室性期前收缩(ventricular premature beats,VPB)的慢性肾功能衰竭患者29例(肾衰组),有VPB的健康人32例作为对照组。两组均行24 h动态心电图(DCG)检查,分析单次VPB后HRT的初始值(turbulence onset,TO)、斜率(turbulence slope,TS),并与心率变异性(heart rate variability,HRV)中的正常RR间期标准差(standard deviation of RR intervals,SDNN)进行相关性分析。结果肾衰组TO、TS、SDNN与对照组比较,差异有统计学意义[0.88±0.99 vs.-1.4±1.64,P<0.01;4.71±3.29 vs.13.09±4.76,P<0.01;57.33±18.97 vs.127.84±27.32,P<0.01]。TS与SDNN存在相关性(r=0.79,P=0.02)。结论肾功能衰竭患者HRT现象明显减弱,HRT与HRV相关性良好,HRT可作为慢性肾功能衰竭心脏自主神经病变的临床预测指标。Objectives To observe the change of heart rate turbulence（HRT） and its clinic significance in patients with chronic renal failure（CRF）. Methods The subjects included 29 CRF patients with ventricular premature beats（VPB） and 32 healthy controls with VPB. All the subjects were examined by 24-hour Holter monitoring. Turbulence onset（TO） and turbulence slope（TS） after single VPB were calculated from Holter records and the abnormal incidences of TO and TS were compared between the two groups. Correlation analysis was performed with standard deviation of RR intervals（SDNN） in heart rate variability（HRV）. Results The values of TO, TS and SDNN in CRF group had significant differences compared with those in control group [0.88±0.99 vs.-1.4±1.64, P〈0.01; 4.71±3.29 vs. 13.09 ±4.76, P〈0.01; 57.33 ±18.97 vs. 127.84 ±27.32, P〈0.01 ]. A good correlation was found between TS and SDNN（r =0.79, P=0.02）. Conclusions HRT significantly decreases in patients with renal failure. A good correlation is observed between HRT and HRV. HRT can become an important clinical index to predict autonomic neuropathy in chronic renal failure.

关 键 词：心率震荡 肾功能衰竭 自主神经病变 

分 类 号：R541.7[医药卫生—心血管疾病]