肾功能不全对冠心病患者心率变异性的影响  

Effect of renal dysfunction on heart rate variability of patients with coronary heart disease

作　　者：强钰伟 杨美艳[1] 李娟[1] 郭新红[1] 张晔[1] 张慧[1] 田留洋 徐勇[1] 

机构地区：[1]解放军总医院心内科,北京100853

出　　处：《解放军医学院学报》2016年第6期579-581,共3页Academic Journal of Chinese PLA Medical School

摘　　要：目的观察肾功能不全对冠心病患者心率变异性(heart rate variability,HRV)的影响。方法 2014年6月—2015年6月于我院心内科就诊的冠心病患者200例,分为单纯冠心病组(n=130)与冠心病合并肾功能不全组(n=70),选择无冠心病的健康人作为对照组(n=70)。采用24 h动态心电图监测3组患者心率情况,记录两个QRS波中R波之间的时间(NN间期)标准差(standard deviation of NN intervals,SDNN)、NN间期平均值标准差(standard deviation of the average NN intervals,SDANN)、NN间期标准差均值(average of the standard deviation NN interval,ASDNN),分析比较3组间的差异。结果 3组的HRV指标(SDNN、SDANN、ASDNN):对照组(139±30)ms,(129±22)ms,(89±17)ms;单纯冠心病组(127±25)ms,(115±20)ms,(70±14)ms;冠心病合并肾功能不全组(100±19)ms,(93±12)ms,(52±15)ms。冠心病患者的HRV较对照组低(P<0.05)。合并有肾功能不全患者的HRV较单纯冠心病患者更低(P<0.05)。结论肾功能不全进一步加重冠心病患者较低的HRV,可能对患者预后产生不良影响。Objective To investigate the effects of renal dysfunction（RD） on heart rate variability（HRV） of patients with coronary heart disease（CHD）. Methods Two hundred consecutive patients with CHD admitted to Chinese PLA General Hospital from June 2014 to June 2015 were divided into CHD alone group（n=130） and CHD with RD group（n=70）. Healthy subjects were selected as control group（n=70）. The heart rate of cases in three groups was monitored by 24 h Holter, and parameters related to HRV [standard deviation of NN intervals（SDNN）, standard deviation of the average NN intervals（SDANN）, average of the standard deviation NN interval（ASDNN）] were measured and analyzed in three groups. Results The SDNN, SDANN and ASDNN of three groups were（139±30） ms,（129±22） ms and（89±17） ms in control group;（127±25） ms,（115±20） ms,（70±14） ms in CHD group;（100±19） ms,（93±12） ms,（52±15） ms in CHD with RD group. HRV parameters of CHD group were significantly lower than control group（P〈0.05）, while it was significantly lower in CHD with RD group when compared with the other two groups（P〉0.05）. Conclusion RD can exacerbate HRV decreasing in CHD patients and may also forecast poor prognosis.

关 键 词：肾功能不全 冠心病 心率变异性 

分 类 号：R692-5[医药卫生—泌尿科学] R541.4[医药卫生—外科学]