老年慢性肾脏病患者超敏C反应蛋白水平与心率变异的相关性  

Relationship of hypersensitive-C reactive protein levels with heart ratevariability in elder patients with chronic kidney disease

作　　者：申志祥[1] 高雪艳[1] 隽晨霞[1] 蒋娟娟[1] 任斌[1] 王屹[1] 应单平[1] 潘继承[1] 卜言丽[1] 郑卉[1] SHEN Zhi-xiang GAO Xue-yan JUAN Chen-xia JIANG Juan-juan REN Bin WANG Yi YING Danping PAN Ji-cheng BU Yan-li ZHENG Hui.(Department of Health Administration, Jiangsu Provincial Offical Hospital, Nanjing 210034, China)

机构地区：[1]江苏省省级机关医院健康管理中心,江苏省南京市210024

出　　处：《实用老年医学》2016年第12期990-993,共4页Practical Geriatrics

基　　金："六大人才高峰"项目(wsn-058)

摘　　要：目的探讨老年慢性肾脏病(chronic kidney disease,CKD)患者超敏C反应蛋白(hs-CRP)水平与心率变异性(heart rate variability,HRV)的关系。方法根据hs-CRP水平将纳入研究的77例老年CKD患者分为正常组65例、异常组12例。对2组患者人口学特征、实验室结果及24 h动态HRV频谱分析技术的时域及频域结果进行比较分析,并与hs-CRP水平作相关分析。结果 77例CKD患者hs-CRP水平为(2.78±3.99)mg/L,正常组为(1.37±1.07)mg/L,异常组为(9.76±6.18)mg/L。相较于正常组,异常组丙氨酸氨基转移酶、总胆红素及间接胆红素水平均较低(P<0.05)。24 h动态心电图检测结果显示,异常组低频及极低频明显低于正常组,差异有统计学意义(P<0.05)。线性回归分析结果显示,hs-CRP与平均心率(β=-0.513,P<0.05)、24 h内相差>50 ms的相邻窦性心搏间期占窦性心搏间期总数的百分比(p NN50)(β=1.278,P<0.05)、低频(β=-16.682,P<0.05)具有相关性。结论 CKD合并高hs-CRP水平患者HRV的频域分析的各项指标参数均减低,hs-CRP与自主神经病变密切相关,对早期发现自主神经病变有益。Objective To study the relationship between hypersensitive C-reactive protein（ hs-CRP） and heart rate variation（ HRV） in the elderly patients with chronic kidney disease（ CKD）. Methods Seventy-seven patients with CKD were devided into normal group and abnormal group according to hs-CRP level. The demographic characteristics,laboratory results and 24-hour dynamic electrocardiogram results including time domain indices and frequency domain indices were compared between two groups. The relationship between hs-CRP level and HRV were analysed by linear single regression analysis. Results In this study,the mean level of hs-CRP was 2. 78 ± 3. 99 mg / L among 77 patients with CKD,while being 1. 37±1. 07 mg / L in normal group,and being 9. 76±6. 18 mg / L in abnormal group. Compared to the normal group,the levels of ALT,TBIL and IBIL in abnormal group were significantly lower（ P〈0. 05）. The results of 24-hour HRV testing showed that LF and VLF were significantly lower in the abnormal group than those in the normal group. Linear single regression analysis showed that hs-CRP was negatively correlated with MHR,LF and positively related with p NN50（ β =-0. 513,-16. 682,1. 278,P〈0. 05）. Conclusions The indexes of the frequency domain analysis by HRV are reduced in patients with CKD with high level of hs-CRP. And the level of hs-CRP is associated with autonomic neuropathy,and beneficial to the early detection of autonomic neuropathy.

关 键 词：慢性肾脏病 超敏C反应蛋白 心率变异度 

分 类 号：R692[医药卫生—泌尿科学]