Saltykova M M, At'kov O Iu, Karlin E K, Zaruba A Iu, Dmitriev A A, Kukharchuk V V
Ter Arkh. 2007;79(4):18-23.
To assess QRS voltage changes with lower total amount of biological fluids under ultrafiltration during hemodialysis.
The study included 14 patients with chronic renal failure. An average of 2.5 +/- 0.24 liters of fluid were removed during a session. 12-lead standard ECG was continuously recorded by means of a computer-aided cardiac recorder throughout the session of hemodialysis. Changes in the amplitude of QRS waves were analyzed in each lead.
Elevated QRS voltage was most pronounced in the anterior chest leads (v1-v4). Moreover, the potentials corresponding to the propagation of a predominant excitation front over the cardiac surface facing both the anterior chest wall--QRS+ (R wave) and the posterior chest wall--ORS-(S or Q waves) increased in most cases. Voltage changes in these leads were observed in 90% of patients, the amplitude of the waves being increased by more than 0.5 mV.
During dehydration, lower chest tissue electroconductivity may cause a considerable increase in QRS voltage. This should be kept in mind while analyzing ECG data during both a session of hemodialysis and antihypertensive therapy resulting in some fluid loss, as well as in the treatment of cardiac and renal failure, leading to diminished concomitant edemas.
评估血液透析超滤过程中生物液体总量减少时QRS波电压的变化。
该研究纳入了14例慢性肾衰竭患者。每次透析过程中平均超滤出2.5±0.24升液体。在整个血液透析过程中，通过计算机辅助心脏记录仪连续记录12导联标准心电图。分析各导联QRS波振幅的变化。
QRS波电压升高在前胸导联（V1-V4）最为明显。此外，在大多数情况下，对应于主要兴奋波阵面在面向前胸壁的心脏表面传播的电位——QRS+（R波）和面向后胸壁的电位——ORS-（S波或Q波）均升高。90%的患者在这些导联出现电压变化，波幅增加超过0.5 mV。
脱水过程中，下胸部组织电导率降低可能导致QRS波电压显著升高。在分析血液透析过程中的心电图数据、导致一定液体丢失的抗高血压治疗以及治疗导致伴随水肿减轻的心脏和肾衰竭时，均应牢记这一点。
