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[慢性血液透析患者的心率变异性改变]

[Heart rate variability alteration in patients on chronic hemodialysis].

作者信息

Salameh E, Mallat S, Hamdan R, Azar H, Azar R, Kadri Z, Kassab R, Abou Jaude S, Badaoui G

机构信息

Département de cardiologie, hôpital Hôtel-Dieu-de-France, Alfred-Naccache Street, Achrafieh, PO Box 166830, Beyrouth-Liban, Liban.

出版信息

Ann Cardiol Angeiol (Paris). 2009 Feb;58(1):7-10. doi: 10.1016/j.ancard.2008.09.003. Epub 2008 Oct 14.

Abstract

BACKGROUND AND AIM

Decrease in heart rate variability (HRV) is a known risk factor for cardiovascular morbidity and mortality. The aim of our study is to evaluate HRV in chronic hemodialysis patients and to determine factors that might decrease or increase it.

METHODS

This is a retrospective study including 51 patients, 23 males and 28 females, with a mean of age of 64.5 years (23-84 years) on chronic hemodialysis for end stage renal disease due to various causes. Twenty-four-hour heart rate monitoring was recorded in all patients to evaluate HRV. HRV of hemodialysis patients was compared to normal patients (control). We also looked for correlation between HRV and a number of clinical and biological factors.

RESULTS

All HRV parameters were decreased in chronic hemodialysis patients compared to normal controls with a significant difference (p<0.0005). HRV decreases with age (p=0.012), and is lower in diabetic patients (p=0.026). Interestingly, we found that chronic hemodialysis patients on beta-blockers had higher HRV with p=0.011.

CONCLUSION

HRV is reduced in chronic hemodialysis patients mainly in old and diabetic patients, but this decrease is less important in those receiving beta-blockers.

摘要

背景与目的

心率变异性(HRV)降低是心血管疾病发病和死亡的已知危险因素。我们研究的目的是评估慢性血液透析患者的HRV,并确定可能降低或增加HRV的因素。

方法

这是一项回顾性研究,纳入了51例患者,其中男性23例,女性28例,平均年龄64.5岁(23 - 84岁),因各种原因患有终末期肾病并接受慢性血液透析。所有患者均记录24小时心率监测以评估HRV。将血液透析患者的HRV与正常患者(对照组)进行比较。我们还研究了HRV与一些临床和生物学因素之间的相关性。

结果

与正常对照组相比,慢性血液透析患者的所有HRV参数均降低,差异有统计学意义(p<0.0005)。HRV随年龄增长而降低(p = 0.012),糖尿病患者的HRV较低(p = 0.026)。有趣的是,我们发现服用β受体阻滞剂的慢性血液透析患者HRV较高,p = 0.011。

结论

慢性血液透析患者的HRV降低,主要见于老年和糖尿病患者,但在接受β受体阻滞剂治疗的患者中这种降低不太明显。

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