Celik Atac, Melek Mehmet, Yuksel Seref, Onrat Ersel, Avsar Alaettin
Cardiology Department, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey.
Hemodial Int. 2011 Apr;15(2):193-9. doi: 10.1111/j.1542-4758.2011.00529.x. Epub 2011 Mar 13.
Patients with end-stage renal disease (ESRD) are likely to have cardiac autonomic dysfunction, which is related with an increased risk of sudden death. The aim of this study is to detect cardiac autonomic dysfunction in patients with ESRD and to evaluate the possible acute effects of hemodialysis (HD) on cardiac autonomic functions measured by heart rate variability (HRV) and heart rate turbulence (HRT). Thirty-one (mean age 50 ± 13 years, 15 males) with ESRD on regular HD program and 31 healthy volunteers (mean age 51 ± 12 years, 15 males) were included in the study. Twenty-four-hour ambulatory electrocardiogram recordings were taken from the subjects before and after HD and from the control group. Heart rate variability and HRT parameters were calculated from these recordings. All of the HRV and HRT parameters were found to be significantly blunted in patients in comparison with healthy individuals. There were significant differences in HRV after HD, but similar differences were not observed in HRT parameters. Cardiac autonomic functions were significantly altered in patients with ESRD. Heart rate turbulence parameters seemed to be less affected from HD and may be more useful in the evaluation of cardiac autonomic functions in the ESRD population.
终末期肾病（ESRD）患者可能存在心脏自主神经功能障碍，这与猝死风险增加有关。本研究的目的是检测ESRD患者的心脏自主神经功能障碍，并评估血液透析（HD）对通过心率变异性（HRV）和心率震荡（HRT）测量的心脏自主神经功能可能产生的急性影响。31例接受常规HD治疗的ESRD患者（平均年龄50±13岁，15例男性）和31名健康志愿者（平均年龄51±12岁，15例男性）纳入本研究。在HD治疗前后以及对照组中，对受试者进行24小时动态心电图记录。从这些记录中计算心率变异性和HRT参数。与健康个体相比，患者所有的HRV和HRT参数均显著降低。HD治疗后HRV存在显著差异，但HRT参数未观察到类似差异。ESRD患者的心脏自主神经功能显著改变。心率震荡参数似乎受HD影响较小，可能在评估ESRD人群的心脏自主神经功能方面更有用。
