Mandić Ante, Tomić Monika, Petrov Bozo, Romić Zeljko
Health Center Siroki Brijeg, Siroki Brijeg, Bosnia and Herzegovina.
Coll Antropol. 2012 Dec;36(4):1395-9.
Atrial fibrillation is one of the most frequent arrhythmias diagnosed in clinical practice and it is also relatively common in dialysis patients. Atrioventricular and intraventricular conduction disturbances are less investigated in hemodialysis patients and data about their prevalence are insufficient. The objective of this study was to determine the prevalence of atrial fibrillation, atrioventricular blocks and bundle branch blocks in hemodialysis patients and to analyze different clinical risk factors. The study included 140 patients on long-term hemodialysis treatment. The presence of atrial fibrillation, atrioventricular blocks and bundle branch blocks was determined by electrocardiogram. Patients were divided into groups depending on the presence or absence of atrial fibrillation/bundle branch blocks and investigated variables were compared. Atrial fibrillation was present in 11 (7.9%) of the 140 patients. In multivariate analysis, age and higher concentration of uric acid were associated with atrial fibrillation. Prevalence of first-degree atrioventricular block was 2.9% (4 patients) and second- and third-degree atrioventricular blocks were not found. Prevalence of bundle branch blocks was 17.1% (24 patients): 5% of patients had a complete right bundle branch block, 6.4% had an incomplete right bundle branch block, 3.6% had a complete left bundle branch block and 2.1% of patients had an incomplete left bundle branch block. The prevalence of atrial fibrillation and bundle branch blocks in this study was relatively high in patients on hemodialysis and greater than that observed in general population. Presence of atrial fibrillation was associated with older age and higher concentration of uric acid.
心房颤动是临床实践中诊断出的最常见心律失常之一，在透析患者中也相对常见。血液透析患者的房室传导和室内传导障碍较少受到研究，关于其患病率的数据也不足。本研究的目的是确定血液透析患者中心房颤动、房室传导阻滞和束支传导阻滞的患病率，并分析不同的临床危险因素。该研究纳入了140例接受长期血液透析治疗的患者。通过心电图确定心房颤动、房室传导阻滞和束支传导阻滞的存在情况。根据是否存在心房颤动/束支传导阻滞将患者分组，并比较所研究的变量。140例患者中有11例（7.9%）存在心房颤动。多因素分析显示，年龄和较高的尿酸浓度与心房颤动相关。一度房室传导阻滞的患病率为2.9%（4例患者），未发现二度和三度房室传导阻滞。束支传导阻滞的患病率为17.1%（24例患者）：5%的患者有完全性右束支传导阻滞，6.4%有不完全性右束支传导阻滞，3.6%有完全性左束支传导阻滞，2.1%的患者有不完全性左束支传导阻滞。本研究中血液透析患者心房颤动和束支传导阻滞的患病率相对较高，高于普通人群中观察到的患病率。心房颤动的存在与年龄较大和尿酸浓度较高相关。
