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本文引用的文献

1
P-wave and QRS complex measurements in patients undergoing hemodialysis.接受血液透析患者的P波和QRS波群测量
J Electrocardiol. 2008 Jan-Feb;41(1):60.e1-7. doi: 10.1016/j.jelectrocard.2006.03.002. Epub 2006 Oct 6.
2
Artificial attenuation of ECG voltage produces shortening of the corresponding QRS duration: clinical implications for patients with edema.心电图电压的人为衰减会导致相应QRS波时限缩短:对水肿患者的临床意义。
Pacing Clin Electrophysiol. 2005 Oct;28(10):1060-5. doi: 10.1111/j.1540-8159.2005.00221.x.
3
QT interval dispersion in dialysis patients.透析患者的QT间期离散度
Nephrology (Carlton). 2005 Apr;10(2):109-12. doi: 10.1111/j.1440-1797.2005.00391.x.
4
P waves in patients with changing edematous states: implications on interpreting repeat P wave measurements in patients developing anasarca or undergoing hemodialysis.水肿状态变化患者的P波:对解释全身性水肿患者或接受血液透析患者重复P波测量结果的意义
Pacing Clin Electrophysiol. 2004 Jun;27(6 Pt 1):749-56. doi: 10.1111/j.1540-8159.2004.00523.x.
5
Chronic kidney disease and cardiovascular disease in the Medicare population.
Kidney Int Suppl. 2003 Nov(87):S24-31. doi: 10.1046/j.1523-1755.64.s87.5.x.
6
Dynamic QT interval analysis in uraemic patients receiving chronic haemodialysis.接受慢性血液透析的尿毒症患者的动态QT间期分析
J Hypertens. 2003 Oct;21(10):1921-6. doi: 10.1097/00004872-200310000-00020.
7
Augmentation of the amplitude of electrocardiographic QRS complexes immediately after hemodialysis: a study of 26 hemodialysis sessions of a single patient, aided by measurements of resistance, reactance, and impedance.血液透析后即刻心电图QRS波群振幅增大:对一名患者26次血液透析过程的研究,辅助以电阻、电抗和阻抗测量
J Electrocardiol. 2003 Jul;36(3):263-71. doi: 10.1016/s0022-0736(03)00050-5.
8
Risk factors for coronary artery disease in patients with renal failure.
Am J Med Sci. 2003 Apr;325(4):209-13. doi: 10.1097/00000441-200304000-00007.
9
Cardiovascular mortality in end-stage renal disease.终末期肾病中的心血管死亡率。
Am J Med Sci. 2003 Apr;325(4):163-7. doi: 10.1097/00000441-200304000-00002.
10
Value of corrected QT interval dispersion in identifying patients initiating dialysis at increased risk of total and cardiovascular mortality.校正QT间期离散度在识别开始透析时全因死亡和心血管死亡风险增加患者中的价值。
Am J Kidney Dis. 2002 Apr;39(4):834-42. doi: 10.1053/ajkd.2002.32005.

血液透析对心电图参数的影响。

The effect of hemodialysis on electrocardiographic parameters.

作者信息

Astan Ramazan, Akpinar Ibrahim, Karan Adnan, Kacmaz Fehmi, Sokmen Erdogan, Baysal Erkan, Ozeke Ozcan, Selçuk Mehmet Timur

机构信息

Department of Cardiology, Batman Regional State Hospital, Batman, Turkey.

Faculty of Medicine, Department of Cardiology, Bulent Ecevit University, Zonguldak, Turkey.

出版信息

Ann Noninvasive Electrocardiol. 2015 May;20(3):253-7. doi: 10.1111/anec.12209. Epub 2014 Sep 9.

DOI:10.1111/anec.12209
PMID:25201342
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6931820/
Abstract

BACKGROUND

Cardiovascular complications are the leading causes of premature deaths in hemodialysis patients. Due to rapid changes in volume and electrolyte concentration following dialysis, the some electrocardiographic (ECG) changes or arrhythmias might be seen.

OBJECTIVE

To investigate the acute effects of hemodialysis on the ECG parameters in patients with chronic end-stage renal disease (ESRD).

METHOD

We included the consecutive ESRD patients who underwent a hemodialysis. Before and after hemodialysis, some 12 lead ECG parameters were analyzed by two different cardiologists by using electronic digital caliper device.

RESULTS

A total of 62 patients (mean 52 ± 15 years; 65% male) with ESRD undergoing hemodialysis were recruited to the study. P-wave amplitude, QRS amplitude, QRS duration, QTc dispersion, the sum of amplitudes in V1S + V5R derivations, total QRS amplitude, and duration were significantly greater in posthemodialysis patients compared to the prehemodialysis ones. However, T-wave amplitude and QTc duration were significantly lower in posthemodialysis patients.

CONCLUSION

The ECG changes including prolangated QRS and increased QTc interval after hemodialysis should be kept in mind and assessed carefully in ESRD patients. Prolongation of these parameters may prove to be a further noninvasive marker of susceptibility to ventricular arrhythmias.

摘要

背景

心血管并发症是血液透析患者过早死亡的主要原因。由于透析后血容量和电解质浓度的快速变化,可能会出现一些心电图(ECG)改变或心律失常。

目的

研究血液透析对慢性终末期肾病(ESRD)患者心电图参数的急性影响。

方法

我们纳入了连续接受血液透析的ESRD患者。透析前后,两位不同的心脏病专家使用电子数字卡尺设备分析了一些12导联心电图参数。

结果

共有62例接受血液透析的ESRD患者(平均年龄52±15岁;65%为男性)被纳入研究。与透析前相比,透析后患者的P波振幅、QRS振幅、QRS时限、QTc离散度、V1S + V5R导联振幅总和、总QRS振幅和时限显著增大。然而,透析后患者的T波振幅和QTc时限显著降低。

结论

在ESRD患者中,应牢记并仔细评估血液透析后包括QRS增宽和QTc间期延长在内的心电图改变。这些参数的延长可能被证明是易发生室性心律失常的进一步非侵入性标志物。