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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.

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。

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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.
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Nephrology (Carlton). 2005 Apr;10(2):109-12. doi: 10.1111/j.1440-1797.2005.00391.x.
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Am J Med Sci. 2003 Apr;325(4):209-13. doi: 10.1097/00000441-200304000-00007.
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Cardiovascular mortality in end-stage renal disease.终末期肾病中的心血管死亡率。
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