Pacyk G, Grzeszczak W
Oddziału Wewnetrznego Wojewódzkiego, Szpitala Zespolonego w Czestochowie.
Pol Arch Med Wewn. 1997 Jan;97(1):22-9.
Altered activity of sympathetic nervous system is one of the potential factors influencing blood pressure elevation during erythropoietin (rHu-EPO) therapy in patients with end-stage renal disease (ESRD). The aim of study was to establish if rHu-EPO administration to ESRD patients affects heart rate variability (h.r.v.) indices in the time domain and activity of the autonomic nervous system (a.n.s.). 23 ESRD hemodialyzed patients were divided into those who recived rHU-EPO (+EPO), N = 12 and did not receive rHu-EPO (-EPO), N = 11. +EPO patients were given 2000-4000 IU rHu-EPO/week for 6 weeks. In both groups h.r.v. indices (mRR, SDNN, rMSSD and pNN50) were calculated during dialysis sessions and interdialytic period and then were analyzed by Cosinor method. It was shown that: 1) during dialysis session there were rhythmic changes in all h.r.v. parameters, which can be described by Cosinor formula. 2) all h.r.v. indices wee lower in +EPO group as compared with -EPO patients. 3) the differences, although not significant, may indicate sympathetic activation in +EPO ESRD patients. 4) Cosinor method applied to h.r.v. analysis may be useful tool for assessing a.n.s. activity.
交感神经系统活动改变是影响终末期肾病（ESRD）患者接受促红细胞生成素（rHu-EPO）治疗期间血压升高的潜在因素之一。本研究的目的是确定对ESRD患者给予rHu-EPO是否会影响时域中的心率变异性（h.r.v.）指标以及自主神经系统（a.n.s.）的活动。23例接受血液透析的ESRD患者被分为接受rHU-EPO的患者（+EPO组，N = 12）和未接受rHu-EPO的患者（-EPO组，N = 11）。+EPO组患者每周给予2000 - 4000 IU rHu-EPO，共6周。在两组中，在透析期间和透析间期计算h.r.v.指标（mRR、SDNN、rMSSD和pNN50），然后用余弦分析法进行分析。结果显示：1）在透析期间，所有h.r.v.参数均有节律性变化，可用余弦公式描述。2）与-EPO组患者相比，+EPO组所有h.r.v.指标均较低。3）尽管差异不显著，但这些差异可能表明+EPO组ESRD患者存在交感神经激活。4）应用于h.r.v.分析的余弦分析法可能是评估a.n.s.活动的有用工具。
