慢性肾衰患者心率变异性改变

目的　通过心率变异性 (HRV)变化测定 ,探讨慢性肾功能衰竭 (CRF)患者的自主神经活动状况。方法　用2 4小时动态心电图分析系统 ,对 2 0例健康者 ,77例CRF患者 (其中 30例氮质血症 ,4 7例尿毒症 )心率变异性的时域指标进行对比研究。结果　CRF患者心率变异性的测定结果为 :SDNN 85 .2 8± 19.96 ,SDANN 75 .5 5± 2 2 .4 7,r-MSSD19.2 2± 11.82 ,PNN50 6 .7± 14 .79,各项指标均明显低于健康者 (P <0 .0 1)。氮质血症期与尿毒症期心率变异性无明显差别。结论　通过HRV时域分析发现 ,CRF患者有自主神经调节功能紊乱。CRF氮质血症期患者已出现HRV下降 ,提示CRF患者早期就存在自主神经功能损害。

The Change of Heart Rate Variability in Chronic Renal Failure

Objective To discuss the situation of autonomic neuropathy in the patients with chronic renal failure (CRF) by Heart Rate variability(HRV). Methods HRV were studied by 24-hour Holter in 20 healthy people for control,77 patients with CRF (30 patients with azotemia and 47 patients with uremia). Results HRV in CRF group was significantly lower than in control group.SDNN (85.28±19.96),SDANN Index (75.55±22.47),r-MSSD (19.22±11.82),PNN 50 (6.7±14.79) (P<0.01).There is no significant difference between azotemia and uremia. Conclusion There was dysfunction of autonomic neuropathy in the patients with chronic renal failure.By the HRV analysis we found that HRV was decreased in the azotemia patient,which suggested that there was autonomic neuropathy lesion in the early stage of CRF.