肾移植对尿毒症心脏自主神经系统的影响

目的通过对尿毒症患者肾移植前后心率变异性(heart rate variability,HRV)分析,以观察肾移植对尿毒症患者心脏自主神经系统(autonomic nervous system,ANS)功能的影响.方法对32名正常人和27名尿毒症患者肾移植前、肾移植后3月进行动态心电图检查.以SDNN、SDANN、SDNN index,RMSSD和PNN50作为HRV分析的指标.结果SDNN、SDANN、SONN index、RMSSD和PNN 50,与正常对照组比较,尿毒症组肾移植前、后均降低(P＜0.05或P＜0.01),与肾移植前相比,移植后上述指标均升高(P＜0.05).结论尿毒症患者心脏自主神经系统功能异常,肾移植能部分恢复异常的心脏自主神经系统功能,对尿毒症患者肾移植前后进行HRV分析有助于病情和预后的评估.

The Effect of Kidney Transplantation on Heart Autonomic Nerve System in Uremic Patients

Objective To assess the effect of kidney transplantation on heart autonomic nerve system in uremic patients by the observation of heart rate variability (HRV). Methods 32 normal controls and 27 uremic patients were analyzed for the HRV before and after 3-month kidney transplantation, respectively. SDNN, SDANN, SDNN-index, RMSSD and PNN50 were used as the indices for the HRV analysis. Results SDNN, SDANN, SDNN-index, RMSSD and PNN50 in uremic group were all significantly lower than those in control group before or after 3-month kidney transplantation respectively (p<0.05 or p<0.01), which all significantly increased after 3-month transplantation compared to those before operation in uremic group (p<0.05). Conclusions Uremic patients have autonomic nerve system dysfunction, which can be partial reversed by kidney transplantation. The HRV analysis in uremic patients before or after operation may conduce to the assessment of severity and prognosis.