非透析慢性肾脏病患者心率变异性的特点及其影响因素分析

目的：分析非透析慢性肾脏病（CKD）患者心率变异性（HRV）的特点及相关因素。方法：对263例住院且尚未行肾脏替代治疗CKD患者进行HRV（包括SDNN、RMSSD、pNN50、LF、HF、LF/HF）检测,并分析影响CKD患者HRV的因素。结果：CKD1～5期患者HRV下降的比例为57.79%,在CKD1、2、3、4、5期的比例分别为30.77%、42.00%、52.94%、72.73%和87.27%,各组间差异具有统计学意义（P〈0.05）。CKD患者SDNN均值为（110.8±33.5）ms,除CKD1与2期J间、CKD3与4间差异无统计学意义（P〉0.05）,其他各组间比较差异具有统计学意义（P〈0.05）;RMSSD均值为（30.2±18.7）ms,CKD5期明显低于其他4组,且与其他4组间比较差异具有统计学意义（P〈0.05）,但其他4组间比较差异无统计学意义（P〉0.05）;pNN50均值为9.4±5.3,CKD1、2、3、4、5期患者的pNN50呈递减趋势,且各组间比较差异均具有统计学意义（P〈0.05）;LF均值为（1014.3±609.2）ms,CKD3、4期间比较差异无统计学意义（P〉0.05）,其他各组间比较差异均具有统计学意义（P〈0.05）;HF均值为（806.9±318.3）ms,CKD3、4期间比较差异无统计学意义（P〉0.05）,其他各组间比较差异均具有统计学意义（P〈0.05）;LF/HF均值为2.1±0.9,CKD1、2期间,CKD3、4期间比较差异无统计学意义（P〉0.05）,其他各组间比较差异均具有统计学意义（P〈0.05）。血红蛋白、性别、血钠及血钾水平与HRV显著相关。结论：非透析CKD患者HRV下降的比例较高,且随着CKD分期增加,发生HRV下降的比例增加。

Clinical Analysis of Heart Rate Variability in Chronic Kidney Disease Without Renal Replacement Therapy

Objective：To observe the characters of heart rate variability（HRV） in chronic kidney disease （CKD） patients in different stage of renal function. And investigate the association between various factors and HRV.Methods：A total of 263 CKD patients were enrolled in this study, every of whom without renal replacement therapy.The parameters of HRV was measured, includeing SDNN、RMSSD、pNN50、LF、HF、LF/HF. The renal function, blood glucose, HbA1c, lipid profile, hemoglobin, serum, potassium, calcium, phosphorus, et al were also measured.Results：57.79% of 263 CKD patients had a declined HRV,and the rate were 30.77% 、42.00%、52.94%、72.73% and 87.27% in patients with CKD stages1~5 respectively,which had statistically significant differences（P0.05）. HRV was significantly correlated with hemoglobin, sex, sodium and potassium in CKD patients（P0.05）.Conclusion：With the decline of renal function, the rate of declined HRV in CKD patients became higher.Hemoglobin, sex, sodium and potassium were related with the decline of HRV in CKD.