摘要
目的 探讨血液透析对慢性肾小球肾炎导致终末期肾病患者电解质、心率变异性的影响。方法 选取2014年12月-2018年12月在本院明确诊断为慢性肾小球肾炎导致终末期肾病并行血液透析的患者30例作为研究对象,比较透析前与透析后3个月的血清钠(Na+)、钾(K+)等电解质水平、24 h动态心电图监测结果。结果 与透析前相比较,血液透析3个月后患者血清Na+、K+明显降低,Ca2+、HCO3-明显升高,差异具有统计学意义(P<0.05);透析3个月后,患者的正常窦性心博间期(NN)的标准差(SDNN)、相邻NN间期差的均方根(RMSSD)、相邻NN间期的差值超过50 ms的心搏数占NN间期总心搏数的百分比(p NN50)、高频功率(HF)、低频功率(LF)均明显升高,差异具有统计学意义(P<0.05);进一步相关性分析发现透析前后血清Na+、K+、Ca2+、HCO3-水平与心率变异性相关参数之间无显著相关性(P>0.05)。结论 慢性肾小球肾炎导致终末期肾病患者电解质紊乱、自主神经系统损害较为严重、心率变异性降低,血液透析可显著改善患者的心率变异性和电解质紊乱,但透析前后电解质水平与心率变异性无显著相关性。
Objective The aim is to investigate the effect of hemodialysis on electrolyte and heart rate variability in patients with end-stage renal disease caused by chronic glomerulonephritis.Methods Thirty hemodialysis patients with end-stage renal disease caused by chronic glomerulonephritis,admitted to our hospital during the time period December 2014 and December 2018,were enrolled as study objects.The levels of serum electrolyte including sodium(Na+)and potassium(K+),the 24 h dynamic electrocardiogram of the patients before the dialysis and three months after dialysis were measured and compared.Results Compared with those before dialysis,3 months after hemodialysis,serum levels of Na+and K+were significantly decreased,however,the concentration of Ca2+and HCO3-were markedly increased,the differences were statistically significant(P<0.05).After 3 months of dialysis,the standard deviation of the inter-sub-interval(NN)of the patient’s normal sinus heart(SDNN),the root mean square of the adjacent NN interval(RMSSD),and the percentages of the amount of the difference in the interval between adjacent NN intervals exceeding 50 ms account for the total heart rate of the NN interval(p NN50),high frequency power(HF),and low frequency power(LF)were all significantly increased(P<0.05).Further correlation analysis found that there was no significant correlation between serum Na+,K+,Ca2+,HCO3-level and heart rate variability parameters before and after dialysis(P>0.05)Conclusions Patients with end-stage renal disease caused by chronic glomerulonephritis showed electrolyte imbalance,autonomic nervous system damage and decreased heart rate variability.And hemodialysis could significantly improve heart rate variability and electrolyte imbalance,but it shows no significant correlation between electrolyte levels dialysis and heart rate variability.
作者
程冬梅
常保超
张海峰
刘磊
陈卫东
CHENG Dong-mei(Department of Nephrology,the first affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233000,China)
出处
《齐齐哈尔医学院学报》
2019年第20期2532-2534,共3页
Journal of Qiqihar Medical University
关键词
慢性肾小球肾炎
终末期肾病
血液透析
心率变异性
电解质
Chronic glomerulonephritis
End-stage renal disease
Hemodialysis
Heart rate variability
Electrolyte
