论文部分内容阅读
目的研究慢性肾脏病(CKD3~5期)患者的微炎症状态与心率变异性的关系。方法分组:CKD组为3~5期CKD住院患者共54例;对照组为30例肾功能正常的健康体检者,以超敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)作为微炎症状态的指标,同时测定两组患者空腹血浆尿素氮(BUN)、肌酐(Scr)、血浆白蛋白(Alb)、总胆固醇(CHO)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及血红蛋白(Hgb),并用24 h动态心电图检测两组患者的心率变异性(heart rate variability,HRV),包括所有窦性心搏间期(NN)的标准差(SDNN),每5 min正常R-R间期平均值标准差(SDANN),每5 min正常R-R间期标准差平均值(SDNNin-dex),相邻正常R-R间期差值均方的平方根(RMSSD),相邻正常R-R间期差值大于50 ms的计数占R-R间期的百分比(PNN50)。结果 3~5期CKD组hs-CRP值较对照组显著升高(P<0.01),而HRV各参数显著低于对照组(P<0.01或P<0.05),且hs-CRP与HRV各参数呈显著负相关。结论 3~5期CKD患者伴有炎症反应的增加和自主神经功能失调,二者相互影响,在CKD患者预后不良的机制中起一定作用。
Objective To investigate the relationship between microinflammatory state and heart rate variability in patients with chronic kidney disease (CKD stage 3-5). Methods: The CKD group consisted of 54 CKD hospitalized patients with stage 3-5 disease. The control group consisted of 30 healthy subjects with normal renal function. High-sensitivity C-reactive protein (hs-CRP) The levels of fasting plasma urea nitrogen (BUN), creatinine (Scr), serum albumin (Alb), total cholesterol (CHO), triglyceride (TG) and high density lipoprotein (HDL) (LDL), and hemoglobin (Hgb). The heart rate variability (HRV), including the standard deviation of all sinus beats (NN), was measured by 24 h Holter monitoring (SDNN ), SDANN of normal RR interval every 5 min, SDNNin-dex of normal RR interval every 5 min, mean square root mean square error (RMSSD) of adjacent normal RR interval, The percentage of RR interval that is greater than 50 ms between adjacent normal RR intervals (PNN50). Results The hs-CRP values in CKD group were significantly higher than those in control group (P <0.01), and the parameters of HRV were significantly lower than those in control group (P <0.01 or P <0.05) Significantly negative correlation. Conclusion CKD patients with stage 3 to 5 with increased inflammatory response and autonomic dysfunction, the two affect each other and play a role in the mechanism of poor prognosis CKD patients.