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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。
Objective: To analyze the characteristics and related factors of heart rate variability (HRV) in patients with non-dialysis chronic kidney disease (CKD). Methods: Totally 263 CKD patients who were hospitalized without renal replacement therapy were tested for HRV (including SDNN, RMSSD, pNN50, LF, HF, LF / HF) and the factors influencing HRV in patients with CKD were analyzed. Results: The proportion of HRV decreased in CKD stage 1 ~ 5 patients was 57.79%, and in CKD 1,2, 4, 4 and 5 phases were 30.77%, 42.00%, 52.94%, 72.73% and 87.27%, respectively Statistical significance (P <0.05). The average value of SDNN in CKD patients was (110.8 ± 33.5) ms. There was no significant difference between CKD3 and 4 except CKD1 and 2 (P> 0.05), but there was significant difference among other groups (P <0.05) ; Mean RMSSD was (30.2 ± 18.7) ms, CKD5 was significantly lower than the other 4 groups, and the difference was statistically significant (P <0.05), but there was no significant difference between the other 4 groups (P <0.05). The mean of pNN50 was 9.4 ± 5.3. The pNN50 of CKD1, 2, 3, 4, 5 patients showed a decreasing trend, and the differences among the groups were statistically significant (P <0.05) 1014.3 ± 609.2) ms, CKD3 and 4, there was no significant difference between the other groups (P <0.05), and the average of HF was (806.9 ± 318.3) ms and CKD3 (P <0.05). There was significant difference between the other groups (P <0.05). The average of LF / HF was 2.1 ± 0.9. During CKD1 and 2, CKD3 and 4 There was no significant difference between the two groups (P> 0.05). The difference between the other groups was statistically significant (P <0.05). Hemoglobin, gender, serum sodium and potassium levels were significantly associated with HRV. CONCLUSIONS: The proportion of HRV declines in non-dialysis CKD patients is high, and as the CKD stage increases, the rate of HRV declines increases.