维持性血液透析患者透析前后血生化指标变化对自主神经功能的影响

摘要

目的 探讨维持性血液透析(MHD)患者血液透析(HD)前后血生化指标变化对自主神经功能是否产生影响.方法 选取2011年8月至2012年8月在广西壮族自治区人民医院进行治疗的80例MHD患者,HD前后测定心率变异性(HRV)时域指标及血生化指标.结果 MHD患者HD前后HRV时域指标的差异无统计学意义(P＞0.05).血钾(K+)、血尿素氮(BUN)、肌酐(Cr) HD前分另为(4.4±0.7)mmoL/L、(21.6±7.5) mmol/L、(735.1±203.7) mmol/L,HD后分别为(3.6±0.5) mmol/L、(7.3±3.5) mmol/L、(271.0±73.2)mmol/L,HD后血K+、BUN、Cr均显著低于HD前(P＜0.05).血Ca2、HCO3-HD前分别为(2.0±0.3) mmol/L、(21.9±2.5) mmol/L,HD后分别为(2.4±0.3) mmol/L、(27.6 ±2.1) mmol/L,HD后血C2+、HCO3-显著高于HD前(P＜0.05).各项生化指标与HRV各项指标间无显著相关性(P＞0.05).结论 MHD患者HD的过程不能改善心脏自主神经功能,HD前后血生化指标的快速变化对自主神经功能无明显影响.%Objective To investigate the effect of sudden changes of the blood biochemical indexes on autonomic nervous function before and after hemodialysis(HD).Methods Time domain of HRV and blood biochemical indexes were measured before and after maintenance hemodialysis (MHD) for 80 patients admitted by People's Hospital of Guangxi Zhuang Autonomous Region from Aug.2011 to Aug.2012.Results There was no significant difference in time domain indexes before and after HD (P ＞0.05).K+,BUN and Cr in serum before HD were (4.4 ± 0.7) mmol/L,(21.6 ± 7.5) mmol/L,(735.1±203.7) mmol/L,K+,BUN and Cr in serum after HD were(3.6 ±0.5) mmoL/L,(7.3 ±3.5) mmol/L,(27 1.0 ± 73.2) mmol/L.The concentrations of K +,BUN and Cr in serum after HD were significantly lower than those before HD.Ca2+,HCO3-in serum before HD were(2.0 ±0.3) mmol/L,(21.9 ±2.5) mmoL/L,Ca2 +,HCO3-in serum after HD were (2.4 ± 0.3) mmol/L,(27.6 ± 2.1) mmol/L,Ca2+,HCO3-in serum after HD were significantly higher than that before HD(P ＜ 0.05).There was no significant correlation between the biochemical and HRV indexes (P ＞ 0.05).Conclusion Autonomic nervous function cannot be improved by MHD or affected by the sudden changes of blood biochemical indexes before and after HD.