尿毒症患者心率震荡的变化与甲状旁腺素关系的探讨

摘要:目的:探讨尿毒症患者心率震荡(HRT)的变化与甲状旁腺素(PTH)的关系。方法:选择尿毒症血液透析患者82例,检测血肌酐、血清全段PTH(iPTH)等指标,24 h动态心电图收集HRT数据,根据iPTH进行分组:A组(iPTH>300 ng/L),B组(iPTH≤300 ng/L);A组给予血液透析、降磷及骨化三醇治疗,治疗后复查上述指标,并进行对比分析;B组给予常规血液透析治疗。结果:与B组相比,A组患者震荡初始值(TO)明显升高,震荡斜率(TS)明显降低,差异有统计学意义(P<0.05);A组治疗前后比较,TO明显升高,TS降低,差异有统计学意义(P<0.05);血iPTH水平与TO呈正相关(r=0.435,P<0.05),与TS呈负相关(r=-0.238, P<0.05)。结论:尿毒症血液透析患者HRT现象明显受损,继发性甲状旁腺功能亢进症(SHPT)与HRT关系密切,治疗SHPT有助于改善HRT。
Objective:To discuss the relationship between heart rate turbulence (HRT) changes and para-thyroid hormone in uremic patients. Methods:Eighty-two MHD patients were divided into group A (iPTH>300 ng/L) and group B (iPTH≤300 ng/L) according parathyroid hormone levels. The patients of group A were given treatment of hemodialysis, blood phosphorus reduction and calcitriol, group B were only given treatment of he-modialysis. All patients underwent 24 h ambulatory electrocardiogram, the turbulence onset (TO) and turbulence slope (TS) were calculated. Blood creatinine, parathyroid hormone were observed before and after treatment. Re-sults:Compared with group B, TO was increased (P<0.05), but TS decreased signiifcantly in group A (P<0.05). Parathyroid hormone levels were positively correlated with TO (r=0.435, P<0.05), and were negatively corre-lated with TS (r=-0.238, P<0.05). Conclusion:Heart rate turbulence is signiifcantly impaired in uremic patients. Secondary hyperparathyroidism (SHPT) is closely related to HRT. Treatment of SHPT is helpful to HRT.

英文标题Relationship between heart rate turbulence changes and parathyroid hormone in uremic patients
关键字心率震荡,尿毒症,血液透析,甲状旁腺素
作者王永业,李若福
所属期刊栏目临 床 经 验,
刊名温州医科大学学报,Journal of Wenzhou Medical University
作者单位李若福:苍南人民医院,王永业:苍南人民医院
DOI10.3969/j.issn.2095-9400.2016.06.016
SSSN2095-9400

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