维持性血液透析中心律失常相关因素的探讨
血液透析;,心律失常;,超滤量,,血液透析;,心律失常;,超滤量,1资料与方法,2结果,3讨论,参考文献:
摘要： 目的：探讨维持性血液透析期间引起心律失常的相关因素。方法： 回顾性分析83例慢性肾功能衰竭患者的临床资料，83例患者进行维持性血液透析,比较不同年龄段(<50岁、50～60岁、>60岁)、不同超滤量(<3 kg、≥3 kg)及不同并发症患者(冠心病、高血压、心包积液、重度贫血)的心律失常发生率，并比较透析中有无心律失常患者透析前、后血压(收缩压、舒张压)、肾功能(血肌酐、尿素氮)、电解质(血清钾、钠、氯、钙离子)的差异。结果：83例患者共行血液透析2 408例次，发生心律失常758例次(31.48%) , 发生于上机后2～4 h者494例次(65.17%)。随着年龄增长，透析中心律失常发生率也随之增加，不同年龄段患者心律失常发生率差异有统计学意义(P<0.05)；超滤量≥3 kg患者心律失常率明显高于超滤量<3 kg者(P<0.05)；并发冠心病、心包积液、重度贫血的患者透析中心律失常发生率均明显高于未并发相应疾病者(P<0.05)；透析中出现心律失常患者的血压、肾功及血清离子在透析前与透析中未出现心律失常患者比较，差异无统计学意义(P>0.05)，在透析后血压、血清钾离子明显低于透析中未出现心律失常患者(P<0.05)。结论：维持性血液透析中心律失常的发生可能与年龄、超滤量、并发症、血透相关性低血压、低血钾有关。关键词: 血液透析; 心律失常; 超滤量
The investigation for the correlation factors of arrhythmia in dialyzing LI Jiang, WANG Lei, XU Min
(Department of Internal Medicine, Second Affiliated Hospital, Xinjiang Medical University,
Urumqi 830000, China)Abstract: Objective: To investigate the correlation factors of arrhythmia in dialyzing. Methods: Retrospectively analyze the data of 83 CRF patients. Compare the incidence rate of arrhythmia in dialyzing in different age group, different ultra filtration volume (<3 kg, ≥3 kg) and complication (CHD, hypertension, pericardiumeffusion, severe anemia) in 83 patients and compare the difference of blood pressure (SBP, DBP) kidney function (BUN, Cr), plasma iron (K+, Na+, Cl-, Ca2+), between the patients with or without arrhythmia before and after dialyzing. Results: In 2 048 hematodialysis cases, 758 cases was arrhythmia (31.48%). 494 cases happened in 2~4 h after hematodialysis beginning. There was significant difference in vary ages (P<0.05). The incidence rate of arrhythmia in dialyzing increased with the age. The incidence rate of arrhythmia in ultra filtration volume ≥3 kg is higher than ultra filtration volume <3 kg, with significant difference (P<0.05). More patients who have complications such as CHD, anemia suffered from arrhythmia than patieats without these complications (P<0.05). The blood pressure and plasma K of the patients with arrhythmia lower than patients without arrhythmia. Conclusion: The age, ultra filtration volume, complications, hypotension, hypokalemia may be the correlation factors to arrhythmia in dialyzing. ......
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