【摘要】目的探讨终末期肾病患者不同血液透析频率对心率变异性(HRV)的影响及血液透析前后心率变异性的变化。 方法 收集规律透析患者107例，根据透析频率将患者分为1次/2d(Q2d组，共40例）、1次/3d(Q3d组，共37例)及1次/4d(Q4d组，共30例)，3组患者透析前后各HRV指标并进行对比分析。 结果 3组患者透析后各HRV指标均出现升高，以Q2d组及Q3d组升高明显[Q2d：相邻RR间期相差＞50ms的个数占总心跳次数的百分比(PNN50)7.01±3.21 比 6.19±2.56 P＜0.05，24h,全部正常RR间期的标准差(SDNN)135.11±21.98 比105.29±20.78 P＜0.01，相邻RR间期差值均方的平方根(RMSSD)80.78±17.96比 67.66±16.87 P＜0.01, 24h内每5min的RR间期平均值的标准差119.22±23.41 比 108.32±21.20 P＜0.05，全部相邻RR间期之差的标准差(SDSD)77.38±17.78 比 68.29±18.48 P＜0.05]；Q3d：SDNN 128.65±23.79 比 101.32±19.88 P＜0.01,RMSSD 74.69±16.56 比 65.36±15.19 P＜0.05,SDANN 116.33±21.01 比105.54±21.07 P＜0.05，SDSD 73.19±17.33 比 65.17±16.08 P＜0.05；Q4d：SDNN 107.16±20.04 比 90.86±19.54 P＜0.05,RMSSD 66.74±17.82 比 58.63±15.88 P＜0.05)，透析前、后3组患者间的方差分析结果显示组间的差别有统计学意义(透析前：PNN50、SDNN、RMSSD、SDANN、SDSD的F值分别为2.96、   3.65、3.09、3.34、2.90，P＜0.05；透析后：PNN50、SDNN、RMSSD、SDANN、SDSD的F值分别为2.96、3.65、3.09、3.34、2.90，P＜0.05)，且随着透析次数减少HRV有降低趋势。 结论 长期充分的血液透析可能有助于心脏自主神经功能的改善。

【Abstract】Aims To explore the impact of hemodialysis and hemodialysis frequency on heart rate variability (HRV) in patients with end stage renal disease.  Methods A total of 107 patients treated with regular hemodialysis were enrolled in this study. They were assigned into 3 groups according to the hemodialysis frequency: Q2d group (once every 2 days), Q3d group (once every 3 days) and Q4d group (once every 4 days). The parameters of HRV were compared between the 3 groups. Results The parameters of HRV were increase after hemodialysis in all patients (P＜0.05), especially in Q2d and Q3d groups (P＜0.01). Analysis of variance showed that there were significant differences in HRV parameters between the 3 groups before and after hemodialysis (P＜0.05). HRV tended downwards when hemodialysis frequency decreased.  Conclusions Long term and adequate hemodialysis may be useful for the improvement of heart autonomic function.