Background: Chronic kidney disease (CKD) is very common now and associates with high overall and cardio-vascular mortality. Numerous studies have reported that Heart rate variability (HRV) could also be used to detect cardiovascular autonomic dysfunction (CAD). We investigated the association of electrochemical skin conduc-tance (ESC) of EZSCAN results with HRV in non-dialysis CKD patients.Methods: In a cross-sectional study, we enrolled 248 prevalent non-dialysis CKD patients. Patients underwent a 24-h Holter (CB-2302-A, Bio Instrument, China). A time domain analysis of HRV was performed, and the following parameters were obtained: SDNN, SDANN, rMSSD, pNN50. EZSCAN device (Impeto Medical, Paris, France) measures ESC values of each participants. Mean global skin conductance computed as 0.5 * (reflecting (right + left hand)/2 + (right and left foot)/2). Log transforms data into a normal distribution for statistical analysis.Results: There were 142 males and 106 females included in the present study. Patients' age was 56.6 +/- 17.08 years. Logarithm(Log) (global ESC) was independently predicted by age (P<0.01), hypertension history, esti-mated Glomerular filtration rate (eGFR) and log SDNN (P<0.05). While log SDANN, rMSSD and pNN50 were not independent predictors for log (global ESC).Conclusion: Increased global ESC significantly associated with elevated HRV, specifically SDNN in non-dialysis CKD patients. This suggested that global ESC may appear to be an important predictor of CAD, and even could be used as a cardiovascular risk factor in non-dialysis CKD patients.

目的 探讨慢性肾脏病3期(CKD3)患者体质指数(BMI)与肺通气功能障碍指标的关系及在临床预测中的作用.方法 回顾性选取2015年1月至2019年10月在昆明医科大学第一附属医院完成肺功能检查的CKD3患者250例.根据是否合并肺通气功能障碍分为肺通气功能正常组(正常组,n=119)和合并肺通气功能障碍组(合并组,n=131).分别比较两组患者的临床资料,采用Pearson及Spearman相关分析第1秒用力呼气容积占预计值百分比(FEV1％pred)与BMI及其他指标的关系,ROC曲线评估BMI对CKD3期患者合并肺通气功能障碍的预测价值.进一步将合并组患者分为轻中度障碍组(50％≤FEV1％pred＜80％,n=80)、重度及以上障碍组(FEV1％pred＜50％,n=51),与正常组(FEV1％pred≥80％,n=119)一起比较三组的临床资料,采用多元Logistic回归分析肺通气功能障碍加重的危险因素.结果 两组患者性别、年龄、吸烟史、慢性支气管炎病史比较差异有统计学意义(P＜0.05),正常组患者BMI高于合并组,差异有统计学意义(P＜0.05).FEV1％pred 与 BMI 呈正相关(r=0.217,P＜0.05).BMI 的 AUC 为 0.686(95％CI:0.607～0.765,P＜0.01),截断值为23.45,预测CKD3期患者发生肺通气功能障碍的灵敏度为66.8％,特异度为62.8％.在轻中度障碍组、重度及以上障碍组年龄大于正常组(P＜0.05),但在有障碍的两组比较差异无统计学意义(P＞0.05);三组有慢性支气管炎病史的患者比例为重度及以上障碍组＞轻中度障碍组＞正常组(P＜0.05);随病情加重,BMI逐渐下降,在三组间比较差异有统计学意义(P＜0.05).多元Logistic回归模型显示BMI(OR=0.898,95％CI:0.822～0.981,P＜0.05)及慢性支气管炎病史(OR=0.130,95％CI:0.052～0.324,P＜0.01)是CKD3患者肺通气功能障碍加重的独立危险因素.结论 BMI对CKD3患者发生肺通气功能障碍有一定的临床预测价值,对疾病的发展及预后有一定的临床指导意义.

近年来,随着医疗技术的飞速发展,彩色超声多普勒技术水平及临床应用也得到长足发展,其中肾动脉阻力指数(RRI)已成为诊断多种疾病和评估病情的重要手段.测定RRI不仅在肾损伤的风险预测、严重程度评估等方面有重要临床价值,并且具有无创、床旁、廉价、可重复等优点.本文就目前RRI在临床上的应用作一简单概述.