中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
24期
2881-2884,2885
,共5页
王军%朱文娴%柳艳松%张付全%周振和
王軍%硃文嫻%柳豔鬆%張付全%週振和
왕군%주문한%류염송%장부전%주진화
抑郁症%复发%病程%心率变异性
抑鬱癥%複髮%病程%心率變異性
억욱증%복발%병정%심솔변이성
Depressive disorder%Recurrence%Disease duration%Heart rate variability
目的:比较首发抑郁症与复发抑郁症患者心率变异性( HRV)的差异,探讨复发及病程对抑郁症患者HRV的影响。方法选取2012年10月—2014年9月无锡市精神卫生中心有偿招募的抑郁症患者81例,根据其实际病情分为首发抑郁症组(首发组,35例)和复发抑郁症组(复发组,46例)。同时有偿招募健康志愿者43例作为对照组。收集受试者临床资料,并行24 h动态心电图检测,分析其HRV,采用协方差分析比较3组时域指标全部正常RR间期标准差(SDNN)、相邻RR间期差值>50 ms的心搏数所占百分比(pNN50)及频域指标低频功率(LF)、高频功率( HF)的差异,并采用偏相关分析探索抑郁症患者病程与各 HRV指标间的相关性。结果首发组病程短于复发组(P<0.05)。交互作用检验显示, HRV指标数据均满足协方差分析的平行性假设(SDNN: F交互=1.234, P交互=0.301; pNN50: F交互=0.382, P交互=0.766; LF: F交互=1.243, P交互=0.297; HF: F交互=1.071, P交互=0.364)。3组LF和HF比较,差异均无统计学意义( P>0.05);3组SDNN和pNN50比较,差异均有统计学意义( P<0.05);其中,首发组和复发组SDNN和pNN50均低于对照组,复发组SDNN低于首发组( P<0.05)。对抑郁症患者(首发组+复发组)进行以年龄、 BMI、汉密尔顿焦虑量表(HAMA)评分及汉密尔顿抑郁量表(HAMD)评分为控制变量的偏相关分析,结果显示,复发组患者病程与SDNN、 HF呈负相关(R=-0.372、-0.261, P=0.001、0.022),与pNN50呈边缘负相关(R=-0.224, P=0.050),与LF无直线相关性(R=-0.076, P=0.513)。结论抑郁症患者存在HRV降低的特点,复发者比首发者HRV更低,且患者病程与SDNN、 HF呈负相关,提示抑郁症复发及病程延长会加重自主神经功能紊乱。
目的:比較首髮抑鬱癥與複髮抑鬱癥患者心率變異性( HRV)的差異,探討複髮及病程對抑鬱癥患者HRV的影響。方法選取2012年10月—2014年9月無錫市精神衛生中心有償招募的抑鬱癥患者81例,根據其實際病情分為首髮抑鬱癥組(首髮組,35例)和複髮抑鬱癥組(複髮組,46例)。同時有償招募健康誌願者43例作為對照組。收集受試者臨床資料,併行24 h動態心電圖檢測,分析其HRV,採用協方差分析比較3組時域指標全部正常RR間期標準差(SDNN)、相鄰RR間期差值>50 ms的心搏數所佔百分比(pNN50)及頻域指標低頻功率(LF)、高頻功率( HF)的差異,併採用偏相關分析探索抑鬱癥患者病程與各 HRV指標間的相關性。結果首髮組病程短于複髮組(P<0.05)。交互作用檢驗顯示, HRV指標數據均滿足協方差分析的平行性假設(SDNN: F交互=1.234, P交互=0.301; pNN50: F交互=0.382, P交互=0.766; LF: F交互=1.243, P交互=0.297; HF: F交互=1.071, P交互=0.364)。3組LF和HF比較,差異均無統計學意義( P>0.05);3組SDNN和pNN50比較,差異均有統計學意義( P<0.05);其中,首髮組和複髮組SDNN和pNN50均低于對照組,複髮組SDNN低于首髮組( P<0.05)。對抑鬱癥患者(首髮組+複髮組)進行以年齡、 BMI、漢密爾頓焦慮量錶(HAMA)評分及漢密爾頓抑鬱量錶(HAMD)評分為控製變量的偏相關分析,結果顯示,複髮組患者病程與SDNN、 HF呈負相關(R=-0.372、-0.261, P=0.001、0.022),與pNN50呈邊緣負相關(R=-0.224, P=0.050),與LF無直線相關性(R=-0.076, P=0.513)。結論抑鬱癥患者存在HRV降低的特點,複髮者比首髮者HRV更低,且患者病程與SDNN、 HF呈負相關,提示抑鬱癥複髮及病程延長會加重自主神經功能紊亂。
목적:비교수발억욱증여복발억욱증환자심솔변이성( HRV)적차이,탐토복발급병정대억욱증환자HRV적영향。방법선취2012년10월—2014년9월무석시정신위생중심유상초모적억욱증환자81례,근거기실제병정분위수발억욱증조(수발조,35례)화복발억욱증조(복발조,46례)。동시유상초모건강지원자43례작위대조조。수집수시자림상자료,병행24 h동태심전도검측,분석기HRV,채용협방차분석비교3조시역지표전부정상RR간기표준차(SDNN)、상린RR간기차치>50 ms적심박수소점백분비(pNN50)급빈역지표저빈공솔(LF)、고빈공솔( HF)적차이,병채용편상관분석탐색억욱증환자병정여각 HRV지표간적상관성。결과수발조병정단우복발조(P<0.05)。교호작용검험현시, HRV지표수거균만족협방차분석적평행성가설(SDNN: F교호=1.234, P교호=0.301; pNN50: F교호=0.382, P교호=0.766; LF: F교호=1.243, P교호=0.297; HF: F교호=1.071, P교호=0.364)。3조LF화HF비교,차이균무통계학의의( P>0.05);3조SDNN화pNN50비교,차이균유통계학의의( P<0.05);기중,수발조화복발조SDNN화pNN50균저우대조조,복발조SDNN저우수발조( P<0.05)。대억욱증환자(수발조+복발조)진행이년령、 BMI、한밀이돈초필량표(HAMA)평분급한밀이돈억욱량표(HAMD)평분위공제변량적편상관분석,결과현시,복발조환자병정여SDNN、 HF정부상관(R=-0.372、-0.261, P=0.001、0.022),여pNN50정변연부상관(R=-0.224, P=0.050),여LF무직선상관성(R=-0.076, P=0.513)。결론억욱증환자존재HRV강저적특점,복발자비수발자HRV경저,차환자병정여SDNN、 HF정부상관,제시억욱증복발급병정연장회가중자주신경공능문란。
Objective To compare heart rate variability ( HRV) between patients with first -episode depression and patients with recurrent depression and investigate the influence of relapse and disease course of depression on HRV .Methods We recruited 81 depressive patients with payment from Wuxi Mental Health Center from October 2012 to September 2014.These patients were divided into two groups: first -episode group (n=35) and recurrent group (n =46).We also recruited 43 healthy people with payment and assigned them into control group . Clinical data of subjects were collected; 24 h dynamic electrocardiogram was undertaken , and HRV was analyzed; analysis of covariance was conducted to compare SDNN , pNN50, LF and HF among the three groups; partial correlation analysis was conducted to determine the correlation between disease duration of depression and HRV indicators .Results The first-episode group had shorter disease duration than the recurrent group (P<0.05).The test on interaction effect showed that HRV indicators all satisfied the parallelism hypothesis of covariance analysis (SDNN: Finteraction =1.234, Pinteraction =0.301; pNN50: Finteraction =0.382, Pinteraction =0.766; LF: Finteraction =1.243, Pinteraction =0.297; HF: Finteraction =1.071, Pinteraction =0.364).The three groups were not significantly different (P>0.05) in LF and HF; the three groups were significantly different ( P <0.05 ) in SDNN and pNN50; the first -episode group and recurrent group were lower (P<0.05) than the control group in SDNN and pNN50, and the recurrent group was lower (P<0.05) than the first -episode group in SDNN.The partial correlation analysis on depressive patients ( first -episode and recurrent group) with age, BMI, HAMA score and HAMD score as the control variables showed the following results: ( R=-0.372, -0.261; P=0.001, 0.022) and marginally negatively correlated with pNN50 (R=-0.224, P=0.050) and had no linear correlation with LF (R=-0.076, P=0.513).Conclusion Depressive patients have low HRV .Patients with recurrent depression have lower HRV than patients with first -episode depression , and disease duration was negatively correlated with SDNN and HF.The lapse of depression and longer disease duration may aggravate autonomic nerve function disorder .