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目的本研究通过观察冠心病经皮冠状动脉介入术(PCI)后伴发抑郁焦虑患者的心率变异性(HRV)变化,探讨HRV与PCI术后伴发抑郁焦虑的相关性和对自主神经功能紊乱的预测价值。方法 85例PCI术后1个月患者,完成PHQ-9和GAD-7量表后进行HRV检测。根据PHQ-9及GAD-7量表评分为四组,A组为PHQ-9评分>13分,且GAD-7评分≤10分;B组为GAD-7评分>10分,且PHQ-9评分≤13分;C组为PHQ-9>13分,且GAD-7评分>10分;D组为PHQ-9≤13分,且GAD-7评分≤10分。分别观察组间的HRV变化及相关性。结果基础心率在A、B、C三组均高于D组(P<0.01或0.05);正常RR间期标准差(SDNN)、正常RR间期平均值标准差(SDANN)、相邻正常RR间期差值均方的平方根(RMSSD)、相邻正常RR间期差值大于50 ms的计数占总RR间期计数的百分比(pNN50)、正常RR间期标准差平均值指标D组明显高于A、B、C组(P均<0.01);SDNN、SDANN、RMSSD指标C组明显低于B组(P<0.01或0.05)。极低频功率(VLF)、低频功率(LF)、LF/HF比值A、B、D三组明显低于C组(P<0.01或0.05);LF、LF/HF比值A、B组明显高于D组(P均<0.01);HF指标D组明显高于C组(P均<0.01)。结论冠心病PCI术后患者伴发抑郁焦虑状态患者存在明显的HRV下降,LF/HF比值可以作为这类患者的神经生物学观察指标,对PCI术后出现抑郁与焦虑情绪有一定的预测价值。
ObjectiveTo investigate the relationship between HRV and depression and anxiety after PCI and the changes of heart rate variability (HRV) in patients with depression and anxiety after percutaneous coronary intervention (PCI) The predictive value. Methods A total of 85 patients (one month after PCI) were enrolled in the study. HRV was detected after PHQ-9 and GAD-7 were completed. According to the scale of PHQ-9 and GAD-7, there were four groups, the score of PHQ-9 was 13 points in group A, the score of GAD-7 was ≤10 points in group A, the score of GAD-7 was> 10 points in group B, Score≤13; group C was PHQ-9> 13, and GAD-7 score was> 10; group D was PHQ-9≤13, and score of GAD-7≤10. The change of HRV and the correlation between the two groups were observed. Results The basal heart rate was higher in group A, B and C than in group D (P <0.01 or 0.05). The standard deviation of normal RR interval (SDNN), standard deviation of normal RR interval (SDANN), adjacent normal RR (RMSSD) of inter-period difference, the percentage of the total RR interval count (pNN50) between adjacent normal RR interval of more than 50 ms, and the average of standard deviation of normal RR interval was significantly higher in group D (P <0.01). The SDNN, SDANN and RMSSD indicators in group C were significantly lower than those in group B (P <0.01 or 0.05). The VLF, LF and LF / HF ratios in group A, B and D were significantly lower than those in group C (P <0.01 or 0.05). The LF and LF / HF ratios in group A and B were significantly higher than those in group C D group (all P <0.01); HF group D group was significantly higher than C group (P <0.01). Conclusions There is a significant decrease of HRV in patients with coronary heart disease and postoperative PCI. The ratio of LF / HF may be used as a neurobiological index in this kind of patients, which may predict depression and anxiety after PCI.