瞳孔测定评估心律失常患者焦虑情绪的可行性

目的 分析心律失常患者焦虑的发生率及程度,建立客观诊断心律失常伴焦虑的瞳孔动态测定法.方法 选择以心悸为主诉就诊的患者117例,根据静息体表12导联心电图和（或）动态心电图检查将其分为实验组（心律失常）和对照组（无心律失常）.采用汉密尔顿焦虑量表（HAMA）评估焦虑的患病率及程度,用心电图诊断心律失常,用瞳孔动态测定法记录受试者瞳孔动态变化规律.将心律失常伴焦虑组与心律失常不伴焦虑组的A值（A值=瞳孔直径/虹膜直径）进行统计学分析.结果 实验组HAMA评分平均值为10.19±5.94,对照组HAMA评分平均值为6.73±5.17,两组差异有统计学意义（P＜0.01）.心律失常伴焦虑组患者的A值平均值为0.41 ±0.07,大于不伴焦虑组患者的A值平均值（0.33±0.02）,差异有统计学意义（P＜0.01）.在相同时间内,心律失常伴焦虑组的A值围绕0.35～0.45近似正态分布,心律失常不伴焦虑组的A值分布集中于0.25～0.35,不呈正态分布.结论 瞳孔动态测定法初步表明能客观判断心律失常患者焦虑情绪的存在.

The feasibility of pupil determination to evaluate anxiety in patient with arrhythmia

Objective To analyze the incidence and severity of anxiety in patients with arrhythmia,establish pupil dy- namic assays to objectively diagnose arrhythmia with anxiety. Methods 117 patients with the chief complaint of palpitations treated in our hospital were chosen,and were divided into experimental group and control group according to rest- ing surface 12-lead electrocardiogram and （or） dynamic electrocardiogram.Hamilton anxiety scale （HAMA） was used to evaluate the prevalence and degree of anxiety,electrocardiogram was used to diagnose arrhythmia,pupil dynamic assays was used to record the dynamic variation of pupiLA value （pupil diameter/iris diameter） in arrhythmia patients with anx- iety group and arrhythmia patients without anxiety group was analyzed. Results HAMA score of experimental group was 10.19±5.94,the control group was 6.73±5.17,there was significant difference between the two groups （P〈0.01）.The A av- erage score of arrhythmia patients with anxiety group was 0.41±0.07,higher than 0.33±0.02 of the arrhythmia patients without anxiety group,the difference was significant （P〈0.01）.In the same time,the A value of the arrhythmia patients with anxiety group was around 0.35-0.45,which was approximate normal distribution;the A value of the arrhythmia patients without anxiety group was around 0.25-0.35,which was not normal distribution. Conclusion Pupil dynamic assay is pre- liminary indicated to be able to objectively determine the presence of anxiety in patient with arrhythmia.