抑郁症与精神分裂症患者心率变异性的对照分析

目的探讨抑郁症与精神分裂症患者的心率变异性（HRV）的差异。方法对36例首次发作的抑郁症患者及年龄、性别与之相匹配的41例首次发作的精神分裂症患者分别进行短时程HRV检测,并对其心率变异指标SDNN、MSD、rMSSD、PNN50、LF、HF、LF/HF结果进行分析。结果抑郁症患者的时阈指标rMSSD（P〈0.05）、PNN50（P〈0.01）较精神分裂症显著降低,而两者之间的频阈分析指标无明显差异。结论抑郁症患者的自主神经功能失调较精神分裂症患者更严重。     

抑郁症焦虑症患者心率变异性特点的对比研究

目的探讨抑郁症、焦虑症患者自主神经功能的特点。方法随机选择42例抑郁症患者,10例焦虑症患者和17例健康对照者分别接受短时心率变异性分析,记录相关考察指标,进行统计学分析。结果心率变异性分析的各项考察指标中,各观察组均有一项或多项低于正常对照组（P〈0．05）;且各组之间互相对比分析P〈0．05。结论抑郁症、焦虑症患者均存在心率变异性的降低,其自主神经功能活性降低。抑郁症患者因伴或不伴有焦虑症状,其心率变异指标不同,可以指导治疗。     

抑郁症与长期住院精神分裂症患者事件相关电位P300对照研究

目的对照抑郁症与长期住院精神分裂症患者之间事件相关电位P300的特点。方法对69例抑郁症患者(DD组),69例长期住院精神分裂症患者(SD组)以及70例健康对照患者(HC组)进行对照研究,记录中央点(Cz电极)N1、P2、N2、P3成分。结果三组之间N1、P2、N2、P3的潜伏期,P3波幅的差异有统计学意义(P<0.01)。SD组N1、P2、N2、P3潜伏期延长较HC组有统计学意义(P<0.01),P3波幅减低有统计学意义(P<0.01);DD组较HC组N2、P3潜伏期延长,P3波幅减低均有统计学意义(P<0.01);SD组N1、P2、N2、P3潜伏期延长较DD组有统计学意义(P<0.01),P3波幅差异无统计学意义(P=0.787)。结论长期住院精神分裂症认知受损程度较抑郁症明显,P300可以对抑郁症与精神分裂症的鉴别提供参考。     

齐拉西酮对首发男性精神分裂症患者心率及变异性的影响

目的 研究齐拉西酮对首发精神分裂症男性患者的心率及变异性影响,为临床安全用药提供参考.方法 将2011年1月～2012年10月收治的首发精神分裂症男性患者61例纳入研究,给予齐拉西酮治疗;健康体检者63例作为对照组,比较治疗前两组心率及变异性的指标差异以及齐拉西酮治疗8周前后心率变异性的指标差异,了解齐拉西酮对精神分裂症男性患者的心率变异性影响.结果 在基线时,研究组和对照组相比,HR及HRV所有指标(SDNN、SDNNi、PNN50、SDANN)的差异均有统计学意义(P＜0.01);研究组治疗8周前后比较,除SDNNi外,其余指标的差异均有统计学意义(P＜0.01);研究组治疗8周后,与对照组比较,除PNN50外,其余指标的差异均有统计学意义(P＜0.01).结论 精神分裂症患者存在心率变异性下降,交感神经张力增加,迷走神经张力降低,有可能增加心源性猝死的几率,齐拉西酮的治疗可能加重其影响;故对于使用齐拉西酮治疗的精神分裂症男性患者需要加强观察以及实行心率变异性的监测,以加强医疗安全.     

不同第二代抗精神病药物对精神分裂症患者心率变异性影响

目的 探讨氯氮平、利培酮、齐拉西酮和奥氮平四种药物对精神分裂症患者心率变异性的影响.方法 将165例精神分裂症患者随机分入氯氮平、利培酮、齐拉西酮和奥氮平治疗组.采用24小时动态心电图在治疗前和治疗8周末分别检测各组的心率变异性(Heart rate variability,HRV)参数变化.结果 治疗8周末与基线期相比,氯氮平组心率显著加快[(86.4±11.8)vs.(76.3±8.1)];氯氮平和齐拉西酮组SDNN值、SDANN、PNN50值显著降低,而利培酮及奥氮平组SDNNI值、PAN50值、rMSSD值显著增高,差异均有统计学意义.结论 在对心率变异性的影响上,奥氮平、利培酮明显优于齐拉西酮和氯氮平,有更好的心脏保护作用.     

抑郁症对老年2型糖尿病患者心率变异性的影响

目的 探讨抑郁症对老年2型糖尿病患者心率变异性的影响.方法 对70例老年2型糖尿病患者进行汉密尔顿抑郁量表(HAMD)测定及动态心电图测定,分为糖尿病合并抑郁症组(研究组)30例,糖尿病不合并抑郁症组(对照组)40例,比较两组患者动态心电图检查中心率变异性的变化.结果 研究组与对照组正常窦性R-R间期总体标准差分别为(81.97±11.63)ms和(111.82±14.11)ms、24 h每5 min窦性R-R间期均值标准差分别为(76.17±14.07) ms和(102.34±16.56) ms、正常连续窦性R-R间期差值均方根分别为(14.67±5.42) ms和(20.13±8.34) ms、相邻R-R间期差值＞50 ms的个数所占的百分比分别为4.65％±2.43％和7.32％±3.15％,差异均有统计学意义(P＜0.01).结论 研究组心率变异性较对照组降低,表明抑郁症增加老年2型糖尿病患者自主神经功能损害.     

躯体化症状为主的抑郁症心率变异性对照研究

目的：探讨躯体化症状为主的抑郁症患者自主神经系统的特点及抑郁症躯体化表现的发生机制。方法：对30例躯体化症状为主的患者（A组）和30例情绪症状为主的患者（B组）及30例健康正常者（C组）分别进行汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定及短时（10min）心率变异性（HRV）分析。结果：A、B、C3组HRV分析指标RR间期标准差（SDNN）分别为（50.84±19.92）ms、（94.93±28.80）ms、（105.77±22.05）ms,A组显著低于C组（t=5.68,P〈0.01）,较B组低（t=3.73,P〈0.05）;3组LF/HF分别为（6.26±2.11）ms、（3.51±2.44）ms、（1.80±1.07）ms,A组显著高于C组（t=6.35,P〈0.01）,较B组高（t=2.50,P〈0.05）;A组HAMD评分（28.30±6.26）分高于B组（24.35±6.69）分,二者差异有显著性（t=3.14,P〈0.05）;A组HAMA评分（22.70±4.92）分显著高于B组（13.05±4.71）分,二者差异有显著性（t=6.17,P〈0.01）;HAMD焦虑/躯体化因子分与HRV指标SDNN、LF、HF、VLF和LF/HF均呈中度相关（r分别为0.49、0.61、0.58、0.50、0.63）（P〈0.05或P〈0.01）。结论：躯体化症状表现为主的抑郁症患者多伴有焦虑,自主神经功能紊乱。     

精神分裂症和抑郁症患者自杀行为的临床特征分析和护理

目的 探讨精神分裂症和抑郁症患者自杀行为的临床特征。方法 采用现症检查的方法对我院住院的精神分裂症和抑郁症患者进行随机抽样，并对资料进行χ^2检验。结果 偏执型精神分裂症与伴有抑郁症状的精神分裂症和兴奋、激惹、有冲动行为的精神分裂症患者易出现自杀。结论 精神分裂症和抑郁症患者自杀行为的临床特征不同，应采取有针对性的治疗措施。     

抑郁症与精神分裂症患者早年与父母分离经历的比较

目的:调查和比较抑郁症与精神分裂症患者早年与父母分离经历,初步探讨早年与父母分离经历与抑郁症之间的关系. 方法:采用随机抽样方法,选取符合国际疾病和相关健康问题统计分类第10版抑郁症和精神分裂症诊断标准的患者各80例,选取80名年龄、性别、受教育年限匹配的正常人为对照组.采用自编早年分离经历调查问卷对3组进行调查. 结果:抑郁症组有早年与父母分离经历的比率(x2分别=5.01,11.02)、在分离期间与父母相距省外的比率(x2分别=8.17,15.07)及对分离经历的负面评价(x2分别=12.57,9.99)均高于精神分裂症组和对照组(P＜0.05或P＜0.01);抑郁症组早年与父母分离后的养育人与精神分裂症组和对照组差异有统计学意义(x2分别=11.91,10.90;P均＜0.05). 结论:早年与父母分离的经历可能是成年后患抑郁症的社会心理因素之一.     

精神分裂症长期住院患者躯体疾病调查

目的：分析精神分裂症长期住院患者躯体疾病情况。方法：对精神分裂症长期住院患者215例进行心电图、血糖、血常规、血钾、血压等检验，并与一般人群进行比较。结果：伴有冠心病、糖尿病和肺结核均以精神分裂症长期住院患者显著较一般人群为多（P均〈0．01），高血压病显著较少（P〈0．05）。结论：应注意长期住院精神分裂症患者用药情况和躯体情况。     

The relationship between heart rate, heart rate variability and depression in patients with coronary artery disease

Seventy-seven patients undergoing elective cardiac catheterization were administered a diagnostic psychiatric interview and their mean heart rates and heart rate variability were determined from the results of a 24 hr ambulatory ECG. The mean heart rate for depressed patients with coronary artery disease (CAD) was significantly higher than for nondepressed CAD patients, independent of the patient's age, smoking status, and beta blocker therapy. Heart rate variability was lower in depressed patients but did not achieve significance. With the exception of smoking, which was more common in depressed patients, there were no significant differences between the depressed and nondepressed patients on any other medical or demographic variable assessed. It is concluded that elevated heart rate may represent increased sympathetic tone in depressed CAD patients, and may help to explain the increased morbidity and mortality reported in these patients.     

Association between depression and heart rate variability in patients after cardiac surgery: a pilot study

ObjectiveDepression is a risk factor for cardiovascular diseases. Reduced heart rate variability (HRV), which reflects altered autonomic nervous system activity, has been suggested as one of the mechanisms linking depression to cardiovascular diseases. However, the relationship between depression and HRV has not yet been investigated in patients undergone cardiac surgery. Therefore, the main aim of this study was to examine whether postoperative depression could be related to reduced HRV.MethodsEleven patients with depression and 22 patients without depression, who had undergone cardiac surgery, were enrolled postoperatively. In all patients, HRV was derived from a four-minute blood volume pulse recording at rest. Analyses of covariance and partial correlations, while controlling for anxiety, were used to examine the associations between postoperative depression and each HRV parameter.ResultsCompared to non-depressed patients, patients with depression showed significantly lower standard deviation of N-to-N intervals (SDNN) (p = .02), root mean square successive difference of N-to-N intervals (rMSSD) (p = .001), and high‐frequency power (p = .002). Partial correlation analyses showed that depression was inversely related to SDNN (r = ? .49, p = .005), rMSSD (r = ? .58, p = .001), and high‐frequency power (r = ? .41, p = .02), whereas it was unrelated to other HRV parameters (p's > .09).ConclusionsThe current findings extend the depression-reduced HRV relationship to the patients after cardiac surgery. Also, our study suggests that postoperative depression is more likely to be associated with reduced vagal modulation on the heart than with excessive sympathetic activity.     

Heart rate variability in patients with major depression

We have previously reported decreased heart rate variability upon standing in panic disorder patients compared with controls. In this study, we extend our report to include patients with major depression (n = 19). Compared to normal controls (n = 20) and panic disorder patients (n = 30), there was no significant difference in the immediate changes in heart rate upon standing in the depressed group. The standing heart rate variability (R-R variability) was significantly lower in panic disorder patients compared to both normal controls and depressed patients as indicated by the corrected standard deviations, the corrected mean consecutive difference, the corrected standard deviation of the mean consecutive difference of the R-R intervals, and the high frequency variability in successive R-R intervals, suggesting an increased vagal withdrawal in panic disorder patients, especially upon standing. There was no significant difference in any of the heart rate variability measures between depressed patients and normal controls.     

Severe depression is associated with markedly reduced heart rate variability in patients with stable coronary heart disease

OBJECTIVE: The purpose of this study was to investigate the relationship between depression and heart rate variability in cardiac patients. METHODS: Heart rate variability was measured during 24-hour ambulatory electrocardiographic (ECG) monitoring in 40 medically stable out-patients with documented coronary heart disease meeting current diagnostic criteria for major depression, and 32 nondepressed, but otherwise comparable, patients. Patients discontinued beta-blockers and antidepressant medications at the time of study. Depressed patients were classified as mildly (n = 21) or moderately-to-severely depressed (n = 19) on the basis of Beck Depression Inventory scores. RESULTS: There were no significant differences among the groups in age, gender, blood pressure, history of myocardial infarction, diabetes, or smoking. Heart rates were higher and nearly all indices of heart rate variability were significantly reduced in the moderately-to-severely versus the nondepressed group. Heart rates were also higher and mean values for heart rate variability lower in the mildly depressed group compared with the nondepressed group, but these differences did not attain statistical significance. CONCLUSION: The association of moderate to severe depression with reduced heart rate variability in patients with stable coronary heart disease may reflect altered cardiac autonomic modulation and may explain their increased risk for mortality.     

Major depression with ischemic heart disease: effects of paroxetine and nortriptyline on long-term heart rate variability measures.

BACKGROUND: Studies have linked depression to sudden death and serious cardiovascular events in patients with preexisting cardiac illness. Recent studies have shown decreased vagal function in cardiac patients with depression and depressed patients without cardiac illness. METHODS: We compared 20-hour, sleeping, and awake heart period variability measures using spectral analysis, fractal dimension, and symbolic dynamics in two patient groups with major depression and ischemic heart disease (mean age 59-60 years) before and after 6 weeks of paroxetine or nortriptyline treatment. RESULTS: Spectral measures showed decreases in awake and sleeping total power (TP: 0.0-0.5 Hz), ultra low frequency power (ULF: 0-0.0033 Hz), very low frequency power (VLF: 0.0033-0.04 Hz), and low-frequency power (LF: 0.04-0.15 Hz) for nortriptyline condition and a decrease in high-frequency power (HF: 0.15-0.5 Hz) for the awake condition in patients who received nortriptyline. A measure of nonlinear complexity, WC-100, significantly increased after paroxetine during the awake condition. CONCLUSIONS: These findings suggest that nortriptyline has stronger vagolytic effects on cardiac autonomic function compared with paroxetine, which is in agreement with previous clinical and preclinical reports. Paroxetine may have some cardio-protective effects, especially in cardiac patients.     

The relationships among heart rate variability,inflammatory markers and depression in coronary heart disease patients

Studies show negative correlations between heart rate variability (HRV) and inflammatory markers. In cardiac patients, depression is related to both. We investigated links between short-term HRV and inflammatory markers in relation to depression in acute coronary syndrome (ACS) patients.We measured C-reactive protein (CRP), interleukin-6 (IL-6), depression symptoms (Beck Depression Inventory, BDI-II), and SDNN, high frequency (HF) and low frequency (LF) power at rest in 682 (553 men) patients approximately two months post-ACS.There were no differences in HRV measures between those with and without elevated depressions symptoms (BDI-II?14). However, all HRV measures were negatively and significantly associated with both inflammatory markers. Relationships were stronger in patients with BDI-II?14. Differences were significant for CRP and not explained by covariates (including age, sex, previous MI, left ventricular ejection fraction, coronary bypass surgery at index admission, diabetes, smoking, body mass index (BMI), fasting cholesterol, fasting glucose, angiotensin-converting-enzyme inhibitors, beta-blockers, statins, and antidepressants). HRV independently accounted for at least 4% of the variance in CRP in the depressed, more than any factor except BMI.Relationships between measures of inflammation and autonomic function are stronger among depressed than non-depressed cardiac patients. Interventions targeting regulation of both autonomic control and inflammation may be of particular importance.     

The relationship between resting heart rate variability and heart rate recovery

Objective  

There is limited research available regarding a possible relationship between resting heart rate variability (HRV) and post-exercise heart rate recovery (HRR). The aim of this study was to examine the relationship between resting HRV and HRR after maximal exercise.