创伤后应激障碍的老年患者心率变异性分析

目的 探讨老年患者发生创伤后应激障碍（PTSD）时自主神经功能改变的特点.方法 采用心率变异性（HRV）分析指标,检测PTSD老年患者（A组,n=32）的HRV参数并与同年龄创伤后未发生PTSD者（B组,n=30）以及同年龄组健康人群（对照组,n=80）进行对比分析.结果 ①A组、B组与对照组相比,SDNN、SDANN、SDNN Index差异均有显著统计学意义（均P＜0.01）;②夜间HRV各项参数与白天比较,SDNN Index [（33.32±22.38）ms、（28.05±19.02）ms]差异有统计学意义（P＜0.05）,SDNN[（48.00±26.55）ms、（43.18±19.91）ms]、rMSSD[（29.18±14.79）ms、（28.00±14.56）ms]、PNN50[（7.81±2.37）ms、（7.57±2.78）ms]及SDANN[（30.18±18.10 ）ms、（29.77±12.98）ms]差异均无统计学意义（均P ＞0.05）.结论 PTSD可引起老年患者自主神经张力异常及调节功能失衡,这种损害以夜间明显.在治疗原发病的同时,应重视PTSD的发生及其对老年人自主神经功能的影响.

An Analysis of Heart Rate Variability in Old Patients with Posttraumatic Stress Disorder

Objective To analyze changes of autonomic function in old patients with posttraumatic stress disorder. Methods The heart rate variability was analyzed and compared in old patients with （group A, n=32） and without （group B, n=30） posttraumatic stress disorder after trauma and healthy old people （control group, n=80）. Results The parameters of heart rate variability were significantly lower in group A than in control group （P 〈 0.01）. The standard deviation of NN intervals （SDNN） index was significantly higher during nighttime than during daytime （33.32±22.38 vs.28.05±19.02） （P 〈0.05）, while SDNN （48.00±26.55 vs.43.18±19.91）, the root-mean-square of differences of adjacent RR intervals （29.18±14.79 vs.28.00±14.56）, the percent of differences between adjacent NN intervals 〉 50 ms （7.81±2.37 vs.7.57±2.78） and the standard deviation of 5-minute means of NN intervals （30.18±18.10 vs.29.77±12.98） were not significantly different between night and day （all P 〉 0.05）. Conclusion Post-traumatic stress disorder may result in an abnormal auto- nomic tone and autonomic imbalance in old patients, which is more obvious at night.