青年官兵血清5-羟色胺、心率变异、心电图特征与抑郁症的相关分析

目的 探讨5-羟色胺（5-hydroxytryptamine,5-HT）、心率变异（heart Rate Variability,HRV）、心电图特征与抑郁症患者的相关关系.方法 测定并比较60例抑郁症组与40例健康对照组血中5-HT的含量;分析血中5-HT含量与症状自评量表（symptom checklist 90,Scl-90）评分的相关性;运用动态心电图系统采集其心电信号并进行HRV分析;描记常规12导联心电图并逐一进行分析.结果 抑郁症组血中5-HT含量（172.08±101.36）ng/ml低于健康对照组（257.34±104.06）ng/ml,差异有统计学意义（P＜0.001）.抑郁症组血中5-HT含量与Scl-90评分的人际关系敏感、抑郁、敌对分数变化相关,相关系数分别为-0.406、-0.384、-0.445,差异有统计学意义（P＜0.01）.抑郁症组24 h内全部正常心动周期的标准差（SDNN）、24 h每5 min正常R-R间期的标准差的平均数（SDANN）、相邻正常心动周期差值的均方根（RmSSD）、相邻两个正常心动周期差值大于50 ms的个数所占的百分比（PNN50）、低频功率（LF）、高频功率（HF）、低频功率与高频功率之比（LF/HF）低于健康对照组（P＜0.001）;抑郁症组心电图中窦性心动过缓、窦性心律不齐、早期复极、早搏检出率高于健康对照组（P＜0.05）.结论 检测血中5-HT含量的方法在抑郁症客观诊断中有重要临床价值,HRV和心电图在该病的诊断中有一定临床参考价值.

Changes of 5-hydroxytryptamine,heart rate variability,electrocardiographic characteristics and their mutual correlations in major depressive disorder patients of young soldiers in Armed Police Forces

Objective To study the changes of 5 - hydroxytryptamine （5 - HT）, heart rate variability （ HRV）, electrocardio- graphic characteristics in major depressive disorder（MDD） patients and the correlation between 5 - HT and MDD. Methods All sub- jects were divided into MDD group （n = 60） and control group （n = 40）. Concentration of 5 -HT in blood was determined by using liquid chromatograph mass spectrometry. We compared the concentrations of 5 - HT between the two groups and analyzed the correla- tion between concentration of 5 - HT and some factors＇ scores in symptom checklist 90 （ scl - 90）. HRV was detected by Holter moni- tor. All subjects underwent the 12 lead electrocardiography and the results were analyzed in detail. Results Concentration of 5 - HT in the MDD group （ 172.08 ±101.36 ng/ml） was significantly lower than that in control group （257.34 ± 104.06 ng/ml） （P 〈 0. 001 ）. Concentration of 5 -HT in the MDD group was correlated with the Scl -90 score of interpersonal relationship（ r = -0. 406）, depression （ r = - 0. 384） and hostility （ r = - 0. 445 ）. All these correlations were significant （ P 〈 0.01 ）. The values of SDNN, SDANN, RmSSD, PNN50, LF, HF, LF/HF in the MDD group were lower than those in thecontrol group （P 〈 0.001 ）. More sinus bradycardia, sinus arrhythmia, early repolarization and premature beats were detected in the MDD group than in thecontrol group（P 〈 0.05 ）. Conclusions It is very valuable to use concentration of 5 - HT for diagnosing MDD. HRV and ECG are somewhat valuable for diagnosis of MDD.