冠心病合并焦虑障碍患者心率变异性的变化临床研究

目的 探讨冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)合并焦虑障碍患者心率变异性(heart rate variability,HRV)的变化.方法 73例经选择性冠状动脉造影确诊为CHD的住院患者,通过医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)的焦虑亚量表评分,分为焦虑障碍组(焦虑组,41例)和对照组(不伴焦虑障碍,32例),运用动态心电图系统采集患者的心电信号进行HRV分析.结果 与对照组比较,合并焦虑障碍的CHD患者HRV指标SDNN、rMSSD、PNN50明显降低,具有统计学差异(P<0.05),而焦虑评分与CHD患者冠脉病变程度无明显相关性,焦虑与焦虑状态比较HRV指标无统计学差异.结论 冠心病合并焦虑症患者更容易引起心率变异性降低,交感神经兴奋增强,有可能增加心源性猝死概率;同时,抗焦虑治疗对预防心源性猝死可能有效.

Heart rate variability in patients with coronary heart disease accompanied by anxiety disorders

Objective To study the heart rate variability（HRV） in patients with coronary heart disease（CHD） accompanied by anxiety disorders.Methods Seventy-three hospitalized patients with CHD diagnosed by selective coronary angiography were entered in this study.The subjects were divided into anxiety group（with anxiety disorders,41 cases）,and control group（without anxiety disorders,32 cases） using the hospital anxiety and depression scale（HADS）-the sub-scale rating of anxiety.The patients＇ ECG was obtained with Holter systems for HRV analysis.Results When the results of CHD patients were compared with those of patients with accompanying anxiety disorders,the latter＇s HRV indicators-SDNN,rMSSD and PNN50 were significantly reduced,with significant difference（P0.05）.There was no significant correlation between anxiety scores and the degree of CHD.There was no significant difference in HRV indicators between anxiety and anxiety state.Conclusions The heart rate variability of patients with coronary heart disease and anxiety disorder is significantly reduced,increasing the chance of cardiogenic sudden death.Anti-anxiety treatment for the prevention of cardiogenic sudden death may be effective.