伴有抑郁的老年冠心病患者自主神经功能的改变

目的:探讨伴有抑郁老年冠心病患者自主神经功能的改变。方法:根据汉密尔顿抑郁量表(HAMD)、Zung氏抑郁自评量表(SDS)、以及冠状动脉造影结果,将163例住院患者及健康体检者分为冠心病伴抑郁组(48例)、冠心病组(65例)、正常对照组(50例);并行24 h动态心电图检查,分析心率变异各项指标及其与抑郁程度的相关性。结果:与正常对照组相比,冠心病伴抑郁组与单纯冠心病组,时域指标均下降,频域指标中低频功率(LF)、LF/高频功率(HF)值上升。冠心病伴抑郁组的抑郁严重度与24 h正常RR间期标准差(SDNN)呈负相关,与LF/HF之间呈正相关(r=-0.967,r=0.971,P均0.05)。结论:伴有抑郁症状老年冠心病患者自主神经功能改变更明显,并与抑郁程度相关。

Changes of autonomic nervous function in elderly coronary heart disease Patients accomPanied by de-Pression

To explore the changes of autonomic nervous function in elderly coronary heart disease（CHD）patients accompanied by depression. Method：According to the scores of Hamilton depres-sion rating scale（HAMD）,Zung self-rating depression scale（SDS）,and the results of coronary angiography, 163 inpatients and health persons were divided into CHD with depression group（48 cases）,CHD group（65 ca-ses）and normal control（NC）group（50 cases）. They were monitoried by 24 h dynamic electrocardiogram. The index of heart rate variability（HRV）and its correlation with depressive severity were analyzed. Results：Compared to NC group,the time domain index of HRV were significantly lower;the mean value of the low-fre-quency（LF）power in the frequency domain index,and the value of LF/ high-frequency（HF）power were signif-icantly increased in CHD with depression group and CHD group. The depressive severity was negatively correlated with 24 h normal phase standard deviation（SDNN）and positive correlated with LF/ HF in CHD patients accom-panied by depression（r = - 0. 967,r = 0. 971,all P ﹤ 0. 05）. Conclusion：The change of autonomic nervous function in CHD patients accompanied by depression is more obvious and correlated with depressive severity.