高血压病伴焦虑抑郁患者的心率变异性分析  

A Study of the Relationship between Anxiety-depression and Heart Rate Variability in Hypertensive Patients

作　　者：万颖[1] 姚家祥[2] 李芸[1] 董昆芸[1] 

机构地区：[1]云南省第一人民医院内干科,昆明市650031 [2]昆明医学院第一附属医院麻醉科

出　　处：《实用全科医学》2007年第3期198-199,共2页Applied Journal Of General Practice

摘　　要：目的观察高血压病患者伴焦虑抑郁情绪障碍情况与心率变异性的关系,探讨合理的抗焦虑抑郁治疗方案。方法应用holter-star24H全信息动态心电图系统对39例确诊为高血压病不伴焦虑抑郁症的患者和81例高血压病合并焦虑抑郁症的患者进行心率变异性频域、时域的检测。对60例高血压病合并焦虑抑郁症患者随机分为药物治疗组(百忧解和黛力新)30例和心理治疗组30例,观察治疗8周后患者的SDNN、rMSSD、NN50、PNN50、SDANN、TP、VLF、LF、HF、VLF、LF/HF、HAMD的评分。结果高血压病合并焦虑抑郁患者SDNN、SDANN、TP、HF、LF的测量值随焦虑抑郁的严重程度下降,与单纯高血压病比较差异有统计学意义(P<0.05)。rMSSD、PNN的测量值随焦虑抑郁的严重程度上升,与单纯高血压病比较差异有统计学意义(P<0.05);药物治疗组和心理治疗组8周治疗后患者的HAMD评分及SDNN、rMSSD、NN50、PNN50、SDANN、TP、VLF、LF、HF、VLF、LF/HF的测量值基本相似,均P≥0.05。结论高血压病合并焦虑抑郁患者存在有交感神经的张力进一步增加;合理的抗焦虑抑郁治疗(药物和心理治疗)均利于改善患者的焦虑抑郁情绪,改善交感神经的张力。Objective To observe the relationship between anxiety-depression and heart rate variability in patients with essential hypertension （EH） and to investigate the treatment of dissipate anxiety. Methods 60 EH patients with anxiety-depression state were divided drug-treatment group （30 causes） and psychological treatment group （30 cases） randomly,the patients with simple hypertension were in control group After 8 weeks treatment,patientsSDNN ,rMSSD, NN50, PNN50 ,SDANN,TP,VLF, LF, HF, VLF,LF/HF, scores of HAMD were detected. Results In EH patients with anxiety - depression, SDNN, SDANN,TP, HF, LF decreased with the severity of anxiety-depression, and rMSSD,PNN increased with it, the difference between simple EH patients and EH patients with anxiety-depression was significant （ P 〈 0. 05 ）. The differences of SDNN, rMSSD, NN50, PNN50, SDANN,TP, VLF, LF, HF, VLF, LF/HF, scores of HAMD between drug-treatment group and psychological treatment group were insignificant （P 〉0.05 ）. Conclusions The excitement of cardiac sympathetic nerve occurred in EH patients with anxiety-de- pression. It can be assuaged by drug-treatment or psychological treatment.

关 键 词：高血压病 焦虑抑郁 心率变异性 

分 类 号：R544.1[医药卫生—心血管疾病] R749.72[医药卫生—内科学]