糖尿病伴焦虑抑郁患者心率变异分析的临床研究  

A study of the relationship between the coronary artery disease witanxiety - depression state and the hear rate variability

作　　者：万颖[1] 姚家祥[2] 李芸 董昆芸 Wan Ying, Yao Jiaxiang, Li Yun, et al（ The first people＇ s hospitol of Yun Nan.）

机构地区：[1]云南第一人民医院内科,云南昆明650031 [2]昆明医学院第一附属医院麻醉科

出　　处：《中国保健》2006年第12X期14-16,共3页Chinese Health Care

摘　　要：目的：观察糖尿病伴焦虑抑郁情绪障碍患者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：①对确定焦虑抑郁症的糖尿病患者计算其在我病房的构成比。②应用holter-star24H全信息动态心电图系统对39例确诊为糖尿病不伴焦虑抑郁症的患者和81例糖尿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。③60例糖尿病合并焦虑抑郁症的患者随机分为药物治疗（百忧解和黛力新）30人和心理治疗组30人,观察治疗8w后患者的SDNN、rMSSD、NN50、PNN50、SDANN、TP、VLF、LF、HF、VLF、LF/HF;HAMD的评分。结果：①糖尿病患者在我病房的发生率为67.5%,其中轻度焦虑抑郁为20%,中度焦虑抑郁为29.17%,重度焦虑抑郁为18.33%。②糖尿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,与单纯糖尿病比较差异有统计学意义。rMSSD,PNN的测量值随焦虑抑郁的严重程度上升,且差异有统计学意义,P〈0.05;③药物治疗组和心理治疗组8w治疗后对患者的HAMD评分两组差异没有统计学意义,P？0.05,SDNN、rMSSD、NN50、PNN50、SDANN、TP、VLF、LF、HF、VLF、LF/HF的测量值差异没有统计学意义,P？0.05。结论：①糖尿病合并焦虑抑郁患者存在有心交感神经的张力增加;②合理的抗焦虑抑郁治疗（药物和心理治疗）利于改善患者的焦虑抑郁情绪,改善交感神经的张力。Objective：Observing the relationships between the coronar artery disease with anxiety -depression state and the hear rate variability. Methods：The first step：calculated the prevalence of anxiety - depressio state in the patients of coronary artery disease. Then we examined the hea rate variability among the 39CHD and the 81 CHD with anxiety -depression stat to determine SDNN 、rMSSD 、 NN50 、PNN50、 SDANN 、TP 、VLF 、LF、HF 、VLF、LF/H by holter - star24H. The third step ：60CHD with anxiety - depression state wer divided drug group 30 causes and mental group 30 cases in stochastic process Observing the SDNN,rMSSD,NN50、PNN50、SDANN、TP、VLF、LF、HF、VLF、LF/HF,score of HAMD,after 8 weeks treatment. Results ：①the prevalence o anxiety- depression state in the patients of coronary artery disease i67.5%. ②SDNN ,SDANN ,TP, HF, LF is lower in the patients of CHD wit anxiety -depression state,the different is signified, rMSSD,PNN is statistical different between CHD and CHD with anxiety -depression state 8 weeks late, SDNN、rMSSD、NN50 、PNN50 、SDANN、TP、VLF、LF、HF、VLF、LF/HF, score of HAMD between drug group＇ s and mental group,there are not statistica different. Conclusion ：①The activity of sympathectomy occurred in th patients of CHD with anxiety - depression state. ②The activity o sympathectomy can be controlled by anti - anxiety - depression state, eithe drug group or mental group. ③Rational treatment is beneficial in CHD wit anxiety -depression state.

关 键 词：糖尿病 焦虑抑郁 心率变异性 

分 类 号：R587.2[医药卫生—内分泌;医药卫生—临床医学;医药卫生—内科学]