焦虑抑郁状态对高血压患者血压及心率变异性的影响  

Influence of Anxiety and Depression on Blood Pressure and Heart Rate Variability in Patients with Hypertension

作　　者：向宇凌 熊红芳 骆文 鲁刚 Xiang Yuling;Xiong Hongfang;Luo Wen;Lu Gang(Department of General Medicine,Shenzhen Hospital of Hong Kong University,Shenzhen 518000,Guangdong Province,China)

机构地区：[1]香港大学深圳医院全科,广东省深圳市518000

出　　处：《中国病案》2020年第7期83-85,共3页Chinese Medical Record

摘　　要：目的探讨焦虑抑郁状态对高血压患者血压和心率的影响及接受抗焦虑抑郁治疗对降低血压、改善心率变异性异常的效果。方法随机选取某院门诊2016年9月1日-2018年9月30日收治的400例高血压患者进行研究;研究对象入院后焦虑自评量表(Self-Rating AmxoetyScale,SAS)评分均<50分,抑郁自评量表(Self-Rating Depression Scale,SDS)评分<53分,为心理状态良好;经1个月观察,将SAS>50分、SDS>53分的129例患者定位焦虑抑郁组,其余271例患者定位非焦虑抑郁组;比较两组患者的临床特点;并根据是否接受抗焦虑抑郁治疗将129例患者分为观察组和对照组,探讨抗焦虑抑郁治疗的可行性及效果。结果相对于非焦虑抑郁组患者,合并焦虑抑郁的高血压患者,24小时平均血压、白昼及夜间平均血压均明显更高,各项数据组间比较均有统计学意义(P<0.05);焦虑抑郁组患者N间期标准差、NN间期平均值标准差、相邻NN间期差值均方根均低于非焦虑抑郁组,各项数据组间比较均有统计学意义(P<0.05);129例合并焦虑抑郁患者中,接受抗焦虑抑郁治疗的69例观察组患者治疗后,SAS评分、SDS评分、24小时平均血压、白昼及夜间平均血压均明显优于对照组,各项数据组间比较均有统计学意义(P<0.05)。结论相对于单纯高血压患者而言,合并焦虑抑郁的患者多具有血压升高幅度大及心率变异性小的特点,通过科学的抗焦虑抑郁治疗可提升降压效果并改善患者心率变异性异常。Objectives To investigate the influence of anxiety and depression on blood pressure and heart rate in patients with hypertension and the effect of receiving anti anxiety and depression treatment on reducing blood pressure and improving heart rate variability. Methods 400 patients with hypertension treated in the outpatient department of our hospital from September 2016 to September 2018 were selected and studied. After admission of two groups of subjects, the scores of SAS were all less than 50 scores, the scores of SDS was less than 53 scores, which the psychological status was good. After observation for one month, 129 cases of patients with SAS >50 and SDS >53 were selected as the anxiety and depression group, other 271 cases of patients were selected as the non-anxiety and depression group. The clinical characteristics of the two groups were compared, and 129 patients were divided into the observation group and the control group according to whether to receive the anti-anxiety and depression treatment. And the feasibility and effect of anti anxiety and depression treatment were discussed. Results Compared with the patients with no anxiety and depression, the average blood pressure and daytime and night average blood pressure during 24 hours of the hypertensive patients with anxiety and depression were significantly higher, and the comparison of the data I two groups was statistically significant(P<0.05). The SDNN, SDANN and RMSSD of the patients in the anxiety and depression group were lower than those in the no anxiety depression group, and the comparison of the data in two groups was statistically significant(P< 0.05). Among the 129 patients with anxiety and depression, after 69 patients in the observation group were treated with anti anxiety and depression treatment, their SAS and SDS scores, the average blood pressure in 24 hours and daytime and night average blood pressure were significantly better than those in the control group, and the comparison of the data in two groups was statistically significant

关 键 词：高血压 焦虑 抑郁 心率变异性 抗焦虑抑郁治疗 血压 

分 类 号：R544.1[医药卫生—心血管疾病]