静息心率预测缺血性卒中后早期抑郁和认知功能的初步研究  

A preliminary study on resting heart rate in predicting early depression and cognition function after ischemic stroke

作　　者：彭俊霖 李昀峰 陈刚涛 黄波[1] 许程燕 PENG Junlin;LI Yunfeng;CHEN Gangtao;HUANG Bo;XU Chengyan(Department of Neurology,Gaozhou People′s Hospital,Gaozhou,Guangzhou 525200,China;Department of Cardiology,Maoming Hospital of Traditional Chinese Medicine,Maoming,Guangzhou 525000)

机构地区：[1]高州市人民医院神经内三科,广东高州525200 [2]茂名市中医院心血管内科,广东茂名525000

出　　处：《徐州医科大学学报》2020年第12期902-906,共5页Journal of Xuzhou Medical University

基　　金：广东省自然科学基金重点项目(2017B030311015)。

摘　　要：目的评估缺血性卒中后早期阶段静息心率(HR)和心率变异性(HRV)与抑郁和认知功能的相关性。方法以2014年5月—2017年5月80名连续住院的缺血性卒中患者为研究对象。分别在住院期间(卒中后2~7 d)和3个月后对患者的静息HR、抑郁、认知功能进行评估。分析卒中后早期测量的HR和HRV是否与卒中后早期和慢性期的抑郁和认知功能相关。结果通过调整年龄、性别、入院时美国国立卫生研究院卒中量表(NIHSS)评分和病变体积后,卒中后早期阶段的医院焦虑和抑郁量表(HADS)评分与每分钟平均心率(mHR)、Ln(RR间隔连续差异均方根,RMSSD)和Ln(低频功率谱密度,LF)显著相关(P<0.05);卒中失语症抑郁问卷(SADQ-10)评分与Ln(RMSSD)和Ln(高频功率谱密度,HF)显著相关(P<0.05);视觉模拟量表(VAS)评分与mHR、Ln(RMSSD)、Ln(HF)和Ln(LF/HF)显著相关(P<0.05);抑郁症的整体z评分与mHR、Ln(RMSSD)、Ln(LF)、Ln(HF)和Ln(LF/HF)显著相关(P<0.05);蒙特利尔认知评估量表(MoCA)评分与任何HR参数无显著相关性。在3个月的随访中,Beck抑郁量表(BDI-Ⅱ)评分与Ln(LF)显著相关(P<0.05);MoCA评分与mHR、Ln(RMSSD)、Ln(LF)和Ln(HF)显著相关(P<0.05)。结论缺血性卒中后早期较高的mHR、较低的HRV和较高的交感神经平衡可能是卒中后抑郁易感性和认知损害的标志。Objective To evaluate the relationship of resting heart rate(HR)and heart rate variety(HRV)in the early stage and depression and cognition function after ischemia stroke.Methods A total of 80 consecutive hospitalized patients were selected from May 2014 to May 2017.They were evaluated based on resting HR,depression,and cognitive function during hospitalization(2-7 days after stroke)and 3 months later.The linear regression model was used to analyze the relationship between early measurement of HR and HRV and early and chronic depression and cognition after stroke.Results After adjustment of age,sex,the National Institutes of Health Stroke Scale(NIHSS)scores and lesion volume at admission,the scores of Hospital Anxiety and Depression Scale(HADS)at early stage were significantly associated with mean heart rate per minute(mHR),Ln(RMSSD),and Ln(LF)(P<0.05).SADQ-10 scores was significantly correlated with Ln(RMSSD)and Ln(HF)(P<0.05).The Visual Analogue Scale(VAS)score was significantly correlated with mHR,Ln(RMSSD),Ln(HF)and Ln(LF/HF)(P<0.05).The global z-score of depression were significantly correlated with mHR,Ln(RMSSD),Ln(LF),Ln(HF),and Ln(LF/HF)(P<0.05).There was no significant correlation between MoCA score and any HR parameters.At three months of follow-up,BDI-II score was significantly correlated with Ln(LF)(P<0.05),and MoCA score was significantly correlated with mHR,Ln(RMSSD),Ln(LF)and Ln(HF)(P<0.05).Conclusions High mHR,low HRV,and high sympathovagal balance in early stage after stroke may be the markers of higher vulnerability to develop poststroke depression and cognitive impairment.

关 键 词：静息 心率 缺血性卒中 抑郁 认知 

分 类 号：R749.13[医药卫生—神经病学与精神病学]