抑郁对急性心肌梗死患者心率变异及预后的影响  

The Influence of Depression on Heart Rate Variability and Short Term Prognosis of Patients with Myocardial Infarction

作　　者：夏大胜[1] 王佩显[2] 曹燕然[1] 张菁[1] 蔡林[1] 汪丽[1] 杨英[1] 

机构地区：[1]天津市第一中心医院心内科,天津300192 [2]天津医科大学总医院心内科

出　　处：《中国临床心理学杂志》2003年第1期53-55,共3页Chinese Journal of Clinical Psychology

摘　　要：Objective:To explore the influence of depression on heart rate variability(HRV) and short term prognosis of patients with acute myocardial infarction(AMI).Methods:120 AMI patients were evaluated with Zung’s self-rating depression scale within 24 hours after admission.The patients were divided into depressive group(45 cases) and non-depressive group(75 cases) according to depressive index.Post-infarction angina pectoris,reinfarction,heart failure and ventricular fibrillation as well as cardiac death were observed during 4 weeks.HRV analysis with 24-hour holter of survivals was perfomed in 1 week after infarction.Results:The prevalence of post-infarction angina pectoris,ventricular fibrillation and cardiac death in depressive group was remarkably elevated compared with non-depressive group(40.0% vs 22.7%,20.0% vs 6.7%,17.8% vs 4.0%,respectively. P <0.05).Multivariate logistic regression analysis results indicated that depression was independently and significantly related to the occurrence of post-infarction angina pectoris,ventricular fibrillation and cardiac death.SDNN,SDANN,RMNN and PNN50 as well as HF in depressive group were obviously reduced,whereas VLF,LF and LF/HF were remarkedly increased compared with non-depressive group( P <0.01 or 0.05).Correlation analysis found that depressive index was negatively related with SDNN,SDANN,RMNN,PNN50 and HF(P<0.01),and positively correlated with VLF,LF and LF/HF( P <0.01).Conclusion:Depression impacts adversely HRV,and was an independent risk factor of the short term prognosis of AMI patients.Objective:To explore the influence of depression on heart rate variability(HRV) and short term prognosis of patients with acute myocardial infarction(AMI).Methods:120 AMI patients were evaluated with Zung's self-rating depression scale within 24 hours after admission.The patients were divided into depressive group(45 cases) and non-depressive group(75 cases) according to depressive index.Post-infarction angina pectoris,reinfarction,heart failure and ventricular fibrillation as well as cardiac death were observed during 4 weeks.HRV analysis with 24-hour holter of survivals was perfomed in 1 week after infarction.Results:The prevalence of post-infarction angina pectoris,ventricular fibrillation and cardiac death in depressive group was remarkably elevated compared with non-depressive group(40.0% vs 22.7%,20.0% vs 6.7%,17.8% vs 4.0%,respectively. P <0.05).Multivariate logistic regression analysis results indicated that depression was independently and significantly related to the occurrence of post-infarction angina pectoris,ventricular fibrillation and cardiac death.SDNN,SDANN,RMNN and PNN50 as well as HF in depressive group were obviously reduced,whereas VLF,LF and LF/HF were remarkedly increased compared with non-depressive group( P <0.01 or 0.05).Correlation analysis found that depressive index was negatively related with SDNN,SDANN,RMNN,PNN50 and HF(P<0.01),and positively correlated with VLF,LF and LF/HF( P <0.01).Conclusion:Depression impacts adversely HRV,and was an independent risk factor of the short term prognosis of AMI patients.

关 键 词：抑郁 急性心肌梗死 心率变异性 预后 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病] R749.4[医药卫生—内科学]