冠心病合并抑郁症患者心率变异性的研究

发布时间：2018-05-11 03:05

  本文选题：冠心病 + 抑郁症　； 参考：《青岛大学》2016年硕士论文

【摘要】：目的探讨冠心病合并抑郁症患者心率变异性的变化,来了解自主神经功能的改变,指导临床治疗和评估预后。方法选取2014年12月至2015年12月间在我院住院的120名患者作为研究对象,其中,冠心病组40例,抑郁症组40例和冠心病合并抑郁症组40例。选取在我院进行健康查体的40例健康成年人作为对照组。所有入选者在入院后均进行动态心电图检查,采用动态心电图来观察心率变异性的的变化。分析心率变异性所用的时域指标是SDNN、r MSSD与p NN50,以及频域指标低频功率(LF)和高频功率(HF)。结果与对照组比较,冠心病组、抑郁症组和冠心病合并抑郁症组的心率变异性的各项指标均降低,且差异有统计学意义。合并抑郁症的冠心病患者与单纯冠心病和抑郁症患者比较,时域指标和频域指标中的多项参数降低的更明显,且差异有统计学意义(p0.05)。结论冠心病患者和抑郁症患者心率变异性均有不同程度的降低,这表明他们的自主神经受损和功能紊乱。与单纯冠心病和抑郁症患者相比,冠心病合并抑郁症患者心率变异性降低的更明显,其自主神经功能损伤更明显,这表明抑郁症的发生加重了患者的自主神经损伤和功能紊乱,发生心血管事件的风险更大。
[Abstract]:Objective to investigate the changes of heart rate variability (HRV) in patients with coronary heart disease (CHD) complicated with depression in order to understand the changes of autonomic nervous function and to guide the clinical treatment and evaluate the prognosis. Methods 120 patients in our hospital from December 2014 to December 2015 were selected as study subjects, including 40 patients with coronary heart disease, 40 patients with depression and 40 patients with coronary heart disease combined with depression. 40 healthy adults in our hospital were selected as control group. All patients were examined by ambulatory electrocardiogram (ECG) after admission, and the changes of heart rate variability (HRV) were observed by ambulatory electrocardiogram (DECG). The time domain indexes used to analyze heart rate variability are SDNNNr MSSD and pNN50, as well as low frequency power and high frequency power in frequency domain. Results compared with the control group, the indexes of heart rate variability in coronary heart disease group, depression group and coronary heart disease combined depression group were all decreased, and the difference was statistically significant. Compared with simple CHD and depression patients with depression, the time domain and frequency domain indexes of multiple parameters decreased more significantly, and the difference was statistically significant (p 0.05). Conclusion Heart rate variability in patients with coronary heart disease and depression is decreased to some extent, which indicates that their autonomic nervous system is damaged and dysfunction. Compared with patients with simple coronary heart disease and depression, heart rate variability and autonomic nerve dysfunction in patients with coronary heart disease and depression were significantly decreased, which indicated that the occurrence of depression aggravated the autonomic nerve damage and dysfunction. Cardiovascular events are at greater risk.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R541.4;R749.4
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本文编号：1872119