焦虑症患者心率变异性与自主神经功能的相关性研究

Correlative study of heart rate variability and autonomic nervous function in patients with anxiety neurosis

目的 探讨焦虑症患者心率变异性与自主神经功能的相关性,为焦虑症患者心身疾病的防治提供理论参考.方法 对90例广泛性焦虑症、惊恐障碍患者和90例健康查体者进行心理问卷测试,并采用汉密顿焦虑量表（HAMA）和汉密顿抑郁量表（HAMD）进行焦虑和抑郁症状的评定,采用24 h动态心电图记录监测心率及心率变异性指标（SDNN、SDANN、RMSSD、PNN50）.结果 焦虑症（GAD）组平均心率显著高于对照组,两组差异均有统计学意义（P〈0.05）;心率变异性各指标均显著低于对照组,两组差异均有统计学意义（P〈0.05）;GAD组的各心率变异性指标均显著低于对照组,而惊恐障碍（PD）组的各心率变异性指标均显著低于GAD组,差异均有统计学意义（P〈0.05）.结论 焦虑症患者存在较高水平的交感神经活动功能,自主神经功能紊乱,且PD患者的交感神经活动功能增高,自主神经功能紊乱程度增加.

Objective To study the correlation of heart rate variability（HRV） and autonomic nervous function in patients with anxiety neurosis, and provide evidence for prevention and treatment of anxiety disorder. Methods 90 patients with generalized anxiety disorder（GAD） and panic disorder（PD） and 90 healthy persons were tested by psychological questionnaire,the anxiety and depression were assessed by HAMA and HAMD. The average heart rate and HRV index were monitored by 24-hour ambulatory ECG. Results The average heart rate of the anxiety group was higher than the control group, compared with the control group the difference was significant （ P 〈 0. 05 ）; The HRV parameters of the anxiety group were lower than the control group, compared with the control group the difference was significant（ P 〈 0. 05 ） ;The HRV parameters of the GAD group were lower than the control group, the HRV parameters of the PD group were lower than the GAD group, the difference was significant （ P 〈 0. 05 ）. Conclusion The patients with anxiety neurosis had high sympathetic nerve activity function and autonomic dysfunction, the PD patients had higher sympathetic nerve activity function and autonomic dysfunction than the GAD patients.