焦虑情绪对老年慢性便秘患者自主神经功能的影响

Influence of anxiety to autonomic nerve on patients with senile constipation

目的通过心理因素评价及心率变异性(HRV)的检测,探讨老年便秘患者焦虑症状与自主神经功能的关系及可能机制。方法收集住院及门诊查体便秘患者资料共计52例,称为便秘组,对照组40例,均为健康老年男性,所有入选者行24h动态心电图检查,观察心率变异性指标SDNN、SDANN、RMSSD、TP、LF及HF并填写焦虑自评量表(SAS)。结果便秘组SAS标准分明显高于正常对照组,便秘组SDNN、RMSSD、TP、LF及HF值低于对照组,且便秘患者焦虑自评量表SAS标准分与SDNN、RMSSD、TP、LF和HF均呈显著负相关。结论焦虑等心理因素在便秘的发病中起一定作用,焦虑症状的产生可能与便秘患者自主神经系统功能异常有关,尤以迷走神经为甚。

[Objective] The purpose of this study was to explore the relationship and mechanisms between anxiety and autonomic nerve function in patients with senile constipation by observing heart rate variability(HRV)and psychological factors.[Methods] 52 senile patients with constipation were choosed from outpatients or hospitalized patients.These enrolled patients were named as constipation groups.40 healthy senile men were regarded as control groups.All enrolled patients were checked with 24 hours dynamic electrocardiogram and observed the index of HRV,including SDNN,SDANN,RMSSD,TP,HF and LF.All subjects filled in self-rating anxiety scale(SAS).[Result] In constipation groups,SAS standard scores were higher than the controls,but SDNN,RMSSD,TP,LF and HF were lower than control groups.In patients with constipation,SAS scores were negative correlated with SDNN,RMSSD,TP,LF and HF significantly.[Conclusion] Psychological factors such as anxiety take a role in the pathology of constipation.The symptoms of anxiety disorders were related with autonomic nerve regulating function disorder,especially related with pneumogastric disorder.