抑郁症对STEMI患者PCI术后心率变异性影响研究

The Clinical Study on the Effect of Depression on Heart Rate Variability in STEMI Patients Treated with PCI

目的:探讨抑郁症对急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)后心率变异性(HRV)影响。方法:随机选择62例合并抑郁症STEMI患者(包括持续抑郁患者26例和一过抑郁症患者36例)和102名非合并抑郁症患者。分别于术后1周和3个月通过BECK抑郁自评问卷(BDI)进行心理测评,并且利用24h动态心电图检测心率变异性。结果:HRV在STEMI患者PCI术后随时间恢复,但在合并抑郁症患者中仍低于非合并抑郁症患者。结论:HRV在合并抑郁症状患者中明显降低,反映其自主神经功能低下,并且与心梗后升高的心源性死亡相关。

Objective： To evaluate the significance of depression on the HRV in patients with STEMI treated with PCI. Method ： The study group consisted of 164 patients with STEMI treated with PCI that was divided into two groups： Group A ：102 persistently no depressed patients,and Group B ：62 patients with depression, including 26 persistently depressed patients and 36 remittent depressed patients. All underwent 24 -hour ambulatory electrocardiographic monitoring at 1 week and 3 months after PCI. Result： HRV were significantly lower in patients with depression than those without depression and higher following with the time after PCI. Conclusion： Depression is associated with reduced HRV in patients with STEMI. Autonomic cardiac regulatory system dysfunction, which is reflected by decreased HRV, is a plausible mechanism linking depression to increase cardiac mortality in post - MI patients.