病毒性心肌炎伴焦虑抑郁症状的临床特点分析

Analysis on the Clinical Features of Viral Myocarditis Patients Complicated with Anxiety and Depression

目的分析病毒性心肌炎伴焦虑、抑郁症状患者的临床特点。方法应用焦虑自评量表(SA S)、抑郁自评量表(SDS)评定49例临床诊断为病毒性心肌炎患者的焦虑抑郁情况;分析伴有焦虑、抑郁症状患者的临床表现、心率变异性。结果 17例患者伴焦虑症状,发生率为34.69%;22例患者伴抑郁症状,发生率为44.90%;神疲、自汗、头痛在有与无焦虑症状患者中差异有统计学意义(P<0.05);神疲在有与无抑郁症状患者中差异有统计学意义(P<0.05);有焦虑、抑郁症状患者的心率变异性均较不伴焦虑、抑郁症状的降低,其中24h连续正常R-R间期的标准差(SDNN-24)、每5m in正常R-R间期平均值的标准差(SDANN)在有与无焦虑症状患者中差异有统计学意义(P<0.05);有焦虑症状患者的平均心率、最小心率、最大心率均快于无焦虑症状的患者,但差异无统计学意义(P>0.05)。平均心率、最大心率在有与无抑郁症状患者中差异有统计学意义(P<0.05)。结论病毒性心肌炎伴焦虑、抑郁症状的患者心率变异性降低,自主神经功能受损。

Objective To analyze the clinical features of the patients suffered from viral myocarditis（VMC） complicated with anxiety and depression symptoms.Methods By using self-rating anxiety scale（SAS） and self-rating depression scale（SDS）,the anxiety and depression symptoms of 49 VMC patients were scored.The clinical symptoms and heart rate variability of the patients were analyzed.Results There were 17 patients complicated with anxiety,the incidence was 34.69%.There were 22 patients complicated with depression,the incidence was 44.90%.The difference in incidence of listlessness,spontaneous sweating,and headache was statistically significant in those who with and without anxiety（P0.05）.The difference in incidence of listlessness was statistically significant in those who with and without depression（P0.05）.The heart rate variability of patients with anxiety and depression was reduced,compared with patients without those symptoms,including the normal R-R interval SDNN24 and every 5min normal R-R interval SDANN,the difference of which was statistically significant in those who with and without anxiety（P0.05）.The average heart rate,minimum heart rate,maximum heart rate of patients with anxiety were faster than those patients without that.The difference in average heart rate and maximum heart rate was statistically significant in those who with and without depression（P0.05）.Conclusion VMC patients complicated with anxiety and depression have reduced heart rate variability and autonomic nerve dysfunction.