创伤后应激障碍的老年患者心率变异性分析

An Analysis of Heart Rate Variability in Old Patients with Posttraumatic Stress Disorder

目的 探讨老年患者发生创伤后应激障碍（PTSD）时自主神经功能改变的特点.方法 采用心率变异性（HRV）分析指标,检测PTSD老年患者（A组,n=32）的HRV参数并与同年龄创伤后未发生PTSD者（B组,n=30）以及同年龄组健康人群（对照组,n=80）进行对比分析.结果 ①A组、B组与对照组相比,SDNN、SDANN、SDNN Index差异均有显著统计学意义（均P＜0.01）;②夜间HRV各项参数与白天比较,SDNN Index [（33.32±22.38）ms、（28.05±19.02）ms]差异有统计学意义（P＜0.05）,SDNN[（48.00±26.55）ms、（43.18±19.91）ms]、rMSSD[（29.18±14.79）ms、（28.00±14.56）ms]、PNN50[（7.81±2.37）ms、（7.57±2.78）ms]及SDANN[（30.18±18.10 ）ms、（29.77±12.98）ms]差异均无统计学意义（均P ＞0.05）.结论 PTSD可引起老年患者自主神经张力异常及调节功能失衡,这种损害以夜间明显.在治疗原发病的同时,应重视PTSD的发生及其对老年人自主神经功能的影响.

Objective To analyze changes of autonomic function in old patients with posttraumatic stress disorder. Methods The heart rate variability was analyzed and compared in old patients with （group A, n=32） and without （group B, n=30） posttraumatic stress disorder after trauma and healthy old people （control group, n=80）. Results The parameters of heart rate variability were significantly lower in group A than in control group （P 〈 0.01）. The standard deviation of NN intervals （SDNN） index was significantly higher during nighttime than during daytime （33.32±22.38 vs.28.05±19.02） （P 〈0.05）, while SDNN （48.00±26.55 vs.43.18±19.91）, the root-mean-square of differences of adjacent RR intervals （29.18±14.79 vs.28.00±14.56）, the percent of differences between adjacent NN intervals 〉 50 ms （7.81±2.37 vs.7.57±2.78） and the standard deviation of 5-minute means of NN intervals （30.18±18.10 vs.29.77±12.98） were not significantly different between night and day （all P 〉 0.05）. Conclusion Post-traumatic stress disorder may result in an abnormal auto- nomic tone and autonomic imbalance in old patients, which is more obvious at night.