恶劣心境患者血清超敏C反应蛋白水平与心率变异性相关研究

A related study of the level of hypersensitive C-reactive protein and the heart rate variability in patients with dysthymic disorder

目的探讨恶劣心境患者血清超敏C反应蛋白（hs—CRP）与心率变异性（HRV）水平及可能的心理生理机制。方法采用心理健康测查表（PHI）对42例恶劣心境患者组（DD组）、33例重性抑郁症患者组（MD组）及30例健康对照组（NC组）进行心理健康水平和人格特质测定，并分析短时（5min）心率变异性及血清hs—CRP水平，评定自主神经及免疫系统功能。结果DD组PHI量表躯体化、焦虑、病态人格及疑心因子分明显高于MD组（P〈0．01或P〈0．05）；DD组HRV频谱指标中SDNN、PNN50及HF较MD及NC组均显著下降（P〈0．01或P〈0．05），LF／HF较MD及NC组均明显升高（P〈0．05），血清hs—CRP水平较MD及NC组明显升高俨〈0．05或P〈0．01）；PHI躯体化及焦虑因子与SDNN、VLF、LF及血清hs—CRP水平均相关（r=-0．27，-0．29、r=0．38，0．33、r=0．41，0．31、r=0．34，0．23，P〈0．05或P〈0．01），且血清hs—CRP水平与SDNN、RMSSD、SDSD、VLF、LF、HF及LF!HF均相关（r=-0．47，-0．45，-0．45，0．26，0．46，-0．51，0．10，P〈0．05或P〈0．01）。结论恶劣心境患者焦虑及躯体化程度更高，自主神经功能紊乱更加显著，且与血清hs—CRP水平增高具有相关性。

Objective To investigate the hypersensitive C-reactive protein （hs-CRP） ,level in serum and the heart rate variability（HRV） in patients with dysthymic disorder, and explore the possible psychological and physiological mechanisms. Methods PHI and short-term HRV were measured in 42 patients with dysthymic disor- der（ DD group） , 33 patients with major depressive disorder （ MD group） and 30 heathy controls （ NC group） , fasting blood samples were also analyzed with high-sensitivity C-reactive protein （hs-CRP）. Results （ 1 ） DD group gained higher score in the somatization, anxiety, psychopathic deviate and hypomania than the MD group（P 〈 0.05 or P〈 O. 01 ）. （2）The standard deviation of differences between the consecutive RR intervals （SDNN） , the percent- age value of consecutive RR intervals that differ more than 50 ms （PNNS0）and the high frequency band （HF） of DD group were lower significantly than MD and NC groups, the low frequency band（LF） , and the ratio of LF to HF power（LF/HF） and hs-CRP level were higher than other two groups （P 〈 0.05 or P 〈 0.01 ）. （3）The somatization and anxiety were correlated with SDNN,the very low frequency band （VLF） , LF and hs-CRP level （ r = -0.27, -0.29, r=0.38,0.33, r=0.41,0.31, r=O. 34,0.23, P 〈 0.05 or P 〈 0.01 ）. （4） The bs-CRP level in serum were correlated with SDNN, the root mean square of successive RR intervals （RMSSD）, the standard deviation of differences between the consecutive RR intervals （ SDSD）, VLF, LF, HF and LF/HF （ r = - 0.47, - O. 45, - 0.45, 0.26,0.46, - 0.51,0. f0, P 〈 0.05 or P 〈 0.01 ）. Conclusion The patients with dysthymic disorder have signifi- cant somatization and anxiety, the personality character was mainly resulting in reducing HRV, which is related with the increasing serum hs-CRP level.