老年胃食管反流病患者心理状态及自主神经功能紊乱的研究

Psychological alterations and autonomic nervous dysfunction in elderly patients with gastro-esophageal reflux disease

目的探讨胃食管反流病(GERD)老年患者,精神心理因素、自主神经功能与疾病症状的关系。方法对门诊GERD老年患者65例(病例组),对照组65例,采用症状自评量表(SCL-90)进行心理因素评分,进行心率变异(低频功率/高频功率)的短程频域分析,进而评价精神心理因素、自主神经功能与GERD的关系。结果 (1)病例组较对照组普遍存在抑郁、焦虑、恐惧、强迫观念和人际关系敏感等异常心理,以焦虑和抑郁更为突出(P<0.05)。(2)心率变异性,在低频功率(LF),高频功率(HF)及LF/HF指标,GERD患者组较对照组HF明显降低(P<0.05),LF/HF值增高(P<0.05)。结论 GERD老年患者多伴有心理异常和自主神经功能紊乱,表现为迷走神经活性减弱,交感神经活性相对增强。

Objective To study the psychological alterations and autonomic nervous dysfunction in elderly patients with gastro-esophageal reflux disease （GERD）. Methods Sixty five patients diagnosed as GERD,and another 65 healthy elderly people were included as control in the study. Short-range frequency domain of heart rate variability（ratio of low to high frequency power,LF/ HF）was used to evaluate psychological alterations and autonomic nervous dysfunction in these patients. Psychological symptoms were measured with the SCL-90 scale. Results Psychological alterations,such as depression,anxiety,phobia,compulsion and hypersensitivity, were more obvious in elderly GERD patients than in controls （P0.05）. There were significant increase in the LF/HF and significant decrease in the high frequency power in GERD patients than normal controls （P0.05）. Conclusions Psychological alterations and autonomic nervous dysfunction were noted in elderly patients with GERD.