抑郁症患者的自主神经功能及胃电图分析

Autonomic nervous function and electrogastrography analysis in patients with major depression disorder

目的研究抑郁症患者的自主神经功能和胃电活动的变化,观察抑郁症患者病程长短、病情严重程度以及消化道症状与胃电活动之间的关系。方法采用胃电图记录38例确诊的抑郁症患者及38例对照组空腹及餐后的胃电活动。通过汉密尔顿抑郁量表(Hamilton depression scale,HAMD-21)和贝克抑郁量表(Beck depression inventory,BDI)评估抑郁症严重程度。自主神经症状通过自主神经症状量表(autonomic nervous symptom-score,ANS-score)评分记录。结果抑郁症患者胃动过速百分比餐前餐后分别为(24.99±1.73)%、(23.66±1.86)%,对照组胃动过速百分比餐前餐后分别为(19.80±1.65)%、(15.48±1.50)%,两组受试者胃动过速百分比总体差异具有统计学意义[F(1,148)=15.6;P=0.0001],两组胃动过速百分比差异在餐前餐后均差异有统计学意义(餐前P=0.033,餐后P=0.001)。抑郁症患者主功率餐前餐后分别为(21.20±2.71)dB、(20.90±2.66)dB,对照组主功率餐前餐后分别为(26.45±2.62)dB、(28.94±2.68)dB,两组受试者主功率在总体上差异具有统计学意义[F(1,148)=6.203;P=0.014],两组主功率差异仅在餐后差异有统计学意义(P=0.037)。有消化道症状组餐后胃节律紊乱百分比(5.17±0.56)%明显高于无消化道症状组的胃节律紊乱百分比(3.19±0.46)%,差异均具有统计学意义(P=0.011)。主功率变异系数在有消化道症状的抑郁症患者中(0.44±0.06)与无消化道症状的抑郁症患者中(0.27±0.05)差异具有统计学意义(P=0.029)。另外,抑郁症患者病程长短与餐后胃动过速百分比存在显著的正相关(r=0.491,P=0.002)。结论抑郁症患者存在自主神经功能紊乱及胃动力异常,并且这种异常与病程长短及是否伴有消化道症状相关。胃电图也可作为衡量抑郁症患者自主神经功能的指标。

Objective To study the alterations of autonomic nervous function in patients with major depression disorder,and to observe the relationship of their gastric electrical activity with the duration of depression,its severity and gastrointestinal symptoms.Methods Electrogastrography(EGG)was performed before and after a test meal ingestion in 38 depressive patients and 38 healthy control subjects.The severity of depression was evaluated through Hamilton depression scale(HAMD-21)and Beck depression inventory(BDI).Autonomic symptoms were recorded by autonomic nervous symptom-score(ANS-score).Results The amount of tachygastria in patients with depression before and after test meal were(24.99±1.73)%,(23.66±1.86)%respectively,the amount of tachygastria in healthy controls before and after test meal were(19.80±1.65)%,(15.48±1.50)%respectively.There was a significant group effect(F(1,148)=15.6,P=0.0001))between the two groups.The amount of tachygastria between the two groups before and after test meal were significant different(before test meal P=0.033,after test meal P=0.001).The main power in patients with depression before and after test meal were(21.20±2.71)dB,(20.90±2.66)dB respectively,the main power in healthy controls before and after test meal were(26.45±2.62)dB,(28.94±2.68)dB respectively.There was a significant group effect(F(1,148)=6.203,P=0.014)between the two groups.The main power between the two groups after test meal were significant different(P=0.037).The percentage of arrythmia after test meal in patients with gastrointestinal symptoms(5.17±0.56)%was higher than the patients without gastrointestinal symptoms(3.19±0.46)%,the differences were statistically significant(P=0.011).And there was a significant difference(P=0.029)of the instability coefficient of main power after test meal between the patients with gastrointestinal symptoms(0.44±0.06)and the patients without gastrointestinal symptoms(0.27±0.05).Besides,there was a significant positive correlation between duration of depression and percentage of postprandial tachycardia(r=0.491,P=0.002).Conclusion Patients with depression have autonomic nerve dysfunction and abnormal gastric motility,which is related to the duration of the disease and whether the patients are accompanied by gastrointestinal symptoms.Electrogastrography can also be used as an index to measure autonomic nervous function in patients with depression.