心率变异性与抑郁关系的研究新进展

New Advance in Research on the Relationship between Heart Rate Variability and Depression

心率变异性(heart rate variability,HRV)是记录并分析连续心跳间期的变化,多与自主神经系统活动密切相关。近年来,心率变异性相关指标被应用于个体抑郁的检测和评估中。研究发现,抑郁患者的HRV时域和频域相关指标显著降低。HRV指标对于个体不同抑郁程度、抑郁类型和抑郁症状也具有一定的敏感性。HRV的降低也能够在一定程度预测其抑郁风险。心率变异性与抑郁的关联可能基于大脑-神经内分泌系统-植物神经功能的生理机制。下丘脑-垂体-肾上腺轴功能障碍和肾素-血管紧张素-醛固酮系统过度激活使抑郁患者交感神经活动过强。抑郁患者交感神经活动增强、副交感神经活动减弱,从而影响对心脏节律性的调节。抑郁还会减弱大脑中枢神经网络的整合功能,引起一系列HRV指标变化。这些指标在抑郁风险预测及抑郁干预效果评估中具有广泛的应用前景。

Heart rate variability(HRV)indices is the recording and analysis of changes in the continuous inter-heartbeat period and is closely related to the individual’s autonomic nervous system’s activity.In recent years,HRV indices have been applied in depression screening and evaluation.Studies have found that the HRV-related indices for patients with depression are decreased significantly.Moreover,the value of these indices can not only distinguish the individuals with different degrees,types and symptoms of depression,but also is related with their potential depression risk.The relation of HRV and depression is based on the physiological mechanism from brain-neuroendocrine system-autonomic nerve function.The dysfunction of hypothalamic-pituitary-adrenal axis(HPA)and excessive activation of renin-angiotensin-aldosterone system(RAAS)lead to excessive sympathetic activity in depressed individuals.The enhancement of sympathetic activity and the decrease of parasympathetic activity affect the regulation of cardiac rhythm.Depression can also weaken the integration function of central autonomic nerve network,causing a series of changes in HRV indices.In the future,this index has wide application prospects in individual depression risk prediction and depression intervention effect evaluation.