脑小血管病患者情绪与心脏自主神经功能变化的相互关系研究及其与体内物质代谢的相关性

Study on the changes,interrelation of mood and cardiac autonomic nervous function in patients with cerebral small vessel disease and their correlation with metabolism of substances in vivo

目的研究脑小血管病(CSVD)患者情绪、心脏自主神经功能变化、相互关系及其与体内物质代谢的相关性。方法回顾性选取2015年4月至2016年4月河北医科大学第一医院住院的CSVD患者作为CSVD组,同期体检的健康者作为对照组。采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评价情绪,采用24 h动态心电图测定心率变异性指标,采集血清并测定尿酸(UA)、同型半胱氨酸(Hcy)、25-羟-维生素D[25-(OD)-Vit D]的含量,采用Pearson检验分析CSVD组HAMD、HAMA评分与心率变异性指标、血清指标的相关性。结果 CSVD组患者的HAMD、HAMA评分以及血清Hcy的含量均高于对照组,SDNN、SDANN、SDNN5、p NN50水平以及血清UA、25-(OD)-Vit D的含量均低于对照组。CSVD患者的HAMD、HAMA评分与SDNN、SDANN、SDNN5、p NN50水平呈负相关; HAMD、HAMA评分与血清Hcy含量呈正相关、与血清UA及25-(OD)-Vit D含量呈负相关,SDNN、SDANN、SDNN5、p NN50水平与血清Hcy含量呈负相关、与血清UA及25-(OD)-Vit Dha含量呈正相关。结论 CSVD患者的焦虑抑郁情绪与心脏自主神经功能发生明显变化并相互影响,且情绪与自主神经功能均受到体内UA、Hcy、Vit D代谢的影响。

Objective To study the changes,interrelation of mood and cardiac autonomic nervous function in patients with cerebral small vessel disease(CSVD)and their correlation with metabolism of substances in vivo.Methods CSVD patients in our department from April 2015 to April 2016 were selected as CSVD group and healthy people during the same period as control group.Emotions were evaluated by Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).The heart rate variability(HRV)was measured by 24-hour ambulatory electrocardiogram,and the serum uric acid(UA),homocysteine(Hcy),25-hydroxyl vitamin D[25-(OD)VitD]content were determined.Pearson analysis was used to analyze the correlation between HAMD,HAMA scores and heart rate variability index,serum index.Results The scores of HAMD,HAMA and the serum content of Hcy of CSVD group were higher than those of the control group,while the levels of SDNN,SDANN,SDN5,pNN50 and the serum contents of UA,25-(OD)-VitD were lower than those of the control group.HAMD and HAMA scores of CSVD patients were negatively correlated with SDNN,SDANN,SDN5 and pNN50 levels.HAMD and HAMA scores were positively correlated with serum Hcy content,negatively correlated with serum UA and 25-(OD)-VitD content,and SDNN,SDANN,SDN5 and pNN50 levels were negatively correlated with serum Hcy content,and positively correlated with serum UA and 25-(OD)-VitD content.Conclusion Anxiety,depression and cardiac autonomic nervous function of CSVD patients have significant changes and interaction,and emotion and autonomic nervous function are affected by UA,Hcy,VitD metabolism in vivo.