抑郁对心绞痛型冠心病患者心率震荡的影响

目的：探讨抑郁对心绞痛型冠心病患者心率震荡（HRT）的影响。方法纳入2008年1月~2012年2月苏州市吴江第一人民医院心绞痛型冠心病患者78例，应用Zung抑郁自评量表（SDS）评定抑郁状况，其中不合并抑郁（SDS评价＜50）的40例患者作为对照组，合并抑郁患者38例作为观察组，并根据SDS评分将观察组进一步分为轻度抑郁组（50≤SDS评分＜60，n=14）、中度抑郁组（60≤SDS评分＜70，n=14）、重度抑郁组（SDS评分≥70，n=10）。所有入选患者均于入组时接受动态心电图检查，测量窦性HRT的参数，包括震荡起始（heart rate turbulance onset，TO）和震荡斜率（heart rate turbulence slope，TS），比较两组之间的差异。结果观察组TO较对照组显著升高（2.16±1.06）%vs.（1.54±0.68）%，P=0.027]，TS较对照组患者显著降低（2.33±1.95）ms/RRIvs.（4.47±3.89）ms/RRI， P=0.014]。观察组亚组分析显示，随着抑郁程度加重，TO逐渐升高而TS逐渐降低。结论抑郁可导致冠心病患者心率震荡明显减弱，抑郁程度越重，HRT减弱越明显。

Influence of depression on heart rate turbulence in patients with angina coronary heart disease

Objective To investigate the influence of depression on heart rate turbulence （HRT） in the patients with angina coronary heart disease （CHD）.Methods The patients （n=78） were chosen from Wujiang First People’s Hospital of Suzhou City from Jan. 2008 to Feb. 2012, and their depression status was assessed by using Zung Self-rating Depression Scale （SDS）. The patients （n=40） without depression （SDS scores〈50） were included into control group and those （n=38） with depression were included into observation group. The observation group was further divided into mild group （50≤SDS scores〈60,n=14）, moderate group （60≤SDS scores〈70, n=14） and severe group （SDS scores≥70,n=10） according to SDS scores. All patients were given examinations of ambulatory electrocardiogram （ECG）, and detection of sinus heart rate turbulence （HRT） parameters including heart rate turbulance onset （TO） and heart rate turbulence slope （TS） for comparing the difference between two groups. Results TO increased significantly （2.16±1.06）%vs. （1.54±0.68）%,P=0.027] and TS decreased significantly （2.33±1.95） ms/RRIvs. （4.47±3.89） ms/RRI,P=0.014] in observation group compared with control group. The analysis on sub-groups of observation group showed that TO increased gradually and TS decreased gradually as depression exacerbated.Conclusion Depression can attenuate HRT significantly, and HRT will more significant as depression exacerbates.