目的 探讨5-羟色胺( 5-hydroxytryptamine， 5-HT)、心率变异( heart Rate Variability， HRV)、心电图特征与抑郁症患者的相关关系。方法 测定并比较60例抑郁症组与40例健康对照组血中5-HT的含量;分析血中5-HT含量与症状自评量表( symptom checklist 90， Scl-90)评分的相关性;运用动态心电图系统采集其心电信号并进行HRV分析;描记常规12导联心电图并逐一进行分析。结果 抑郁症组血中5-HT含量( 172.08±101.36)ng/ml低于健康对照组( 257.34±104.06)ng/ml， 差异有统计学意义( P＜0.001)。抑郁症组血中5-HT含量与Scl-90评分的人际关系敏感、抑郁、敌对分数变化相关， 相关系数分别为-0.406、-0.384、-0.445， 差异有统计学意义( P＜0.01)。抑郁症组24 h内全部正常心动周期的标准差( SDNN)、24 h每5 min正常R-R间期的标准差的平均数( SDANN)、相邻正常心动周期差值的均方根( RmSSD)、相邻两个正常心动周期差值大于50 ms的个数所占的百分比( PNN50)、低频功率( LF)、高频功率( HF)、低频功率与高频功率之比( LF/HF)低于健康对照组( P＜0.001);抑郁症组心电图中窦性心动过缓、窦性心律不齐、早期复极、早搏检出率高于健康对照组( P＜0.05)。结论 检测血中5-HT含量的方法在抑郁症客观诊断中有重要临床价值， HRV和心电图在该病的诊断中有一定临床参考价值。
Abstract
Objective To study the changes of 5-hydroxytryptamine ( 5-HT), heart rate variability ( HRV), electrocardiographic characteristics in major depressive disorder( MDD) patients and the correlation between 5-HT and MDD. Methods All subjects were divided into MDD group ( n=60) and control group ( n=40). Concentration of 5-HT in blood was determined by using liquid chromatograph mass spectrometry. We compared the concentrations of 5-HT between the two groups and analyzed the correlation between concentration of 5-HT and some factors’ scores in symptom checklist 90( scl-90). HRV was detected by Holter monitor. All subjects underwent the 12 lead electrocardiography and the Results were analyzed in detail. Results Concentration of 5-HT in the MDD group ( 172.08±101.36 ng/ml) was significantly lower than that in control group ( 257.34±104.06 ng/ml)( P＜0.001). Concentration of 5-HT in the MDD group was correlated with the Scl-90 score of interpersonal relationship( r=-0.406), depression ( r=-0.384) and hostility ( r=-0.445). All these correlations were significant( P＜0.01). The values of SDNN, SDANN, RmSSD, PNN50, LF, HF, LF/HF in the MDD group were lower than those in thecontrol group ( P＜0.001). More sinus bradycardia, sinus arrhythmia, early repolarization and premature beats were detected in the MDD group than in thecontrol group( P＜0.05). Conclusions It is very valuable to use concentration of 5-HT for diagnosing MDD. HRV and ECG are somewhat valuable for diagnosis of MDD.
关键词
5-羟色胺 /
心率变异 /
心电图 /
抑郁症
Key words
5-hydroxytryptamine /
heart rate variability /
electrocardiography /
major depressive disorder
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参考文献
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基金
武警部队卫生专业科研立项( WJWSB2012-01)
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