Ma Ying, Li Hui-chun, Zheng Lei-lei, Yu Hua-liang
Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
J Zhejiang Univ Sci B. 2006 Feb;7(2):133-7. doi: 10.1631/jzus.2006.B0133.
This study is aimed at exploring the relationship between hemodynamic changes and depressive and anxious symptom in depression patients.
The cardiac function indices including the left stroke index (LSI), ejection fraction (EF), heart rate (HR), diastolic pressure mean (DPM), systolic pressure mean (SPM), left ventricle end-diastolic volume (LVDV), effective circulating volume (ECV), resistance total mean (RTM) and blood flow smooth degree (BFSD) were determined in 65 patients with major depressive disorders and 31 healthy normal controls. The clinical symptoms were assessed with Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA).
In patients with depression without anxiety, LSI, EF, LVDV, DPM, SPM, ECV, BFSD were significantly lower than those in controls, while RTM was higher than that in controls. Patients with comorbidity of depression and anxiety showed decreased LVDV, ECV, BFSD, and increased HR in comparison with the controls. The anxiety/somatization factor score positively correlated with LSI, EF, LVDV, but negatively correlated with RTM. There was negative correlation between retardation factor score and DPM, SPM, LVDV.
The study indicated that there are noticeable changes in left ventricle preload and afterload, blood pressure, peripheral resistance, and microcirculation in depressive patients, and that the accompanying anxiety makes the changes more complicated.
本研究旨在探讨抑郁症患者血流动力学变化与抑郁及焦虑症状之间的关系。
测定65例重度抑郁症患者和31名健康正常对照者的心脏功能指标,包括左室每搏指数(LSI)、射血分数(EF)、心率(HR)、平均舒张压(DPM)、平均收缩压(SPM)、左心室舒张末期容积(LVDV)、有效循环血量(ECV)、总平均阻力(RTM)和血流平滑度(BFSD)。采用汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评估临床症状。
无焦虑的抑郁症患者,其LSI、EF、LVDV、DPM、SPM、ECV、BFSD显著低于对照组,而RTM高于对照组。与对照组相比,合并抑郁和焦虑的患者LVDV、ECV、BFSD降低,HR升高。焦虑/躯体化因子评分与LSI、EF、LVDV呈正相关,但与RTM呈负相关。迟缓因子评分与DPM、SPM、LVDV呈负相关。
该研究表明,抑郁症患者左心室前负荷和后负荷、血压、外周阻力及微循环存在明显变化,且伴随的焦虑使这些变化更为复杂。