[使用抗抑郁药噻奈普汀治疗的缺血性心脏病合并抑郁症患者心率变异性的变化趋势]

[Trends in heart rate variability in patients with ischemic heart disease and depression treated with antidepressant tianeptine].

作者信息

Soboleva G N, Erpylova E A, Riabykina G V, Sobolev A V, Kozhemiakina E Sh, Fedorova V I, Gorel'tseva S Iu, Karpov Iu A

出版信息

Ter Arkh. 2006;78(3):56-60.

PMID:17019960

Abstract

AIM

To study heart rate variability (HRV) according to 24-h Holter monitoring of ECG in patients with ischemic heart disease (IHD) and to examine effects of tianeptine on HRV.

MATERIAL AND METHODS

Twenty eight patients with IHD (17 males and 11 females aged 40-70 years) with a verified IHD diagnosis and atherosclerosis of the coronary arteries participated in the trial. Severity of depressive syndrome was assessed by CES-D questionnaire. HR V was assessed by weighted mean variation of the rhythmogram (WMVR) for 24 hours.

RESULTS

Initial WMVR (m +/- sigma) in the study group (IHD with depression, n = 15) was 670 +/- 260 ms, in the control group (IHD without depression, n = 13) - 625 +/- 191 ms (the difference was insignificant (p = 0.72). Initial (m +/- sigma) WMVR in men of the study group (n = 6) before therapy was 460 +/- 139 ms that was less than in the control group (633 +/- 183 ms, n = 11).

CONCLUSION

In men HRV depends on duration of the disease. There was a negative correlation between WMVR difference before and after treatment with tianeptine and difference of relevant depression indices with high correlation coefficient (-0.74, p = 0.03).

摘要

目的

通过对缺血性心脏病（IHD）患者进行24小时动态心电图监测来研究心率变异性（HRV），并考察噻奈普汀对HRV的影响。

材料与方法

28例确诊为IHD且患有冠状动脉粥样硬化的患者（17例男性，11例女性，年龄40 - 70岁）参与了该试验。采用流调中心用抑郁量表（CES - D）问卷评估抑郁综合征的严重程度。通过24小时节律图的加权平均变异（WMVR）评估HRV。

结果

研究组（伴有抑郁的IHD，n = 15）的初始WMVR（m±σ）为670±260毫秒，对照组（不伴有抑郁的IHD，n = 13）为625±191毫秒（差异无统计学意义（p = 0.72））。研究组男性（n = 6）治疗前的初始（m±σ）WMVR为460±139毫秒，低于对照组（633±183毫秒，n = 11）。