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心率变异性在躯体症状障碍患者血压测量中的应用。

Application of heart rate variability during blood pressure measurement in patients with somatic symptom disorder.

机构信息

Department of Psychiatry, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei City 100, Taiwan, ROC; Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 640, Taiwan, ROC; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 100, Taiwan, ROC.

Department of Neurology and Pharmacology, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei City 100, Taiwan, ROC; Department of Neurology, National Taiwan University Hospital, Yun-Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 640, Taiwan, ROC.

出版信息

J Clin Neurosci. 2020 Apr;74:25-31. doi: 10.1016/j.jocn.2020.01.064. Epub 2020 Jan 22.

Abstract

OBJECTIVE

This study wants to test whether the heart rate variability (HRV) analysis using sphygmomanometers can effectively reflect the physical and emotional distress of somatic symptom disorder (SSD) cases and assist in further health management.

METHODS

This study includes 66 female SSD cases and 32 male SSD cases. All cases received a 200-second blood pressure (BP) measurement, after which the numerical figure for the heart rate was obtained from the BP signal for HRV analysis. All cases also filled out Patient Health Questionnaire-15 (PHQ-15), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI) to understand the extent of their somatic distress, depression, and anxiety. The relationship between psychological conditions and HRV indicators are examined statistically. Receiver operating characteristic (ROC) curve analysis was used to understand whether HRV indicators can assist in the determination of psychosomatic problems.

RESULTS

Considering all and female SSD cases, low-frequency power (LF) and PHQ-15 in the HRV index have the most significant correlations. In male SSD cases, root mean square of successive NN interval differences (RMSSD) and BDI-II have the highest correlations. The results of ROC curve analysis indicate that LF is useful to judge the severity of female SSD cases, while RMSSD has reference value in determining whether male patients of SSD cases have depression or not. In addition, physical stress index (PSI) can also help determine the degree of depression in male SSD cases.

CONCLUSION

The use of BP in HRV analysis can help in the monitoring of somatic distress and depression issues in SSD cases. LF, RMSSD, PSI are potential physiological indicators.

摘要

目的

本研究旨在测试使用血压计进行心率变异性(HRV)分析是否能有效反映躯体症状障碍(SSD)患者的身体和情绪困扰,并有助于进一步的健康管理。

方法

本研究纳入 66 例女性 SSD 患者和 32 例男性 SSD 患者。所有患者均接受 200 秒血压(BP)测量,然后从 BP 信号中获取心率数值,用于 HRV 分析。所有患者还填写了患者健康问卷-15(PHQ-15)、贝克抑郁量表第二版(BDI-II)、贝克焦虑量表(BAI),以了解其躯体困扰、抑郁和焦虑的程度。统计分析心理状况与 HRV 指标之间的关系。采用受试者工作特征(ROC)曲线分析了解 HRV 指标是否有助于确定身心问题。

结果

考虑所有 SSD 患者和女性 SSD 患者,HRV 指标中的低频功率(LF)和 PHQ-15 相关性最强。在男性 SSD 患者中,RMSSD 和 BDI-II 与 HRV 指标的相关性最高。ROC 曲线分析结果表明,LF 有助于判断女性 SSD 患者的严重程度,而 RMSSD 对判断男性 SSD 患者是否患有抑郁症具有参考价值。此外,生理压力指数(PSI)也有助于确定男性 SSD 患者的抑郁程度。

结论

使用 BP 进行 HRV 分析有助于监测 SSD 患者的躯体困扰和抑郁问题。LF、RMSSD、PSI 是潜在的生理指标。

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