精神分裂症和精神情感障碍的心率变异性

O. Antipova, M.K. Reznikov
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摘要

本综述的目的:分析和整理精神分裂症和分裂情感性障碍患者心率变异性的研究结果。要点。大多数研究表明,精神分裂症和分裂情感性障碍患者的总心率变异性和副交感神经张力和反应性降低,包括对认知或压力负荷的反应。气压反射灵敏度也有所下降。在未服药的精神分裂症患者以及健康的一线亲属中检测到的自主心脏失调这些变化的程度与生产性、阴性和情感性症状的严重程度以及代谢综合征的存在有关。自主心脏失调在精神病状态下更为明显。具有抗胆碱能和/或α1-肾上腺素溶解活性的抗精神病药物可加重这些变化。总心率变异性和迷走神经活动的减少不仅在精神分裂症中发现,而且在其他精神和躯体疾病中也发现,这些疾病的发病机制涉及到痛苦。结论。使用心率变异性指标作为评估精神病严重程度、预测治疗效果以及心血管风险早期分层的附加标准的可能性,需要进一步的科学研究。关键词:心率变异性,自主神经系统,精神分裂症,分裂情感性障碍,抗精神病药物,生物标志物
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Heart Rate Variability in Schizophrenia and Shizoaffective Disorder
Objective of the Review: To analyze and systematize the results of the studies of heart rate variability in schizophrenia and schizoaffective disorder. Key points. Most studies demonstrate a reduction in total heart rate variability and a decrease in parasympathetic tone and reactivity in patients with schizophrenia and schizoaffective disorder, including in response to a cognitive or stress load. And also the baroreflex sensitivity decrease was revealed. Autonomic cardiac dysregulation detected in unmedicated patients with schizophrenia, as well as in healthy first-line relatives. The extent of these changes correlates with the severity of productive, negative and affective symptoms, as well as with the presence of metabolic syndrome. Autonomic cardiac dysregulation is much more pronounced in psychotic states. Antipsychotics with anticholinergic and/or α1-adrenolytic activity can exacerbate these changes. Reductions in total heart rate variability and vagal activity are detected not only in schizophrenia, but also in other mental and somatic disorders, in the pathogenesis of which distress is involved. Conclusion. The possibility of using heart rate variability indicators as additional criteria for assessing the severity of psychosis, predicting the effectiveness of therapy, as well as for early stratification of cardiovascular risks requires further study in scientific research. Keywords: heart rate variability, autonomic nervous system, schizophrenia, schizoaffective disorder, antipsychotics, biomarkers.
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