| [Objective]Through comparing the levels of hair cortisol(COR)of healthy subjects with patients with first acute coronary syndrome(ACS)and the follow-up of those with ACS,we are to observe whether the level of hair cortisol of patients with ACS is higher than that of healthy people,there are the relationship between burnout and hair cortisol Levels in patients with ACS,and the hair cortisol levels have effects on heart rate variability(HRV),quality of life and physical recovery in ACS patients.[Method]1.The participants were patients with their first ACS and admitted to the Cardiology Department of the First Affiliated Hospital of Kunming Medical University during March 2015 to February 2017 and the similar number of healthy person.All the participants signed the informed consent.2.Participants'basic data,including Demographic characteristics,tobacco and alcohol addiction,past medical history,family history of heart disease,clinical manifestations and disease diagnosis were collected during their admission.3.To complete the collection of hair samples from all ACS patients and healthy person.All participants' should have a hair length of not less than 3 cm.In the head of the five different positions to take each participants' hair from root near the scalp not less 3?6 cm hair a total of 100?200 mg.Marked with a head and tail placed in a diaposable sterile sampling box,stored at room tempurature.4.The heart rate variability was analyzed by 24-hour dynamic electrocardiogram,and time threshold index and frequency threshold index were obtained.Burnout was assessed by the general burnout subscale of Copenhagen Burnout Inventory(CBI)during hospitalization.Based on the upper quartile(P75)of general burnout score,all patients were divided into two groups:high burnout group(burnout score>P75)and low burnout group(burnout score<P75).5.At one month follow-up patients were discharged,all participants were asked to do a physical capacity test,whose name is Short Physical Performance Battery(SPPB).Medical Outcome Study Short Form-8(SF-8)and Seattle Angina Questionnaire(SAQ)were used to evaluate the quality of life.6.After the pretreatment of the hair samples of the experimental group and the contral group,the level of cortisol was detected by high performancce liquid chromatography.The experimental group was grouped according to the level of hair cortisol,also based on the upper quartile(P75)of the detection of the concentration of cortisol,all patients were divided into two groups:high cortisol level group(burnout score>P75)and low cortisol level group group(burnout score<P75).7.All data will be analyzed by SPSS 20.0 statistical software.Because HRV frequency threshold index like TP,LF,BF,VLF and ULF are not a normal distribution of information,first,we need to carry out nature logarithmic conversion,so that we turn them into InTP,lnLF,lnHF,InVLF,and InULF,and then make an statistical analysis.It is necessary to determine whether there is significant difference between the experimental group and the control group,the high burnout group and the low burnout group,the high cortisol group and the low cortisol group.If the measurement data is consistent with the normal distribution,the group will be selected to design the t test;If not,the group will be selected to design the rank sum test,whose counting information will be used chi-square to test.It is statistically significant,if P<0.05.[Results]1.The study involved 85 patients,in which one patient was withdrawn,8 cases were free the disease,3 were in the experimental group and 5 in the control group,so 76 patients finished the test and were followed up,among which 38 were in the experimental group and 38 in the control group;according to CBI general burnout score and upper quartile P75 in cortisol,taking P75 = 62.5 points as the boundary,those with higher than or equal to 62.5 points were included in the high burnout group,a total of 12 cases;or else,those in low burnout group,a total of 26 cases;taking cortisol levels P75 = 9.33 ng/g,those with high cortisol levels were 9,and those with low cortisol levels were 29.2.For the level of cortisol in the experimental group was higher than that in the control group(p = 0.015),it was statistically significant(p=0.001).3.Because the level of cortisol in high burnout group was significantly higher than that in low burnout group(p = 0.001),it was statistically significant(p=0.001).4.There was no obvious difference in both the high and low cortisol level group with HRV in time domain index SDNN,frequency domain index InTP,InLF,InHF,InVLF,and InULF(p>0.05).The physiological and psychological health scores of SF-8 in the high cortisol level group were lower than those in the low cortisol group.Statistical analysis showed that the scores of physical health scores were statistically different(p = 0.047),while there was no difference in mental health scores(p>0.05).The score of 5 dimensions of SAQ in high cortisol group was lower than that in low cortisol group,in which the difference between AS(p = 0.012)and DP score(p ?0.037)was statistically significant,while there was no statistical significance in score difference of PL,AF and TS(p>0.05).There was no statistical significance in SPPB score difference in the two groups(p>0.05).[Conclusion]Through comparing the levels of cortisol(COR)of healthy subjects with patients with first acute coronary syndrome(ACS)and the follow-up of those with ACS,we came to the conclusion:1.The level of hair cortisol in patients with ACS was higher than that in normal subjects.2.Burnout promoted the level of cortisol in patients with ACS,in other words,they were positively correlated.3.The level of hair cortisol had an effect on quality of life of patients with ACS after discharge,mainly in the physiological health,angina stable state and disease awareness,and less effect on heart rate variability and physical activity. |
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