A型行为与高血压患者心理社会事件及血管内皮功能的相关性  

The Correlation between Psychosocial Factors,Physiological Factors and Type A Behavior Pattern in Hypertensive Patients

作　　者：李梦[1] 玛依努尔·赛买提 李昭[1] 胡健[1] 孙远刚[3] 

机构地区：[1]中国医科大学附属第一医院心内科,沈阳110001 [2]新疆阿克陶县妇幼保健站,新疆845550 [3]辽宁师范大学教育学院心理学系,大连116011

出　　处：《中国心理卫生杂志》2008年第10期724-728,共5页Chinese Mental Health Journal

摘　　要：目的:探讨高血压患者的A型行为与生活事件、社会支持、情绪障碍及血管内皮功能的关系。方法:从207例住院高血压病患者中,选取收缩压≥140mmHg和(或)舒张压≥90mmHg者,共入组197例。从参加体检的健康者中随机选取46例为正常对照组。用A型行为问卷、生活事件量表、社会支持评定量表、症状自评量表评定心理状况,并测定血浆内皮素、血清一氧化氮和血脂。结果:高血压组中的A型行为比例显著高于正常对照者(76.7%vs.45.7%,χ2=9.77,P=0.003),高血压组A型行为者负性生活事件频度、负性生活事件强度、焦虑因子分及血浆内皮素水平均高于非A型行为者[(3.4±1.0)vs.(2.5±0.9),P=0.007;(23.2±6.0)vs.(15.9±4.2),P<0.001;(1.8±0.5)vs.(1.4±0.7),P=0.004;(79.8±12.3)vs.(57.7±11.4),P=0.006],血清一氧化氮水平、主观支持分低于非A型行为者[(39.8±9.7)vs.(56.2±10.5),(8.1±6.4)vs.(16.7±4.2),均P<0.001]。血清一氧化氮、血浆内皮素、负性LEI平均值、主观支持分、焦虑因子分、脉压与A型行为显著相关(β=-0.22、0.19、0.24、-0.21、0.15、0.19)。结论:A型行为是高血压发病的内在因素,与生活事件、社会支持、情绪障碍等心理社会因素密切相关,血管内皮功能障碍可能是A型行为引起高血压的重要生理机制之一。Objective： To explore the relationship between type A behavior pattern, life events, social support, emotion disorders and endothelial dysfunction in hypertensives. Methods： Mental status of 197 hypertensives （ systolic blood pressure ≥140mmHg and/or diastolic blood pressure≥90mmHg） and 46 healthy subjects were measured by the type A behavior pattern questionnaire, life events scale, social support scale and symptom checklist 90. The plasma en- dothelin, nitric oxide and serum lipid concentrations were also determined. Results： Proportion of type A behavior pattern in hypertensives was higher than that in healthy subjects （ 76. 65% vs. 45. 65%, P = 0. 003 ） . Negative life events frequency, negative life events intensity, anxiety and endothelin of hypertensives with type A behavior pattern were higher than that of non-type A behavior pattern patients [ （ 3.4 ± 1.01 vs. { 2. 5 ±0. 9 }, P = 0. 007 ; { 23.2± 6.0} vs. （15.9±4.2）, P〈0.001; （1.8±0.5} vs. （1.4±0.7）, P=0.004; （79.8±12.3} vs. （57.7±11.4 } , P = 0. 006 ] ; nitric oxide and subjective social support of hypertensives with type A behavior pattern were lower than that of non-type A behavior pattern patients. Nitric oxide, endothelin, negative life events intensity, subjective social Support, anxiety and pulse pressure were significantly correlated with type A behavior pattern （ β = -0. 22, 0. 19, 0. 24, -0. 21, 0. 15, 0. 19 ） . Conclusion： Type A behavior pattern is the concomitant of hypertension, which is closely associated with life events, social support and emotion disorders. Endothelial dysfunction may be an important physiological mechanism for hypertensio.

关 键 词：高血压病 A型行为 心理社会因素 血管内皮功能 横断面调查 

分 类 号：R395.1[哲学宗教—心理学]