接受冠状动脉支架置入治疗者的心理状态分析  

Mental status of patients undergoing coronary stent implantation

作　　者：朱性霞[1] 武惠敏[2] 许志亮[1] 杨瑞兰[1] 

机构地区：[1]新乡医学院第二附属医院,河南省新乡市453002 [2]新乡医学院第三附属医院,河南省新乡市453003

出　　处：《中国组织工程研究与临床康复》2009年第30期5955-5958,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:探讨冠状动脉粥样硬化性心脏病(简称冠心病)患者接受冠状动脉支架置入前后焦虑、抑郁水平。方法:汇总文献分析冠心病患者发生抑郁、焦虑情绪障碍机制。临床验证病例选择2008-03/12住院接受冠状动脉内支架置入治疗的冠心病患者61例为研究组,同时期选择与患者相匹配的新乡市某区居民61例为对照组,由经过培训的心理工作人员对研究组于手术前后1周内进行焦虑自评量表、抑郁自评量表调查。结果:早期的研究提出了抑郁对冠心病可能存在的影响机制,包括行为因素如患者对治疗的依从性差等和生理因素如心律失常等。近期又提出了一些新的生理机制,如心脏自主神经功能改变、炎症过程、血栓形成、内皮功能障碍、遗传因素等。冠心病患者的焦虑情绪障碍发生机制十分复杂,目前认为与遗传、行为类型、环境因素等有关。临床验证结果:研究组手术前焦虑自评量表、抑郁自评量表评分均高于对照组第1次评分(P<0.01)。研究组手术后焦虑自评量表、抑郁自评量表得分与手术前比较,差异无显著性意义(P>0.05)。对照组第2次焦虑自评量表、抑郁自评量表得分与第1次比较,差异无显著性意义(P>0.05)。结论:冠状动脉支架治疗者焦虑、抑郁情绪明显。在接受支架置入治疗时,还要积极配合心理社会干预,帮助患者改善焦虑、抑郁情绪,以促进其疾病康复,提高生活质量。OBJECTIVE： To explore the levels of anxiety-depression in patients prior to and after coronary stent implantation. METHODS： The mechanisms of anxiety-depression in patients with coronary artery disease were analyzed. Totally 61 patients received coronary stent implantation between March and December were selected. Simultaneously, 61 healthy residents of Xinxiang were served as control group. The self-rating anxiety scale and the self-rating depression scale were performed at 1 week prior to and after operation. RESULTS： Previous study proposed that the influence mechanism of depression on coronary artery disease including behavior factor and physiologic factor, such as poor compliance to treatment or arrhythmia. Recently, it is demonstrated that change of heart autonomic nervous function, inflammatory process, thrombosis, endothelial dysfunction, and genetic factor can also affect coronary artery disease. Mechanisms underlying emotional disorders are complex, which correlated to genetic, behavior and environmental factors. The result of study revealed that the first scoring of self-rating anxiety and self-rating depression scale of the experimental group was higher than that of control group prior to operation （P 〈 0.01）, however, there was no significant difference in the scoring prior to and after operation in the experimental group （P 〉 0.05）. The difference between the second and the first scoring in the control group had no obvious significance （P 〉 0.05）. CONCLUSION： There was high incident rate of anxiety-depression symptoms in patients received coronary stent implantation, therefore, early intervention should be strengthened to reduce anxiety-depression and promote disease rehabilitation.

关 键 词：冠状动脉 介入治疗 焦虑 抑郁 自尊 

分 类 号：R541.4[医药卫生—心血管疾病]