冠脉内支架置入患者术后应激反应及相关因素  

Stress responses and related factors of patients with coronary heart disease after coronary intervention

作　　者：杜金玲[1] 刘德祥[1] 陈文强[2] 江虹[1] 张茜[1] 潘芳[1] 

机构地区：[1]山东大学医学院医学心理学研究所,济南250012 [2]山东大学齐鲁医院心内科,济南250012

出　　处：《山东大学学报（医学版）》2012年第2期131-134,共4页Journal of Shandong University:Health Sciences

基　　金：国家科技支撑计划项目(2009BA77B05)

摘　　要：目的观察冠脉内支架置入患者术后应激反应,并分析相关因素。方法采用焦虑自评量表、抑郁自评量表、90项症状自评量表和D型人格问卷对60例冠心病患者于冠脉内支架置入术后3 d进行调查,同时对皮肤电阻值进行测试。以30名正常人作为对照。结果患者组的焦虑自评量表、抑郁自评量表得分、症状自评量表总分和各因子分显著高于对照组(P<0.05,P<0.01)。患者的积极应对方式与对照组无统计学差异,而消极应对方式明显高于对照组(P<0.05)。患者组的皮肤电阻值显著低于正常对照组(P<0.05)。患者的D型人格得分、消极情感和社会内向均显著高于对照组(P<0.05,P<0.01﹚。不良情绪、心理健康水平和应对方式与性别、年龄、职业和受教育程度不相关。焦虑、抑郁情绪和心理健康状况与人格类型、应对方式具有相关性(P<0.001)。结论冠状动脉支架置入手术患者在术后存在明显的焦虑和抑郁情绪,心理健康水平较低,这与患者存在的D型人格特征和使用消极的应对方式有关。Objective To study stress responses and related factors of patients with coronary heart disease after coronary intervention. Methods For 60 patients 3 days post-coronary intervention, a survey was performed using the Self-rating Anxiety Scale （ SAS）, Self-rating Depression Scale （ SDS）, Symptom Checklist-90 （ SCL-90）, D Personality Ques- tionnaire and Trait Coping Style Questionnaire （TCSQ）. Skin resistance was also measured for all patients. A group of 30 healthy individuals was used as a control. Results Both total scores and unit scores of SAS, SDS and SCL-90 of the patient group were significantly higher than those of the control group （P 〈 0. 05, P 〈 0.01 ）. The patient group scored significantly higher for both type D personality and negative affectivity/social inhibition than the control group （ P 〈 0. 05 ; P 〈 0.01 ）. The patients had more negative coping style （ P 〈 0.05 ）. In addition, the patient group exhibited lower skin resistance than the control group（ P 〈 0.05 ）, indicating an elevated sympathetic response the former. It was shown that depression, anxiety and level of mental health had no correlation with age, gender and education, while a significant correlation was detected with personality and coping style （ P 〈 0. 001 ）. Conclusion Coronary intervention in patients with coronary heart disease triggered strong responses to stresses including anxiety, depression, and lower mental health. These responses were related to personality and negative coping style.

关 键 词：冠状内支架置入术 应激 焦虑 抑郁 应对 人格 

分 类 号：R737.9[医药卫生—肿瘤]