冠心病伴焦虑抑郁患者的临床特点研究  

Clinical Characteristics of Anxious or Depressed Patients with Coronary Artery Disease

作　　者：石炜祺 刘如辉[2] 倪奕[2] 王真 马文林[2] SHI Weiqi;LIU Ruhui;NI Yi;WANG Zhen;MA Wenlin(Tongji University School of Medicine,Shanghai 200082,China;Department of Cardiovascular Medicine,Tongji Hospital of Tongji University,Shanghai 200065,China)

机构地区：[1]同济大学医学院,上海市200082 [2]同济大学附属同济医院心血管内科,上海市200065

出　　处：《中国全科医学》2019年第18期2166-2171,2175,共7页Chinese General Practice

基　　金：上海市科委西医引导项目(16411965500)——急性ST段抬高型心肌梗死患者院前延误相关社会因素多中心研究

摘　　要：背景焦虑抑郁在冠心病(CAD)患者中高发,常迁延不愈,影响疾病的治疗与预后。然而在临床实际工作中,由于对这类患者的临床特点认识不足,漏诊率较高。目的分析CAD伴焦虑抑郁患者临床特点,为临床医生早期识别该病提供帮助。方法本研究为单中心横断面研究。连续选取2013年3-7月在同济大学附属同济医院明确诊断的CAD患者131例。采用一般信息调查表及贝克焦虑量表(BAI)、贝克抑郁量表(BDI)、症状自评量表(SCL-90,包括躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他症状10个维度)进行问卷调查,由患者独立填写问卷。结果共发放问卷131份,回收有效问卷120份,有效回收率为91.6%。120例患者中共39例(32.5%)患者伴焦虑或抑郁,其中38例(31.7%)患者伴焦虑,7例(5.8%)患者伴抑郁,6例(5.0%)患者同时伴焦虑抑郁。躯体化维度中,CAD伴焦虑抑郁患者“头痛”“头晕或晕倒”“胸痛”“呼吸有困难”“身体发麻或刺痛”“喉咙有梗塞感”“感到身体的某一部分软弱无力”“感到手或脚发重”阳性率高于CAD不伴焦虑抑郁患者(P<0.05)。强迫症状维度中,CAD伴焦虑抑郁患者“头脑中有不必要的想法或字句盘旋”“感到难以完成任务”“做事必须反复检查”“难以做出决定”“脑子变空了”“不能集中注意”“必须反复洗手、点数”阳性率高于CAD不伴焦虑抑郁患者(P<0.05)。人际关系敏感维度中,CAD伴焦虑抑郁患者“对旁人责备求全”“感到比不上他人”“感到对别人神经过敏”“感到在公共场合吃东西很不舒服”阳性率高于CAD不伴焦虑抑郁患者(P<0.05)。抑郁维度中,CAD伴焦虑抑郁患者“对异性的兴趣减退”“想结束自己的生命”“容易哭泣”“经常责怪自己”“感到孤独”“感到苦闷”“过分担忧”“对事物不感兴趣”“感到对前途没有希�Background Anxiety and depression is common among patients with coronary artery disease(CAD), which protracts the course of disease,affecting the treatment and prognosis,with high rate of missed diagnosis.Clinical characteristics of these patients remain unexplored.Objective To identify the clinical characteristics of CAD patients with anxiety and depression,which can be helpful for early diagnosis.Methods In this single-center cross-sectional study,a total of 131 patients diagnosed with CAD in Tongji Hospital of Tongji University from March to July 2013 were enrolled.General Information Questionnaire,Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI),Symptom Checklist 90(SCL-90, composed of 10 dimensions,including somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety, hostility,terror,paranoia,psychosis and other symptoms) were distributed and completed by the patients independently. Results A total of 131 questionnaires were distributed,and all were recovered,of which 120 were valid,with an effective response rate of 91.6%.Thirty-nine patients(32.5%) were accompanied by anxiety and/or depression,of which 38(31.7%) had anxiety,seven(5.8%) had depression,and six(5.0%) accompanied by both.In somatization dimension,compared to those without anxiety or depression,the CAD patients with anxiety and/or depression complained more“ headaches“”faintness or dizziness”“chest pain”“trouble breathing”“numbness or tingling in parts of your body”“ sense of obstruction in your throat”“feeling weak in parts of your body”“heavy feelings in your arms or legs”(P<0.05).In the dimension of obsessive-compulsive symptoms,the incidence of “unwanted thoughts or ideas that won't leave your head”“feeling difficult in getting things done”“having to check and double check what you do”“difficulty in making decisions”“your mind going blank”“trouble in concentrating”“having to repeat the same actions such as counting,washing”in CAD patients with

关 键 词：冠心病 焦虑 抑郁 症状自评量表 躯体型障碍 双心医学 

分 类 号：R541.4[医药卫生—心血管疾病]