双心医疗干预对86例合并焦虑抑郁的急性心肌梗死患者随机对照研究  

A Randomized Controlled Study on Psycho-cardiology Intervention of 86 Acute Myocardial Infarction Patients with Anxiety and Depression

作　　者：任磊 宁彬[1] 马震[1] 郭影 张婷婷 胡成燕[1] 唐丽丽 国小丽 李传芳 张大鹏 REN Lei;NING Bing;MA Zhen;GUO Ying;ZHANG Ting-ting;HU Cheng-yan;TANG Li-li;GUO Xiao-li;LI Chuan-fang;ZHANG Da-peng(Cardiovascular Medicine Department,Fuyang Peopled Hospital,Fuyang 236000,China;Psychiatry Department,Fuyang Third People's Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院心血管内科,阜阳236000 [2]阜阳市第三人民医院精神科,阜阳236000

出　　处：《中国临床心理学杂志》2021年第4期887-890,共4页Chinese Journal of Clinical Psychology

摘　　要：目的:研究双心医疗对急性心肌梗死(AMI)合并焦虑抑郁患者心脏康复的效果以及AMI合并焦虑抑郁的危险因素。方法:对照组和双心组各纳入43例患者,其中对照组实施常规治疗和健康宣教,双心组则于对照组的基础上增用双心医疗干预。对比合并焦虑抑郁组和未合并焦虑抑郁组患者的相关因素,使用Logistic回归筛选影响合并焦虑抑郁的可能危险因素。结果:干预后双心组LVEF(左室射血分数)水平、QOL评分、Barthel指数均高于对照组(均P<0.05);而LVEDV(左心室舒张末容积)水平、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分、干预期间恶性心律失常发生率均低于对照组(P<0.05)。Logistic回归分析发现:年龄≥70岁、女性、工作时长≥10h/d、配偶和父母直系亲属有慢性重大疾病均是AMI合并焦虑抑郁的独立危险因素(均P<0.05)。结论:双心医疗的应用可促进AMI合并焦虑抑郁患者心功能、生活质量以及日常生活活动能力的改善。高龄、女性、长时间工作、配偶和父母直系亲属有慢性重大疾病可能是AMI合并焦虑抑郁的危险因素。Objective: To study the cardiac rehabilitation effect of psycho-cardiology intervention on Acute Myocardial Infarction(AMI) patients with anxiety and depression and the risky factors of AMI patients with anxiety and depression.Methods: Patients with AMI complicated with anxiety and depression were divided into the Psycho-cardiology group and the control group, and 43 patients were included in each group. The control group received routine treatment and health education, while the Psycho-cardiology group received additional Psycho-cardiology intervention. Comparing related factors between AMI patients with anxiety and depression and AMI patients without anxiety and depression to filtrate risk factors of the complication of anxiety and depression through Logistic regression analysis. Results: LVEF, QOL and Barthel index were higher in the two heart group than in the control group(P<0.05);The LVEDV(left ventricular end diastolic volume),anxiety self-assessment scale(SAS), depression self-assessment scale(SDS) score, and the incidence of malignant arrhythmia during intervention were lower than that of the control group(P<0.05). Logistic regression analysis showed that age ≥70 years old, female, working time ≥10 h/d, spouse and parents with chronic major diseases were independent risk factors of AMI combined with anxiety and depression(P<0.05). Conclusion: The application of Psycho-cardiology intervention can improve the heart function, quality of life and the ability of daily life activity in AMI patients with anxiety and depression.The risk factors of AMI with anxiety and depression may include advanced age, female, working long hours and chronic major diseases in spouse and parents.

关 键 词：急性心肌梗死 焦虑 抑郁 双心医学 危险因素 

分 类 号：R395.5[哲学宗教—心理学]