非心源性胸痛患者冠状动脉造影术前发生心理障碍的识别研究  

Identification of psychological disorder in patients with non-cardiac chest pain before coronary angiography

作　　者：郭英杰 王皓 张守彦 Guo Yingjie;Wang Hao;Zhang Shouyan(Department of Cardiovascular Medicine,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;不详)

机构地区：[1]郑州大学第二附属医院心血管内科,郑州450000 [2]郑州大学附属洛阳中心医院心血管内科,洛阳471000

出　　处：《中国循证心血管医学杂志》2021年第11期1360-1363,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的对比缺血性胸痛(ICP)组与非心源性胸痛(NCCP)组患者的临床特征及心理状态,初步实现对NCCP患者发生心理障碍的识别。方法连续收集2018年5月至2019年10月以胸痛为主诉拟诊冠状动脉粥样硬化性心脏病(冠心病)患者,根据冠状动脉(冠脉)造影结果分为NCCP组和ICP组。两组均采用躯体症状自评量表(SSS)、广泛性焦虑自评量表(GAD-7)、健康问卷抑郁症状群量表(PHQ-9)进行心理状态评估,对比两组的临床资料及量表得分,对发生NCCP的影响因素行多因素Logistic回归分析,绘制ROC曲线。结果入选493例胸痛患者,与ICP组相比,NCCP组患者较年轻,吸烟史、用药史比例低,血脂水平、血糖水平较低;血清同型半胱氨酸水平、甲状腺激素水平较高(P<0.05)。NCCP组SSS、PHQ-9和GAD-7得分高于ICP组(P<0.05)。多因素Logistic回归分析显示,FBG、SSS得分、同型半胱氨酸、TG是NCCP的危险因素,SSS得分、同型半胱氨酸及SSS得分与同型半胱氨酸联合检测对NCCP的发生可能有预测价值(P<0.05)。结论SSS得分、同型半胱氨酸及SSS得分与同型半胱氨酸联合检测对NCCP可能有预测价值,单个指标中以SSS量表对NCCP的预测价值最大,联合检测敏感度较高,有助于提高NCCP患者发生心理障碍早期识别。Objective To compare the clinical characteristics and psychological state between ischemia chest pain group(ICP group)and non-cardiac chest pain group(NCCP group),and preliminarily realize the recognition on psychological disorders in NCCP patients.Methods The patients with chest pain as chief compliant and suspected coronary heart disease(CHD)were chosen from May 2018 to Oct.2019,and divided,according to coronary angiography(CAG)results,into NCCP group and ICP group.The psychological state was reviewed by using Somatic Self-rating Scale(SSS),Generalized Anxiety Disorder-7 Items(GAD-7)and Patient Health Questionnaire-9 Items(PHQ-9)in 2 groups,and clinical data and scores from the scales were compared between 2 groups.The influence factors of NCCP were analyzed by using multi-factor Logistic regression analysis for drawing ROC curve.Results There were totally 493 patients with chest pain included.The percentages of youth,smoking and medication were lower,levels of blood fat and blood sugar were lower,and levels of homocysteine(Hcy)and thyroid hormone were higher in NCCP group compared with ICP group(P<0.05).The scores of SSS,PHQ-9 and GAD-7 were higher in NCCP group than those in ICP group(P<0.05).The results of multi-factor Logistic regression analysis showed that FBG,SSS scores,Hcy and TG were risk factors of NCCP,and SSS scores,Hcy and combined detection of SSS scores and Hcy had predictive value to NCCP incidence(P<0.05).Conclusion SSS scores,Hcy and combined detection of SSS scores and Hcy have predictive value to NCCP incidence.Among single indexes,SSS scores have the highest predictive value and combined detection of SSS scores and Hcy has the highest sensitivity to NCCP,which is helpful in early recognition on psychological disorders in NCCP patients.

关 键 词：非心源性胸痛 躯体化症状 焦虑 抑郁 

分 类 号：R816.2[医药卫生—放射医学]