双心医学如何发展——从理论研究到智能诊疗  

How is the Psycho-Cardiology Developing:from Theoretical Research to Disease Diagnosis and Screening

作　　者：陈姝妍 赵太宏 徐兢[2,3] CHEN Shuyan;ZHAO Taihong;XU Jing(Nanjing First Hospital of Nanjing Medical University,Nanjing 210006,China;Branch of Government,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Cardiology,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属南京医院,江苏省南京市210006 [2]南京医科大学附属脑科医院行政机关,江苏省南京市210029 [3]南京医科大学附属脑科医院心内科,江苏省南京市210029

出　　处：《中国全科医学》2024年第19期2388-2394,共7页Chinese General Practice

摘　　要：心脏疾病与精神心理疾病之间存在诱发或并发关系,进而发生并发展为双心医学,需要从精神心理学的角度出发,辅助心血管疾病的治疗。本文对双心医学国内外研究现状进行简要概述,首先,通过分析双心疾病的内在机制及外在影响因素,建立理论学机制,确定双心疾病高发风险指标,基线信息(年龄、性别、BMI、饮食情况、吸烟、饮酒、体育锻炼、社会地位、家族史、高血压等共病史),血液学指标(离子浓度、血细胞含量、炎性因子水平、激素含量),生化指标(心肌酶谱、血糖、血脂、尿酸、半胱氨酸),结构功能指标(静息心率、心率变异性、左心室射血分数、左心室舒张末期内径)等类别指标是心血管疾病与精神心理疾病之间的桥梁。然后,利用以上风险指标,探讨两种双心疾病诊断模式,传统模式下的双心疾病多轴、多等级、多量表的诊断方法,以及构建的智能化诊断体系,旨在帮助临床医生做双心疾病的早期筛查及精准诊断,并实施有效的干预措施。There is an induced or concurrent relationship between cardiovascular disease and psychological illness,which occurred and developed into Psycho-Cardiology.It is necessary to assist the treatment of cardiovascular disease from the perspective of psychology,the resulting is the Psycho-Cardiology.This article briefly summarized the research status at home and abroad about Psycho-Cardiology.Firstly,analyzing the internal mechanism and external influencing factors to establish theoretical mechanism,and determine the high incidence risk index of the Psycho-Cardiology disease.Baseline information,including age,gender,BMI,diet,smoking,alcohol consumption,physical exercise,social status,family history,comorbidity including hypertension.Hematological indicators,including ion concentration,blood cell,inflammatory factor,hormone.Biochemical indicators,including myocardial enzyme spectrum,blood glucose,blood lipid,uric acid,cysteine.Structural and functional indicators,including resting heart rate(RHR),heart rate variability(HRV),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVDd).These factors have a relevance between cardiovascular disease and psychological illness.Then,exploring two diagnosis models of this disease,including a traditional model of multi-axis,multi-grade,and multi-scale diagnosis methods,and a intelligent diagnosis section system based on the risk indexes.From the clinical practice,aiming to help clinicians achieve early psychological screening and accurate diagnosis of Psycho-Cardiology disease patients,and implement effective intervention measures.

关 键 词：心血管疾病 精神病性障碍 双心疾病 诊断 疾病诊断 

分 类 号：R54[医药卫生—心血管疾病] R749[医药卫生—内科学]