负性情绪干预对冠心病患者发生缺血相关事件的影响

Psychotherapy on negative emotions for the incidence of ischemia related events in patients with coronary heart disease

目的:探讨心理治疗对冠心病患者负性情绪的干预效果,以及减少冠心病缺血性的血管事件发生的有效康复介入手段。方法:将136例冠心病患者随机分为心理治疗组71例及对照组65例,两组病例均给予内科治疗,心理治疗组给予综合心理干预治疗,治疗前完成首次焦虑自评量表(SAS)及抑郁自评量表(SDS)评定,治疗后第二次评定,及进行西雅图心绞痛调查量表(SAQ)评定,比较两组SAS,SDS,SAQ得分及临床疗效。出院随访1年,记录2组患者冠心病缺血性心血管事件的发生情况。结果:心理治疗组治疗后SAS,SDS评分降低显著低于对照组(P均<0.001),临床疗效及SAQ评分显著高于对照组(P<0.01～0.001),心理治疗组住院时间较对照组缩短(P<0.001),心理治疗组临床随访1年总缺血相关事件发生率为19%(11/58),明显低于对照组(P<0.05)。结论:心理治疗显著降低冠心病患者负性情绪的严重程度,提高临床疗效,缩短住院时间,减少冠心病心血管事件发生,改善预后。

AIM:To investigate the effects of comprehensive psychotherapy on negative emotions of coronary heart disease(CHD)patients and study effective rehabilitative intervention methods to reduce the incidence of ischemia related events. METHODS:Totally 136 patients with CHD were randomly divided into psychotherapy group(71 cases) and non psychotherapy group(65 cases).Both groups were given conventional treatment;the psychotherapy group was treated with comprehensive psychotherapy.Self rating anxiety scale(SAS) and self rating depression scale(SDS) were conducted before psychotherapy for the first time and after psychotherapy for the second time,and Seattle angina questionnaire(SAQ) were finished after psychotherapy.The scores of SAS,SDS,SAQ and clinical outcome were compared between the two groups.All patients were followed up for 1 year to observe the ischemic events. RESULTS:The scores of SAS and SDS in the psychotherapy group were significantly lower than those of the control group(P< 0.001),while the SAQ scores and clinical outcome were significantly higher than those of the control group(P< 0.01-0.001).The length of stay in the psychotherapy group was shorter than that of the control group(P< 0.001).During the one year follow up,the ischemia related events occurring in the psychotherapy group(19%,11/58) was significantly lower than that in the control group(P< 0.05). CONCLUSION:Comprehensive psychotherapy can significantly decrease the severity of negative emotions and improve clinical outcome,shorten the length of stay in hospital,decrease the incidence of ischemia related events,and improve the prognosis of CHD.