胸痛患者冠状动脉造影术前心理状态研究

Psychological status prior coronary angiography in patients with and without coronary artery disease

目的观察胸痛及冠心病患者的心理状态及其临床意义。方法横断面研究。采用整群抽样法,对在我院进行冠状动脉造影术(CAG)检查的99例胸痛患者术前使用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表-17项(HAMD-17)进行心理状态评估,观察冠心病和非典型胸痛患者CAG 术前焦虑抑郁等情绪改变;同时,结合 CAG 结果,比较 CAG 阳性与阴性患者在一般情况和心血管危险因素方面的差异。结果 99例患者中术前有焦虑症状者44例,占44.4%;有抑郁症状者18例,占18.2%;既有焦虑又有抑郁者16例,占16.2%。CAG 检查阳性者46例,阴性者53例,CAG 阴性率53.5%。CAG 阴性组焦虑症状较 CAG 阳性组更明显(HAMA 平均分:14.1±7.2比11.1±6.7,P<0.05)。CAG 阴性组具有女性多,传统心血管病危险因素少,焦虑水平高等特点。结论冠心病和非典型胸痛的患者均具有较高的焦虑、抑郁症状发生率。

Objective To compare the prior coronary angiography （CAG） psychological status in chest pain patients with and without coronary artery disease （CAD）. Methods Ninety-nine patients with chest pain and scheduled for CAG were selected by cluster sampling method. The mental status was measured by Hamilton Anxiety Rating Scale （HAMA） and Hamilton Depression Rating Scale-17（ HAMD- 17） 24 hours before CAG, and the risk factors for CAD were also determined. Results There were 43 patients with HAMA score 〉114, 18 patients with HAMD-17 score1〉14 and 16 patients with beth scores ≥14. CAD was diagnosed in 46 patients by CAG. HAMA score was significantly higher in patients without CAD than patients with CAD （ 14. 1 ± 7. 1 vs. 11.1 ±6. 7, P 〈 0. 05 ）. Conclusions Incidences of anxiety and depression were high in chest pain patients prior CAG and incidence of anxiety prior CAG was significantly higher in chest pain patients without CAD compared to chest pain patients with CAD.