心理干预疗法对冠心病患者血管内皮舒张功能的影响

Effect of mental intervention on endothelial function of patients with coronary heart disease

目的观察心理干预对冠心病患者血管内皮功能的影响。方法将430例冠心病患者随机分为观察组235例和对照组195例,两组患者均给予常规调节血脂、抑制血小板聚集等治疗,治疗组在常规治疗的同时实施支持性心理干预,观察治疗前后两组患者的血管内皮功能变化情况。采用肱动脉超声检查动脉功能进行评价。结果观察组肱动脉管径、血流速度、血流量和扩张性增加,血流阻力和肱动脉内膜-中膜厚度降低;与对照组比较血管内皮功能指标改善更明显,差异有统计学意义(P<0.05)。在反应性充血状态下,观察组肱动脉管径、血流速度、血流量增加,血流阻力降低;而对照组血流速度、血流量、血流阻力、肱动脉管径等指标与治疗前比较差异无统计学意义(P>0.05)。结论心理干预可以明显改善冠心病患者的血管内皮功能,有助于冠心病的治疗。

Objective To investigate effect of mental intervention on endothelial function of patients with coronary heart disease （CHD）. Methods 430 patients with CHD confirmed by coronary arteriography were randomly divided into the following two groups including 235 in the observed group and 195 in the control group. Routine treatments such as regulateing blood-fat,restraining platelet aggregation and so on were adopted in the both groups. Meanwhile,mental intervention was performed in the treated group. Then, the changes of endothelial function were observed before and after the therapy. Ultrasonic inspection was employed to evaluate the function of brachial artery. Results Brachial artery diastolic diameter,mean flow velocity,blood flow volume and distensibility were increased,and resistance of blood flow and IMT were decreased in the treated group. The endothelial function indexes were improved significantly in the treated group compared with the control （P〈0.05）. Under condition of reactive hyperemia （RH）, brachial artery diameter, flow velocity, blood flow volume increased in artery reactive hyperaemia test and resistance of blood flow decreased. However,there was no difference in blood flow rate （BFR）,blood flow （BF）, resistance of blood flow and arterial eanai diameter in the treated group between before and after treatment （P〉0.05）. Conclusion Mental intervention can significantly improve endothelial function of patients with CHD,which is helpful for the treatment of CHD.