心肌梗塞患者心理卫生状况测评及心理干预

Evaluation of psychological health status and interventions in patients with myocardial in farction

目的:探讨心肌梗塞(Myocardial infarction,MI)患者的心理卫生状况及进行心理干预的临床意义。方法:87例患者随机分成对照组43例,干预组44例;对照组用常规内科治疗药物治疗,干预组内科药物治疗+心理干预+小剂量抗抑郁药百忧解;两组均进行症状自评量表,汉密尔顿抑郁量表测评及行为测评;3月后均随访心功能分级、射血分数及心血管事件发生率。结果:MI患者心理障碍发生率较高,达82.75%,以抑郁为主要表现;A型行为占62.07%,干预组心理障碍、心功能、射血分数较对照组明显改善,心血管事件发生率明显低于对照组。结论:MI患者普遍存在心理障碍,以抑郁为主要表现,在内科药物治疗同时进行心理干预,能有效缓解病情改善预后。

Objective：To investigate the psychological health status and the intervention in patients with myocardial infarction. Methods： 87 Patients with myocardial infarction were randomly divided into control group （n = 43） and psychological intervention group （n = 44）. Both groups were assessed with Symptom checkist-90, Hamilton depression and behavior pattern test. The control group was treated with routine therapy. The psychological intervention group was treated with routine therapy, psychological intervention, and low dose fluoxetine hydrochloride. After three months of follow-up, New York Heart Association （NYHA） class, ejection fraction and the occurrence of adverse cardiac events were assessed. Results：The patients with myocardial infarction had high prevalence of psychological disorder （82.75%）, depression was the major symptoms （type-A behavior 62.07% ）. Compared with the control group, psychological disorder, NYHA class, and ejection fraction were significantly improved in the intervention group. Moreover, the occurrence of cardiac events was much lower than the control group. Conclusion：The patients with myocardial infarction had high prevalence of psychological disorder and the major symptoms were depression. The combination of routine therapy and psychological intervention may be effective at alleviation the symptoms and improvement the prognosis.