双心医学疗法在急性冠状动脉综合征治疗中的应用

Application of psycho-cardiology in treatment of acute coronary syndrome

目的探讨双心医学在急性冠状动脉综合征（ACS）治疗中的应用价值。方法选取2013年1月至2014年2月于浙江省台州市立医院就诊的64例ACS患者，依据随机数字表法将其分为对照组和观察组，每组32例。对照组患者采用常规治疗方法，观察组患者在对照组的基础上采用双心医学疗法治疗。治疗后，对2组患者的抑郁焦虑评分、血脂、心功能及心律失常发生率的变化进行对比分析。结果治疗后，观察组的抑郁焦虑评分为（0．92±0．14）分，明显低于对照组的（1．52±0．26）分（P〈0．05）。治疗后观察组的总胆固醇[（4．0±0．8）mmol／L]、高密度脂蛋白胆固醇[（0．83±0．16）mmol／L]、低密度脂蛋白胆固醇[（2．3±0．4）mmol／L]明显低于对照组[（4．5±0．6）、（1．03±0．25）、（2．7±0．4）mmol／L]。心功能指标的改善程度方面，观察组治疗后的脑钠肽前体、左心室射血分数、心律失常发生率均明显优于对照组[（397±113）ng／L比（453±127）ng／L、（66±6）％比（56±6）％、34．4％（11／32）比65．6％（21／32）]。结论在ACS治疗中，应用双心医学疗法比常规治疗方法在改善患者血脂、心功能指标及心律失常发生率方面具有更好的效果。

Objective To analyze the clinical benefits of psycho-cardiology in diagnosis and treatment of acute coronary syndrome. Methods Totally 64 patients with acute coronary syndrome from January 2013 to Feb- ruary 2014 were enrolled and randomly divided into control group （32 cases） and observation group （32 cases）. In control group, patients had conventional treatment; in observation group, patients had psycho-cardiological treatment on the basis of conventional treatment. After the treatment, the changes of depression and anxiety score, level of blood lipid, cardiac function and arrhythmia incidence were assessed and compared between two groups. Results The depression and anxiety score in observation group （0.92 ±0.14） was significantly lower than that in control group （ 1.52 ±0.26） （ P 〈 0.05 ）. The total cholesterol, high density lipoprotein, low density lipoprotein in observation group [ （4.0 ±0. 8 ） , （0.83 ± 0.16 ） , （ 2.3 ± O. 4 ） mmol/L ] were all significantly lower than those in control group [ （4.5 ± 0.6）, （ 1.03 ± 0.25 ）, （2.7 ± 0.4） mmol/L, P 〈 0.05 ]. Improvement of heart function, brain natriuretic peptide, left ventricular ejection fraction and the incidence of arrhythmia in observation group [ （397 ± 13）ng/L, （66 ± 6）% ,34.4% （11/32）] were improved more significantly that those in control group [ （453 ± 127 ） ng/L, （ 56 ± 6 ） %, 65.6% （ 21/32 ） ]. Conclusions The effect of psycho-cardiological treatment is better than conventional treatment in treatment of acute coronary syndrome.