摘要
目的:在因急性冠状动脉综合征(ACS)住院3个月时,应用创伤后应激自评量表来评估创伤后应激症(PTSD)的发生率和预测因素。设计:2个阶段的前瞻性研究。机构:4个冠心病监护病房。患者:135例经ECG和心肌酶学变化而证实为ACS的住院患者。
Objectives: To assess frequency and predictors of post-traumatic stress disorder (PTSD), measured by the Post Traumatic Stress-self report version, at three months after admission for acute coronary syndromes (ACS). Design: Two-phase prospective study. Setting: Four coronary care units. Patients: 135 patients admitted to hospital with ACS confirmed by ECG and cardiac enzyme changes. Results: 20 patients (14.8%) showed a symptom pattern characteristic of PTSD at three months assessed by a conservative scoring criterion. Severity of chest pain and psychological factors during admission were predictive of PTSD severity. Acute stress symptoms, depression, negative affect, hostility, and pain scores were independent predictors of three-month PTSD symptoms (R=0.495, p< 0.001). In contrast, demographic factors (age, sex, education level and income) were unrelated to post-traumatic symptoms, as were markers of clinical disease severity. Conclusions: Patient vulnerability to PTSD three months after ACS is predictable on the basis of psychological state and chest pain at the time of admission. This may be valuable to the clinician, as PTSD after myocardial infarction is associated with poorer quality of life, reduced adherence to drug treatment and increased likelihood of cardiovascular morbidity.
