精神社会调节器的胸痛对心肌缺血的反应
Suzanne V Arnold1, John A Spertus, Paul S Ciechanowski
1Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.
Circulation
|July 1, 2009
概括
患有类似诱导性缺血症的患者,如果他们有冠状动脉再血管化,焦虑或抑郁症的病史,则会更频繁地经历心痛. 与缺血同时解决心理社会困扰是有效治疗 angina 的关键.
科学领域:
- 心脏病学 心脏病学
- 精神病体医学是一种精神病体医学.
背景情况:
- 在患有类似冠状动脉疾病严重程度的患者中,心脏病的症状差异很大.
- 心肌缺血可能是由动脉样硬化阻塞引起的.
- 了解影响胸痛症状变化的因素至关重要.
研究的目的:
- 为了比较与频繁心痛相关的临床和心理社会特征.
- 在评估心痛频率时,为了调整可诱导性缺血的数量.
主要方法:
- 单光子发射计算断层扫描 (SPECT) 压力输液成像用于评估缺血.
- 西雅图心痛问卷 (SAQ) 用于量化心痛的频率.
- 多变量顺序逻辑回归分析了胸痛和患者特征之间的关联.
主要成果:
- 在191名患有可诱导性缺血症的患者中,频繁的胸痛与先前的冠状动脉再血管化,焦虑和抑郁有关.
- 焦虑显示出与心痛频率增加的显著关联 (OR 4.72).
- 抑郁症 (OR 3.12) 和重血管化史 (OR 2.24) 也与此有显著的关联.
结论:
- 冠状动脉再血管化病史,焦虑和抑郁症状与患有类似缺血负担的患者中更频繁的胸痛有关.
- 胸痛治疗策略应考虑减少心理社会痛苦.
- 支持综合治疗方法,解决缺血和心理社会因素.
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