Sumanen Markku P T, Suominen Sakari B, Koskenvuo Markku J, Sillanmäki Lauri H, Mattila Kari J
Kangasala Health Centre, Finland.
Health Qual Life Outcomes. 2004 Nov 8;2:60. doi: 10.1186/1477-7525-2-60.
The typical symptoms of coronary heart disease (CHD), chest pain and breathlessness, are well-known. They are considered quite dramatic, and can thus be fairly reliably mapped by a survey. However, people might have other clearly unpleasant symptoms impairing quality of life. The aim of this study is to evaluate the appearance of these complaints of working-aged people with self-reported CHD.
The study consists of a postal questionnaire of randomly selected Finns in age groups 30-34, 40-44 and 50-54, a response rate of 39% (N = 15,477). The subjects were asked whether or not a doctor had told them that they had angina pectoris or had had myocardial infarction. Four randomly selected age and sex matched controls were chosen for every patient. The occurrence of self-reported dyspnoea, chest pain during anger or other kind of emotion, palpitation and perspiration without physical exercise, irregular heartbeats, flushing, trembling of hands and voice, jerking of muscles, depression and day-time sleepiness were examined. Odds ratios (OR) with 95% confidence intervals (CI), between occurrence of symptoms and CHD with and without heart infarction, were computed by multivariate logistic regression analysis.
The sample eventually comprised 319 CHD patients. Dyspnoea, chest pain during anger or other kind of emotion, palpitation, perspiration without physical exercise, irregular heartbeats daily or almost daily, trembling of hands and voice, and jerking of muscles occurred statistically significantly more frequently among CHD patients than among controls. The CHD patients also reported more depressive mood according to Beck's inventory scores and poorer sleep and more frequent day-time sleepiness than controls. In the multivariate logistic regression analysis chest pain during anger or other kind of emotion (ORs 4.12 and 3.61) and dyspnoea (ORs 2.33 and 3.81) were the symptoms most associated with CHD.
Working-aged people with self-reported coronary heart disease evince a number of symptoms limiting the quality of their every day life. This aspect should be paid attention to when evaluating functional capacity of these patients.
冠心病（CHD）的典型症状，如胸痛和呼吸急促，广为人知。它们被认为较为严重，因此通过调查能够相当可靠地确定。然而，人们可能还有其他明显影响生活质量的不适症状。本研究旨在评估自述患有冠心病的劳动年龄人群这些症状的出现情况。
该研究包括对年龄在30 - 34岁、40 - 44岁和50 - 54岁的芬兰人进行随机抽样的邮政问卷调查，回复率为39%（N = 15477）。受试者被问及医生是否告知他们患有心绞痛或心肌梗死。为每位患者随机选择4名年龄和性别匹配的对照。检查了自述的呼吸困难、愤怒或其他情绪时的胸痛、心悸、无体育锻炼时出汗、心跳不规则、脸红、手抖和声音颤抖、肌肉抽搐、抑郁和日间嗜睡的发生情况。通过多因素逻辑回归分析计算症状出现与有或无心肌梗死的冠心病之间的比值比（OR）及95%置信区间（CI）。
最终样本包括319例冠心病患者。冠心病患者中，呼吸困难、愤怒或其他情绪时的胸痛、心悸、无体育锻炼时出汗、每日或几乎每日心跳不规则、手抖和声音颤抖以及肌肉抽搐的发生频率在统计学上显著高于对照组。根据贝克量表评分，冠心病患者还报告有更抑郁的情绪，睡眠质量比对照组更差，日间嗜睡更频繁。在多因素逻辑回归分析中，愤怒或其他情绪时的胸痛（OR分别为4.12和3.61）和呼吸困难（OR分别为2.33和3.81）是与冠心病最相关的症状。
自述患有冠心病的劳动年龄人群表现出一些限制其日常生活质量的症状。在评估这些患者的功能能力时应注意这一方面。
