Freedland K E, Carney R M, Krone R J, Smith L J, Rich M W, Eisenkramer G, Fischer K C
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63178.
Psychosom Med. 1991 Jan-Feb;53(1):13-24. doi: 10.1097/00006842-199101000-00002.
To determine whether psychological factors differentiate patients with silent versus symptomatic myocardial ischemia, a battery of psychometric tests was administered to 68 patients with positive thallium stress tests. Compared with patients who became symptomatic (n = 25), patients with silent ischemia on the treadmill (n = 24) were less often aware of cardiac and other bodily sensations (p less than 0.005) and were less avoidant of harm or pain in general (p less than 0.05). They did not differ on variables associated with symptom reporting biases. To clarify the relationship between ischemia and symptom reporting, symptomatic patients were subgrouped on the basis of anginal pain latency. Psychologically, the patients with silent ischemia were most similar to patients with the longest pain latencies and most different from those who reported angina before the onset of ST depression. The psychological profile of patients with silent ischemia during exercise testing is consistent with a reduced sensitivity to pain and other bodily sensations.
为了确定心理因素是否能区分无症状与有症状心肌缺血患者，对68例铊负荷试验阳性的患者进行了一系列心理测试。与出现症状的患者（n = 25）相比，跑步机试验显示无症状缺血的患者（n = 24）较少意识到心脏和其他身体感觉（p < 0.005），并且总体上对伤害或疼痛的回避较少（p < 0.05）。他们在与症状报告偏差相关的变量上没有差异。为了阐明缺血与症状报告之间的关系，有症状的患者根据心绞痛疼痛潜伏期进行了亚组划分。在心理方面，无症状缺血患者与疼痛潜伏期最长的患者最为相似，与那些在ST段压低发作前就报告心绞痛的患者差异最大。运动试验期间无症状缺血患者的心理特征与对疼痛和其他身体感觉的敏感性降低一致。
