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急性冠状动脉综合征患者乏力(缺乏能量)的患病率和特征。

Prevalence and characteristics of anergia (lack of energy) in patients with acute coronary syndrome.

机构信息

Center for Cardiovascular Behavioral Health, Columbia University, New York, New York, USA.

出版信息

Am J Cardiol. 2012 Nov 1;110(9):1213-8. doi: 10.1016/j.amjcard.2012.06.022. Epub 2012 Jul 25.

Abstract

Anergia, a commonly occurring syndrome in older adults and patients with cardiovascular diseases, is associated with functional and clinical limitations. To date, the prevalence and clinical-demographic characteristics of anergia in patients with acute coronary syndrome (ACS) have not been elucidated. We examined the prevalence and clinical-demographic characteristics of anergia in a multiethnic sample of patients with ACS. Hospitalized patients with ACS (n = 472), enrolled in the Prescription Usage, Lifestyle, and Stress Evaluation (PULSE) prospective cohort study, completed assessments of demographic, behavioral, and clinical characteristics within 7 days of hospitalization for an ACS event. Current depressive disorder was ascertained using a structured psychiatric interview 3 to 7 days after discharge. Anergia was assessed at baseline and defined using patients' binary responses (yes/no) to 7 items related to energy level. At least 1 complaint of anergia was reported by 79.9% of patients (n = 377) and 32% of patients (n = 153) met criteria for anergia. In a multivariable logistic regression model, anergia was independently associated with being a woman, being white (compared to black), having bodily pain, participating in exercise, having current depressive disorder, and having higher values on the Charlson Co-morbidity Index. In conclusion, anergia is a highly prevalent syndrome in patients with ACS. It is distinct from depression and is associated with modifiable clinical factors such as participation in exercise and bodily pain that may be appropriate targets for intervention.

摘要

乏力是老年人和心血管疾病患者中常见的综合征,与功能和临床限制有关。迄今为止,急性冠状动脉综合征 (ACS) 患者乏力的患病率和临床人口统计学特征尚未阐明。我们研究了 ACS 多民族患者样本中乏力的患病率和临床人口统计学特征。患有 ACS 的住院患者(n = 472)参加了处方使用、生活方式和压力评估(PULSE)前瞻性队列研究,在 ACS 事件住院后 7 天内完成了人口统计学、行为和临床特征的评估。出院后 3 至 7 天使用结构化精神病学访谈确定当前抑郁障碍。乏力在基线时进行评估,并使用患者对与能量水平相关的 7 个项目的二项式回答(是/否)来定义。79.9%的患者(n = 377)报告至少有 1 项乏力投诉,32%的患者(n = 153)符合乏力标准。在多变量逻辑回归模型中,乏力与女性、白人(与黑人相比)、身体疼痛、参加运动、当前抑郁障碍和 Charlson 合并症指数值较高独立相关。总之,乏力是 ACS 患者中一种高发综合征。它与抑郁不同,与可改变的临床因素有关,如参加运动和身体疼痛,这些因素可能是干预的适当目标。

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