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接受冠状动脉成形术患者心理社会和医学预后的心理预测因素。

Psychologic predictors of psychosocial and medical outcomes in patients undergoing coronary angioplasty.

作者信息

Shaw R E, Cohen F, Fishman-Rosen J, Murphy M C, Stertzer S H, Clark D A, Myler R K

出版信息

Psychosom Med. 1986 Nov-Dec;48(8):582-97. doi: 10.1097/00006842-198611000-00005.

Abstract

The relationship between psychologic variables (the match between repressive style and level of cardiac information, and anxiety level) and medical complications, re-stenosis (renarrowing), and psychosocial adjustment was studied in 97 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for treatment of narrowed coronary arteries. Three major findings emerged for outcomes measured 6 months after PTCA: repressors with a high level of cardiac information (coping style-information level mismatch) and no history of heart attack were at higher risk for late medical complications (p less than 0.001); sensitizers with a low level of cardiac information (coping style-information level mismatch) and whose PTCA was only moderately successful were at higher risk for re-stenosis of the artery previously widened during PTCA (p less than 0.01); and patients who were more anxious during hospitalization had poorer social functioning and more mood disturbance 6 months after PTCA (p less than 0.05). Thus, psychologic, information, and medical factors are important in predicting 6-month outcomes in patients undergoing PTCA.

摘要

对97例因冠状动脉狭窄而接受经皮腔内冠状动脉成形术(PTCA)治疗的患者,研究了心理变量(压抑型应对方式与心脏信息水平的匹配情况以及焦虑水平)与医疗并发症、再狭窄(血管再度变窄)和心理社会适应之间的关系。在PTCA术后6个月进行的结果测量中出现了三项主要发现:具有高水平心脏信息的压抑者(应对方式与信息水平不匹配)且无心脏病发作史的患者发生晚期医疗并发症的风险更高(p<0.001);具有低水平心脏信息的敏感者(应对方式与信息水平不匹配)且PTCA仅取得中度成功的患者,其在PTCA期间曾扩张的动脉发生再狭窄的风险更高(p<0.01);住院期间焦虑程度较高的患者在PTCA术后6个月的社会功能较差且情绪障碍更多(p<0.05)。因此,心理、信息和医疗因素对于预测接受PTCA治疗患者的6个月预后很重要。

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