Lantinga L J, Sprafkin R P, McCroskery J H, Baker M T, Warner R A, Hill N E
Veterans Administration Medical Center, Syracuse, New York 13210.
Am J Cardiol. 1988 Aug 1;62(4):209-13. doi: 10.1016/0002-9149(88)90213-5.
As many as 30% of patients with chest pain symptoms who are referred for arteriography are found to have normal coronary arteries. Research has shown that patients with anginal symptoms and normal coronary arteries score higher on neuroticism measurements (anxiety, depression and somatic concerns) at the time of catheterization than patients with anginal symptoms who have coronary artery disease. Research examining the cardiac course of chest pain patients with normal coronary arteries indicates that this is a nonprogressive disorder. Although follow-up studies of these patients report continued chest pain and diminished physical activity, these studies have ignored the psychologic status of the patients. Thus, it is not known whether their higher neuroticism scores at the time of catheterization persist following angiography or whether such elevated indexes of neuroticism are transient phenomena associated with precatheterization anticipatory stress. The present study examined 48 Veterans Administration Medical Center patients: 24 with anginal symptoms and normal coronary arteries and 24 with documented coronary artery disease. The patients completed a structured clinical interview and a set of psychologic inventories on the day before catheterization and 1 year later. The findings established continued high neuroticism scores among patients with anginal symptoms only and supported the findings of other investigators regarding continuing chest pain and restricted physical activity. The knowledge alone of benign coronary artery status resulted in virtually no change in the psychosocial status of these patients. Alternative treatment methods are discussed.
在因胸痛症状而接受血管造影检查的患者中，多达30%被发现冠状动脉正常。研究表明，有心绞痛症状且冠状动脉正常的患者在导管插入术时的神经质测量（焦虑、抑郁和躯体担忧）得分高于患有冠状动脉疾病且有心绞痛症状的患者。对冠状动脉正常的胸痛患者的心脏病程进行的研究表明，这是一种非进行性疾病。尽管对这些患者的随访研究报告了持续的胸痛和体力活动减少，但这些研究忽略了患者的心理状态。因此，尚不清楚他们在导管插入术时较高的神经质得分在血管造影后是否持续存在，或者这种升高的神经质指标是否是与导管插入术前预期压力相关的短暂现象。本研究对48名退伍军人管理局医疗中心的患者进行了检查：24名有心绞痛症状且冠状动脉正常，24名有记录的冠状动脉疾病。患者在导管插入术前一天和一年后完成了一次结构化临床访谈和一系列心理量表。研究结果表明，仅有心绞痛症状的患者神经质得分持续较高，并支持了其他研究者关于持续胸痛和体力活动受限的研究结果。仅了解冠状动脉状况良好这一事实，实际上并没有改变这些患者的心理社会状态。文中还讨论了替代治疗方法。
