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对从事铁路和公路交通安全工作的高血压患者进行降压治疗效果评估的心理学调查。

Psychologic investigation in the estimation of the effects of hypotensive therapy in hypertensive patients working in the railway and highway traffic security.

作者信息

Guţiu I, Nişanian A, Popescu E, Nistorescu D, Munteanu R, Pompilian V

出版信息

Med Interne. 1985 Apr-Jun;23(2):109-13.

PMID:4023583
Abstract

Sixty four hypertensive patients working in railway and highway traffic security (engine operators, drivers, switchmen, etc.) were studied clinically and paraclinically and were also submitted to psychologic tests since the characteristics of their work requires a normal psychophysical state. The patients investigated, mostly males (93%), mean age 45.2 years, had essential arterial hypertension (AH) stages I (36 patients) and II (28 patients). After 3-4 days of low salt diet, therapy with propranolol (8 to 360 mg/day) and diuretics was started in most of the patients. In 8 patients with AH stage II, hydralazine (50-100 mg/days) was added to the treatment. The psychologic tests used were: the pencil-paper test "Labyrinth", "Barrage" and "A.D. Praga" and a motor test "Piorkowsky" used 2 times, i.e., before and after treatment. After 15 days of treatment the blood pressure values decreased: systolic from a mean value of 155 +/- 25 mmHg to 136 +/- 81 mmHg; diastolic from 102 + 18 mmHg to 84 +/- 11 mmHg. The marks for the psychologic test were: very poor, poor, medium, good, very good. The post-therapeutic changes obtained were noted in percentages. Improvements obtained: for the "Praga" test in 54% of the patients, for the "Barrage" in 44% of the patients and for the "Labyrinth" in 66% of the patients. Improvements for the first "Piorkowsky" test (slow rate stimuli) were obtained in 54% of the patients and for the second (faster rate stimuli) in 69%. No decrease of psychologic performance was observed in any of the patients. Therefore the psychologic tests used may contribute to the follow-up of the effectiveness and of the side effects of modern hypotensive therapy especially in patients working in traffic security in whom the psychophysical state should be at its best.

摘要

对64名铁路和公路交通安全领域的高血压患者(发动机操作员、司机、扳道工等)进行了临床和辅助临床研究,并对他们进行了心理测试,因为他们的工作特性要求具备正常的心理生理状态。被调查的患者大多为男性(93%),平均年龄45.2岁,患有原发性动脉高血压(AH)I期(36例患者)和II期(28例患者)。在进行3 - 4天的低盐饮食后,大多数患者开始使用普萘洛尔(8至360毫克/天)和利尿剂进行治疗。在8例AH II期患者中,治疗中添加了肼屈嗪(50 - 100毫克/天)。所使用的心理测试包括:纸笔测试“迷宫”“屏障”和“A.D.普拉加”,以及运动测试“皮尔科夫斯基”,在治疗前后各进行2次。治疗15天后,血压值下降:收缩压从平均值155±25毫米汞柱降至136±81毫米汞柱;舒张压从102 + 18毫米汞柱降至84±11毫米汞柱。心理测试的评分等级为:非常差、差、中等、好、非常好。治疗后获得的变化以百分比记录。改善情况如下:“普拉加”测试中54%的患者有改善,“屏障”测试中44%的患者有改善,“迷宫”测试中66%的患者有改善。第一次“皮尔科夫斯基”测试(慢速率刺激)中54%的患者有改善,第二次(快速率刺激)中69%的患者有改善。未观察到任何患者的心理表现下降。因此,所使用的心理测试可能有助于对现代降压治疗的有效性和副作用进行随访,特别是对于从事交通安全工作的患者,他们的心理生理状态应处于最佳水平。

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