Kurosawa H, Shimizu Y, Nishimatsu Y, Hirose S, Takano T
Jpn Circ J. 1983 Jun;47(6):723-8. doi: 10.1253/jcj.47.723.
We studied the relationship between the mental disorders and the mental severities of 163 patients with acute myocardial infarction (AMI), who were admitted to the CCU (Coronary Care Unit) of Nippon Medical School Hospital during the past 2 years. Their mental disorders were diagnosed by psychiatrists, and the relationship between their physical severities according to Killip's classification and their mental severities was investigated. Based on these studies, the authors described the way to manage AMI patients in a CCU, especially from a psychiatric point of view. 1) About 64% of all the patients showed some mental disorders, and many of them were in a state of anxiety or depression. In most of the cases their mental severities were considered to be mild or moderate. 2) We found some correlation between physical severities according to Killip's classification and mental severities (r = 0.3061, p less than 0.005). Many patients with grade I of Killip's classification showed a normal or mild severity, and many with grade II had a mild or moderate severity. About one half of the patients with grades III and IV showed moderate and severe severities, respectively. 3) About 26% of the subjects were in need of psychotropic medication. 4) About 10% of the subjects showed disorientation or cloudy consciousness. The mental severity of patients with an acute lidocaine intoxication was severe. These results showed that there was a significant correlation between physical severity according to Killip's classification and mental severity of AMI patients in the CCU. Patients whose physical severity was not so great showed comparatively mild mental disorders. As Killip's grade of physical severity progressed, mental disorder became more severe.
我们研究了163例急性心肌梗死（AMI）患者的精神障碍与精神严重程度之间的关系，这些患者在过去两年中被收入日本医科大学医院冠心病监护病房（CCU）。精神科医生对他们的精神障碍进行了诊断，并调查了根据Killip分级法确定的身体严重程度与精神严重程度之间的关系。基于这些研究，作者描述了在CCU中管理AMI患者的方法，特别是从精神病学角度。1）所有患者中约64%表现出某种精神障碍，其中许多处于焦虑或抑郁状态。在大多数情况下，他们的精神严重程度被认为是轻度或中度。2）我们发现根据Killip分级法确定的身体严重程度与精神严重程度之间存在一定相关性（r = 0.3061，p小于0.005）。许多Killip分级为I级的患者表现为正常或轻度严重程度，许多II级患者为轻度或中度严重程度。III级和IV级患者中约一半分别表现为中度和重度严重程度。3）约26%的受试者需要使用精神药物。4）约10%的受试者出现定向障碍或意识模糊。急性利多卡因中毒患者的精神严重程度较重。这些结果表明，CCU中AMI患者根据Killip分级法确定的身体严重程度与精神严重程度之间存在显著相关性。身体严重程度不太严重的患者表现出相对较轻的精神障碍。随着Killip身体严重程度分级的进展，精神障碍变得更加严重。
