Kop W J, Appels A P, Mendes de Leon C F, de Swart H, Bär F W
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799.
Int J Cardiol. 1993 Dec 31;42(3):269-76. doi: 10.1016/0167-5273(93)90059-p.
Excess fatigue and exhaustion are among the most prevalent premonitory complaints of myocardial infarction and sudden cardiac death. These feelings may reflect subclinical heart disease, prolonged psychological tension, or both. The present study investigates to what extent coronary artery disease explains exhaustion. For this purpose, the relationship between the severity of coronary artery disease and exhaustion, and the relief of exhaustion after successful percutaneous transluminal coronary angioplasty (PTCA) is investigated. Patients who had a successful elective PTCA (N = 120) were evaluated on feelings of exhaustion on admission, 2 weeks after discharge and 6 months after discharge, making use of the Maastricht Questionnaire. Multiple regression analyses were used to investigate to what degree exhaustion on admission and after PTCA was determined by the extent of coronary artery disease and other patient characteristics. Severity of coronary artery disease before PTCA was positively associated with exhaustion and successful PTCA resulted in a significant decrease of exhaustion scores (P < 0.001). However, less than 5% of the variance of the exhaustion scores before PTCA could be explained by severity of coronary artery disease (R2 = 0.04, F = 5.1, P = 0.03). The majority of patients who were exhausted before PTCA remained exhausted after PTCA. Exhaustion was present in 75% of the patients before PTCA and in 65% 2 weeks after PTCA, which indicates that restoration of coronary perfusion by successful PTCA does not substantially reduce the number of exhausted patients. At 6 months, exhaustion was present in 60% of the patients, and there was no difference between patients with and without typical anginal complaints at that time.(ABSTRACT TRUNCATED AT 250 WORDS)
过度疲劳和精疲力竭是心肌梗死和心源性猝死最常见的先兆症状。这些感觉可能反映了亚临床心脏病、长期心理紧张，或两者皆有。本研究调查冠状动脉疾病在多大程度上导致了精疲力竭。为此，研究了冠状动脉疾病的严重程度与精疲力竭之间的关系，以及成功进行经皮腔内冠状动脉成形术（PTCA）后精疲力竭症状的缓解情况。对120例成功接受择期PTCA的患者，利用马斯特里赫特问卷评估其入院时、出院后2周和出院后6个月的精疲力竭感受。采用多元回归分析来研究入院时和PTCA后精疲力竭程度在多大程度上由冠状动脉疾病的严重程度和其他患者特征所决定。PTCA前冠状动脉疾病的严重程度与精疲力竭呈正相关，成功的PTCA导致精疲力竭评分显著降低（P<0.001）。然而，PTCA前精疲力竭评分的变异中，只有不到5%可由冠状动脉疾病的严重程度来解释（R2 = 0.04，F = 5.1，P = 0.03）。大多数PTCA前精疲力竭的患者在PTCA后仍感精疲力竭。PTCA前75%的患者存在精疲力竭，PTCA后2周这一比例为65%，这表明成功的PTCA恢复冠状动脉灌注并不能大幅减少精疲力竭患者的数量。6个月时，60%的患者存在精疲力竭，此时有典型心绞痛症状和无典型心绞痛症状的患者之间没有差异。（摘要截选至250字）
