Titscher G, Huber C, Ambros O, Gruska M, Gaul G
Psychosomatischen Beratungsstelle der II. Med. Abteilung, Hanusch-Krankenhauses Wien.
Z Psychosom Med Psychoanal. 1996;42(2):154-68.
Coronary Angioplasty (PTCA) has become one of the standard procedures in the therapy of coronary heart disease. One of the main issues is the 20-40% incidence of restenosis of the dilated vessel. Up to now, the subject of predictors of restenosis has not yet been sufficiently clarified. Our study is concerned with two questions; first, is it possible to prove any connections between the amount of restenosis and psychosocial factors? Second, is it possible to distinguish groups of patients with and without subsequent restenosis on the basis of psychosocial variables, even before the diagnostic coronary angiography? 138 (91m, 47f) patients were assessed before the diagnostic coronarangiography, the 25 PTCA-patients (20m, 5f) were furthermore reassessed three months after the PTCA (the time of the angiographic control). Somatic and social data were collected and a semistandardised interview was conducted. In addition, coping, stress-coping control over disease and health and life-contentment were determined. Highly significant correlations was found between the amount of restenosis and resignative stress-coping, self-pity, depressive coping and flight-tendency. With the help of stress-coping-subtests (which were given at the first examination) it was possible to separate the group of patients with restenosis from the group without it.
冠状动脉血管成形术（PTCA）已成为冠心病治疗的标准程序之一。主要问题之一是扩张血管再狭窄的发生率为20%至40%。到目前为止，再狭窄预测因素的问题尚未得到充分阐明。我们的研究关注两个问题：第一，能否证明再狭窄程度与心理社会因素之间存在任何关联？第二，即使在诊断性冠状动脉造影之前，是否有可能根据心理社会变量区分有或没有后续再狭窄的患者群体？在诊断性冠状动脉造影之前对138名患者（91名男性，47名女性）进行了评估，另外对25名接受PTCA的患者（20名男性，5名女性）在PTCA后三个月（血管造影对照时间）进行了重新评估。收集了身体和社会数据并进行了半标准化访谈。此外，还确定了应对方式、对疾病和健康的应激应对控制以及生活满意度。发现再狭窄程度与顺从性应激应对、自怜、抑郁应对和逃避倾向之间存在高度显著的相关性。借助应激应对子测试（在首次检查时进行），可以将有再狭窄的患者组与无再狭窄的患者组区分开来。
