Friedman M, Breall W S, Goodwin M L, Sparagon B J, Ghandour G, Fleischmann N
Meyer Friedman Institute, UCSF-Mount Zion Medical Center, San Francisco, Calif. 94143-1680, USA.
Am Heart J. 1996 Nov;132(5):933-7. doi: 10.1016/s0002-8703(96)90001-0.
Thirteen of 32 patients with coronary heart disease who also exhibited symptoms and signs of severe time urgency and hostility (the two overt components of type A behavior [TAB]) were found to exhibit multiple episodes of silent myocardial ischemia over a 48-hour period of Holter monitoring as indicated by electrocardiogram ST depressions. Ten of these 13 patients were given 14 months of TAB counseling in an attempt to diminish the intensity of their time urgency and hostility. The remaining three patients served as controls. After counseling, the intensity of the time urgency and hostility of the 10 counseled patients diminished 53% and 59%, respectively, as measured by the videotaped clinical examination. The time urgency and hostility of the three uncounseled control patients did not significantly change. The mean frequency of ischemic episodes in the 10 patients who received TAB counseling significantly declined from an initial 6.6 to 3.1 ischemic episodes per 24 hours. However, the mean frequency of ischemic episodes did not significantly decline in 2 of the 3 uncounseled patients. The third uncounseled patient developed a conduction defect in the 14-month interlude, making an analysis of his repeat 48-hour electrocardiogram for episodes of ST depression impossible.
32例冠心病患者中，有13例同时表现出严重的时间紧迫感和敌意症状及体征（A型行为[ TAB ]的两个明显组成部分），在动态心电图监测的48小时内，经心电图ST段压低显示，这些患者出现多次无症状性心肌缺血发作。这13例患者中有10例接受了14个月的A型行为咨询，试图减轻他们时间紧迫感和敌意的强度。其余3例患者作为对照。咨询后，通过录像临床检查测量，10例接受咨询患者的时间紧迫感和敌意强度分别降低了53%和59%。3例未接受咨询的对照患者的时间紧迫感和敌意没有明显变化。10例接受A型行为咨询患者的缺血发作平均频率从最初的每24小时6.6次显著下降至3.1次。然而，3例未接受咨询的患者中有2例缺血发作的平均频率没有显著下降。第3例未接受咨询的患者在14个月的间隔期出现了传导缺陷，因此无法对其重复进行的48小时心电图进行ST段压低发作分析。
