冠状动脉慢血流与焦虑抑郁心理性因素的关系研究(1)
【摘要】 目的：研究分析冠状动脉慢血流与焦虑抑郁心理性因素之间的关系。方法：选取笔者所在医院2015年1月-2018年10月行冠脉造影提示冠状动脉慢血流患者(101例)，行躯体化症状自量表(SSS)评分，低分组为对照组34例，高分组又分为观察组34例和治疗组33例。对照组和观察组采用常规治疗，治疗组在常规治疗基础上加用氟哌噻吨美利曲辛片治疗，观察治疗后三组慢血流变化情况和治疗组各因子变化情况。结果：治疗后对照组和观察组LAD慢血流改善与治疗前比较，差异有统计学意义(P<0.05)，而治疗组LAD、LCX及RCA慢血流改善与治疗前比较，差异均有统计学意义(P<0.05)。对照组用药前后慢血流血管改善有效率为25.6%，观察组为25.0%，治疗组为47.9%，三组间比较差异有统计学意义(P<0.05);治疗组S因子、A因子分值治疗前后分别为(24.4±6.6)、(18.3±3.5)分及(10.1±4.5)、(7.0±2.8)分，差异有统计学意义(P<0.05)。Logistic回归分析结果提示S因子(OR=1.196，P=0.014)，A因子(OR=1.051，P=0.048)与冠脉慢血流存在相关性。结论：心理性因素是冠状动脉慢血流的危险因素。
【关键词】 冠状动脉 冠脉造影 慢血流 心理性因素 氟哌噻吨美利曲辛片
[Abstract] Objective： To study and analyze the relationship between coronary slow flow and psychological factors. Method： A total of 101 patients with coronary slow flow by Coronary angiography in our hospital from January 2015 to October 2018 were selected. All patients were divided into three groups by application of SSS (self-rating somatization symptoms scale). The control group was a low-score group(n=34)， while the observation group (n=34) and treatment group(n=33) were both high-score. The control group and observation group were treated with conventional therapy， and the treatment group was treated with Flupentixol and Melitracen Tablets on this basis. The changes of slow blood flow in three groups and the changes of factors in the treatment group were observed before and after treatment. Result： The slow blood flow of LAD in the control group and the observation group were significant improvement after treatment than before treatment (P<0.05)， yet the slow blood flow of LAD， LCX and RCA in the treatment group were significant better after treatment than before treatment (P<0.05). The effective rate of slow blood vessel improvement before and after treatment in the control group was 25.6%， while that in the observation group was 25.0% and the treatment group was 47.9%. There was a significant difference among the three groups (P<0.05). The scores of the factor S and the factor A after treatment were significantly lower than those before treatment (24.4±6.6) and (18.3±3.5) points， (10.1±4.5) and (7.0±2.8) points， there were significant differences (P<0.05). The factor S (OR=1.196， P=0.014) and the factor A (OR=1.051， P=0.048) were correlated with slow coronary flow by Logistic regression analysis. Conclusion： Psychological factors are risk factors for slow coronary flow.
冠状动脉慢血流(coronary slow flow，CSF)是指在排除冠状动脉再灌注治疗后，冠状动脉发生扩张、痉挛，心功能不全，心瓣膜病及某些累及冠脉微血管的结缔组织疾病等因素，而反复胸痛的患者在冠脉造影时显示心外膜下血管正常或轻度狭窄(<50%)，而冠状动脉前向血流缓慢，远端血流灌注延迟的现象[1]。CSF在冠脉介入检查中的检出率随着技术的开展越来越高，为1%～7%[2]。CSF的发生机制目前研究很多，包括动脉粥样硬化、炎症介质释放增强、内皮功能紊乱、血小板异常活化等[3]，随着“双心医学”及“生物心理社会”模式的深入研究，发现焦虑抑郁群体较正常群体更容易发生慢血流。因此本研究旨在探讨冠状动脉慢血流与焦虑抑郁所致心理性因素之間的相关性。, 百拇医药(李骞 叶伟祥 张强 黄志坚 李秀研)
【关键词】 冠状动脉 冠脉造影 慢血流 心理性因素 氟哌噻吨美利曲辛片
[Abstract] Objective： To study and analyze the relationship between coronary slow flow and psychological factors. Method： A total of 101 patients with coronary slow flow by Coronary angiography in our hospital from January 2015 to October 2018 were selected. All patients were divided into three groups by application of SSS (self-rating somatization symptoms scale). The control group was a low-score group(n=34)， while the observation group (n=34) and treatment group(n=33) were both high-score. The control group and observation group were treated with conventional therapy， and the treatment group was treated with Flupentixol and Melitracen Tablets on this basis. The changes of slow blood flow in three groups and the changes of factors in the treatment group were observed before and after treatment. Result： The slow blood flow of LAD in the control group and the observation group were significant improvement after treatment than before treatment (P<0.05)， yet the slow blood flow of LAD， LCX and RCA in the treatment group were significant better after treatment than before treatment (P<0.05). The effective rate of slow blood vessel improvement before and after treatment in the control group was 25.6%， while that in the observation group was 25.0% and the treatment group was 47.9%. There was a significant difference among the three groups (P<0.05). The scores of the factor S and the factor A after treatment were significantly lower than those before treatment (24.4±6.6) and (18.3±3.5) points， (10.1±4.5) and (7.0±2.8) points， there were significant differences (P<0.05). The factor S (OR=1.196， P=0.014) and the factor A (OR=1.051， P=0.048) were correlated with slow coronary flow by Logistic regression analysis. Conclusion： Psychological factors are risk factors for slow coronary flow.
冠状动脉慢血流(coronary slow flow，CSF)是指在排除冠状动脉再灌注治疗后，冠状动脉发生扩张、痉挛，心功能不全，心瓣膜病及某些累及冠脉微血管的结缔组织疾病等因素，而反复胸痛的患者在冠脉造影时显示心外膜下血管正常或轻度狭窄(<50%)，而冠状动脉前向血流缓慢，远端血流灌注延迟的现象[1]。CSF在冠脉介入检查中的检出率随着技术的开展越来越高，为1%～7%[2]。CSF的发生机制目前研究很多，包括动脉粥样硬化、炎症介质释放增强、内皮功能紊乱、血小板异常活化等[3]，随着“双心医学”及“生物心理社会”模式的深入研究，发现焦虑抑郁群体较正常群体更容易发生慢血流。因此本研究旨在探讨冠状动脉慢血流与焦虑抑郁所致心理性因素之間的相关性。, 百拇医药(李骞 叶伟祥 张强 黄志坚 李秀研)