中国临床心理学杂志

A型行为与心电图ST-T缺血性改变、冠状动脉病变的关系

作者：黄伟¹ 2 杨明施¹ 肖雪辉¹ 丁四清¹ 肖涛¹ 郭美英¹ 秦露露² 肖水源²

单位：1. 中南大学湘雅三医院急诊科长沙410013
2. 中南大学公共卫生学院长沙410078

分类号：R395.1

出版年,卷(期):页码：2015,23(5):861-864

摘要：

目的:从行为医学角度分析A型行为与心电图ST-T缺血性改变、冠状动脉造影改变的关系.方法:对采用Judkins造影法行冠状动脉造影的患者,随机抽取350例,进行A型行为问卷调查,收回有效问卷341例,分为A型行为组及非A型行为组,对比分析两组心电图ST-T及冠状动脉造影的临床情况.结果:A型行为组与非A型行为组心电图ST-T缺血性改变的阳性率的差别无统计学意义(χ²=2.319,P =0.128).在非A型行为组中,女性的心电图ST-T缺血阳性率高于男性(χ²=9.589,P <0.05).A型行为组的冠状动脉的阳性率高于非A型行为组(χ²=5.551,P <0.05).在A型行为组和非A型行为组中,男性与女性的冠脉造影阳性率差异均无统计学意义.A型行为组中,心电图ST-T缺血性改变与冠状动脉造影缺血改变有相关性.结论:A型行为组冠心病发生率高于非A型行为组,A型行为组中心电ST-T缺血性改变与冠状动脉造影缺血改变有相关.

Objective: To analyze the relationship of Type A Behavior with the ischemic changes of the electrocardio-gram(ECG) ST-T and coronary arteriographic changes from the perspective of behavioral medicine, and discuss the correla-tion of the behavioral factors and the coronary heart disease. Methods: 350 cases were selected randomly among the pa-tients after coronary angiography by using the Judkins imaging method and surveyed by a questionnaire about Type A be-havior. 341 questionnaires were taken back with effective exampling rate of 97%. They were divided into Type A behavior group and Non-Type A behavior group so as to compare the clinical situations of ECG ST-T and coronary arteriography. Results: There is no statistically significant difference in ECG ST-T ischemic change between the Type A behavior group and the non-Type A behavior group(χ²=2.319,P =0.128). In the non-Type A behavior group, the rate of ECG ST-T isch-emia change of female is higher than male(χ²=9.589,P <0.05). Regarding the coronary angiography, the group with Type A behavior has a higher"positive"rate than that of Non-Type A behavior group(χ²=5.551,P <0.05); And there is no statistical-ly significant gender difference in"positive"rate of coronary angiographic ischemia in both the Type A behavior group and the non-Type A behavior group. The ECG ST-T ischemic change in Type A behavior group is related to the coronary angio-graphic ischemia in the Type A behavior group. Conclusion: The incidence of coronary artery ischemia in Type A Behavior Group is higher than that in Non-Type A Behavior Group. Furthermore, the ischemic change of ECG ST-T in Type A Be-havior Group is associated with the change out of coronary angiographic ischemia.

基金项目：

2013年中国湖南科技厅支撑项目

作者简介：

参考文献：

1 John Hunter. Early association of Type A behavior with cardiac mortality. The American Journal of Cardiology, 2014, 114(1): 148-150
2 Roacnman RH, Rrand RJ. Coronary heart disease in Western Collaborative Group Study. Final follow-up experience of 8.5 years. JAMA, 1975, 233(13): 872
3 赵兴蓉,白俊云,李娜,等. A型行为问卷评估A型行为与冠心病关系的应用研究. 临床心身疾病杂志,2008,14(4): 353-359
4 吴学勤,苗丹民,等. A型行为因子与冠心病的关联性. 心脏杂志,2008,20(6):728-732
5 杨敏. 住院A型行为冠心病患者负性情绪影响因素的探究. 吉林医学,2011,25(32):5328-5332
6 杨涛. 冠心病患者76例心电图与冠状动脉造影的对比分析. 中国社区医生,2012,14(7):242-247
7 张伯源. 心血管病人的心身反应特点的研究. 心理学报, 1985,3:31
8 David CG, Richard JC. Bipolar disorder, Type A behaviour and coronary disease. Health Psychology Review, 2012, 6 (2): 180-196
9 Shulman JK, Stromberg S. On the value of doing nothing: Anger and cardiovascular disease in clinical practice. Cardiology in Review, 2007, 15(3): 123-132
10 陈小珍,陈芳菲,张洁,等. 冠心病住院患者A型行为的横断面调查. 中国临床心理学杂志,2010,20(3):301-304
11 宁传艺,陈务贤,梁晓梅,等. 不同性别冠心病患者血管病变程度的比较分析. 护理进修杂志,2011,26(3):204-207
12 梁发杰,孟庆云. 对140例女性心电图及冠状造影特点与冠状动脉病变的探讨.中国实用医药,2011,7(6):71-73
13 龚纪文,杨晓刚,黄冠荣. 冠状动脉造影与心电图的对比分析. 中国现代医药杂志,2008,10(1):42-44
14 俞阅彦,江时森,宋宏宾,等. 不同性别冠心病危险因素与冠脉病变程度的相关性. 心脏杂志,2012,24(2):205-2018
15 Macleod J, Davey SG, Heslop P, et al. Are the effects of psychosocial exposures attributable to confounding? Evidence from a prospective observational study on psychological stress and mortality. Journal of Epidemiology and Community Health, 2001, 55(4): 878-884
16 Ksenija P, Damir B. Risk factor analysis and diagnoses of coronary heart disease in patients with hypercholesterolemia from croatian zagorje county. Collegium Antropologicum, 2008, 32(2): 369-374
17 John Hunter. Early association of Type A behavior with Cardiac Mortality. The American Journal of Cardiology, 2014, 114(1): 148-150
18 Krantz DS. Personality, behavior patterns and physical illness: Conceptual and methodological issues. New York: Guilford Press, 2000. 38-86
19 那开宪,余平,张桂云,等. 冠心病危险因素的性别差异. 中国临床医生,2009,37(11):3-7
20 Liu BC, Tang RN, Feng Y, et al. A single Chinese center investigation of renel artery stenosis in 141 consecutive cases with coronary angiography. American Journal of Nephrology, 2004, 24(6): 630-634

服务与反馈：

【文章下载】【加入收藏】