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目的探讨心理行为干预对急性心肌梗死(AMI)者临床及心电图改变的影响。方法将符合诊断标准的AMI者随机分为研究组(A组)和对照组(B组),并用焦虑自评量表(SAS)、抑郁自评量表(SDS)进行焦虑抑郁水平测定,观察临床及心电图变化。结果心理行为干预前A组,SAS、SDS分别为(62·31±8·25)、(65·13±7·20),B组为(61·82±9·6),(66·23±8·08),两组对比无明显差异(P>0·05)。心理行为干预后,各时段评分A组明显减小,1周、2周、4周SAS评分分别为(53·21±6·74、47·23±7·18、44·59±4·18);SDS分别为(58·21±5·89)、(49·20±6·14)、(45·43±4·79),与B组对比有显著性差异(P<0·05)。临床及心电图指标,如恶性心律失常、再梗死、梗死后心绞痛、死亡及QTc、QTa、ΣST两组均有显著性差异(P<0·05)。结论心理行为干预可有效地改善AMI者的负性情绪,减轻心电图变化,避免恶性心律失常等的发生。
Objective To investigate the effects of psychological intervention on the clinical and electrocardiographic changes in patients with acute myocardial infarction (AMI). MethodsAll patients with diagnostic criteria were randomly divided into study group (group A) and control group (group B), and anxiety and depression were measured by SAS and SDS. Clinical and ECG changes. Results Before psychological intervention, the scores of SAS, SDS in group A were (62.31 ± 8.225), (65.13 ± 7.20), in group B (61.82 ± 9.6), (66.23) ± 8.08), no significant difference between the two groups (P> 0.05). After psychological intervention, the scores of group A decreased significantly at each time point, and the scores of SAS at 1 week, 2 weeks and 4 weeks were (53.21 ± 6.74, 47.23 ± 7.88, 4.49 ± 4.18 ) And SDS (58.21 ± 5.89), (49.20 ± 6.14) and (45.43 ± 4.79), respectively, which were significantly different from those in group B (P <0.05) . The clinical and electrocardiographic parameters, such as malignant arrhythmia, re-infarction, post-infarction angina pectoris and death, as well as QTc, QTa and ΣST were significantly different (P <0.05). Conclusion Psychological and behavioral intervention can effectively improve the negative emotions of AMI, reduce ECG changes and avoid the occurrence of malignant arrhythmias.