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目的经股动脉行冠状动脉介入治疗后,应用中国版90项症状清单(Symptom Checklist 90,SCL-90)评价发现患者的躯体化因子评分高于常模。本研究的目的是了解经不同血管径路行冠状动脉介入手术是否会影响患者的心理状况。方法本研究为非随机同期对照研究。198例因疑诊冠心病首次行冠状动脉造影或介入治疗的患者,其中经股动脉径路者105例,经桡动脉径路者93例。所有患者均于术前24 h内及术后24～48 h行中国版90项症状清单评价。根据数据的分布特点、基线指标分别采用x2检验或t检验进行两组间比较;采用双因素方差分析检验经不同血管径路及冠状动脉介入手术本身对患者SCL-90评分的影响。结果两组之间年龄、性别、体重、烟酒嗜好、职业、文化程度、婚姻状况、家庭关系、心脑血管病家族史、本人及家庭年收入以及医疗费用的支付方式(即是否有医疗保险)等方面差异均无统计学意义;两组间合并高血压和糖尿病的人数也无差别;确诊冠心病以及行冠状动脉介入治疗的患者数亦相似。与术前相比,冠状动脉介入手术后躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、总均分和阳性项目数等项目评分均有明显下降(分别为1.50±0.51比1.64±0.53;1.50±0.48比1.67±0.55;1.28±0.41比1.38±0.49;1.42±0.43比1.55±0.53;1.38±0.41比1.58±0.54;1.32±0.35比1.44±0.41;1.38±0.34比1.49±0.42;和23.08±17.30比27.72±18.79,P均<0.05)。与经股动脉径路相比,经桡动脉行冠状动脉介入手术显著减少躯体化、抑郁和阳性症状均分等项目评分(分别为1.52±0.51比1.62±0.53;1.43±0.54比1.54±0.43;2.36±0.66比2.50±0.43,P均<0.05)。结论经桡动脉行冠状动脉介入手术可减轻患者的躯体化及抑郁症状;冠状动脉介入手术后患者的心理症状明显减轻。
Objective To evaluate the somatization factor scores of 90 Chinese Symptom Checklist 90 (SCL-90) patients after interventional coronary intervention via femoral artery. The purpose of this study was to understand if coronary intervention under different vascular approaches would affect the patient’s psychological status. Methods This study was a non-randomized, controlled, synchronized study. Of the 198 patients who underwent coronary angiography or interventional therapy for the first time due to suspected coronary artery disease, 105 were found to be via femoral artery approach and 93 via radial artery approach. All patients were evaluated by Chinese version of 90 symptom checklist within 24 h before operation and 24-48 h after operation. According to the distribution characteristics of the data, the baseline indexes were compared between the two groups using x2 test or t test respectively. The two-way analysis of variance (ANOVA) was used to test the effect of different pathways of coronary artery and coronary artery intervention on SCL-90 score. Results The age, gender, body weight, alcohol and tobacco preferences, occupation, educational level, marital status, family relationship, family history of cardiovascular and cerebrovascular disease, annual income of family and I and the payment of medical expenses (ie medical insurance ) And other aspects were not statistically significant; there was no difference between the two groups in the number of patients with hypertension and diabetes; the number of patients diagnosed with coronary heart disease and coronary intervention was also similar. Comparing with preoperative, scores of somatization, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, total score and number of positive items decreased significantly after coronary intervention (1.50 ± 0.51 vs 1.64 ± 0.53; 1.50 ± 0.48 to 1.67 ± 0.55; 1.28 ± 0.41 to 1.38 ± 0.49; 1.42 ± 0.43 to 1.55 ± 0.53; 1.38 ± 0.41 to 1.58 ± 0.54; 1.32 ± 0.35 to 1.44 ± 0.41; 1.38 ± 0.34 to 1.49 ± 0.42; And 23.08 ± 17.30 than 27.72 ± 18.79, P <0.05). Transradial coronary intervention significantly reduced somatization, depression, and positive symptom scores (1.52 ± 0.51 vs 1.62 ± 0.53; 1.43 ± 0.54 vs 1.54 ± 0.43, respectively; 2.36 vs. ± 0.66 vs 2.50 ± 0.43, P <0.05). Conclusions Transradial coronary intervention can reduce somatization and depressive symptoms in patients. The psychological symptoms of patients after coronary intervention are significantly reduced.