心理社会因素对急性冠脉综合征患者的影响因素分析

摘要/Abstract

摘要： 目的分析心理社会因素对于急性冠脉综合征患者的影响。方法选取2021年2-12月在福建省立医院住院的急性冠脉综合征患者203例,采用9项患者健康问卷（PHQ-9）、7项广泛性焦虑障碍量表（GAD-7）、生活事件量表（LES）、患者临床指标、一般状况调查表等作为研究工具进行问卷调查,分析心理社会因素对急性冠脉综合征患者的影响。结果（1）急性冠脉综合征患者PHQ-9总分为（5.60±1.70）,抑郁程度为轻度;GAD-7总分为（7.18±3.19）,焦虑程度为轻度;LES负性事件总分为（10.74±11.60）;（2）独立样本t检验结果显示：性别、有无支架史、睡前玩手机时间、心脏射血分数、有无抑郁、有无焦虑和是否急诊PCI与肌钙蛋白I（cTnI）水平有关（P<0.05）;（3）肌钙蛋白I水平与患者年龄和尿酸呈负相关关系;与负性生活事件得分、PHQ-9分数、GAD-7分数、低密度脂蛋白、总胆固醇、B型尿钠肽（BNP）水平呈正相关;（4）多因素线性逐步回归分析结果显示,GAD-7分数、负性生活事件得分、性别、BNP水平、总胆固醇和睡前玩手机≥2 h是肌钙蛋白I的独立影响因素。GAD-7、负性生活事件得分、BNP水平、总胆固醇与肌钙蛋白I水平呈正相关关系,该值越大,肌钙蛋白I水平越高。不同性别中,女性肌钙蛋白I水平较男性低;睡前玩手机时间<2 h者肌钙蛋白I水平较≥2 h者更低。结论急性冠脉综合征患者多数处于轻度焦虑、轻度抑郁状态。焦虑、负性生活事件、BNP水平、总胆固醇水平、睡前玩手机时间≥2 h者存在升高肌钙蛋白I风险,可加重患者病情。

关键词: 急性冠脉综合征, 焦虑, 抑郁, 生活事件, 影响因素

Abstract: Objective To investigate the impact of psychosocial factors on patients with acute coronary syndrome. Methods A total of 203 patients with acute coronary syndrome who were hospitalized in Fujian Provincial Hospital from February to December 2021 were enrolled, and a questionnaire survey was conducted to analyze the impact of psychosocial factors on patients with acute coronary syndrome using the research tools of Patient Health Questionnaire-9 (PHQ-9), 7-item Generalized Anxiety Disorder (GAD-7), Life Event Scale (LES), clinical indicators, and general status questionnaire. Results The patients with acute coronary syndrome had a total PHQ-9 score of 5.60±1.70 (indicating mild depression), a total GAD-7 score of 7.18±3.19 (indicating mild anxiety), and a total negative life event score of 10.74±11.60 in LES. The independent samples t-test showed that sex, presence or absence of stenting history, the time spent playing mobile phone before going to bed, cardiac ejection fraction, presence or absence of depression, presence or absence of anxiety, and presence or absence of emergency PCI were associated with the level of cardiac troponin I (cTnI) (P<0.05). The level of cTnI was negatively correlated with age and uric acid and was positively correlated with negative life event score, PHQ-9 score, GAD-7 score, low-density lipoprotein, total cholesterol, and B-type natriuretic peptide (BNP). The multivariate linear stepwise regression analysis showed that GAD-7 score, negative life event score, sex, BNP level, total cholesterol, and the time spent playing mobile phone before going to bed were independent influencing factors for cTnI. GAD-7, negative life event score, BNP level, and total cholesterol were positively correlated with cTnI level. Female individuals tended to have a lower cTnI level than male individuals, and individuals playing mobile phone for <2 hours tended to have a lower cTnI level than those playing mobile phone for ≥2 hours. Conclusion Most patients with acute coronary syndrome are in the state of mild anxiety and mild depression. Patients with anxiety, negative life events, relatively high levels of BNP and total cholesterol, and the habit of playing mobile phone for ≥2 hours before going to bed tend to have a higher risk of increase in cTnI, which can lead to the aggravation of disease conditions.

Key words: Acute coronary syndrome, Anxiety, Depression, Life events, Influencing factors

王巍, 郑小星, 陈惠敏, 刘丹韵. 心理社会因素对急性冠脉综合征患者的影响因素分析[J]. 心血管病防治知识, 2025, 15(12): 46-51.

WANG Wei, ZHENG Xiaoxing, CHEN Huimin, LIU Danyun. Impact of psychosocial factors on patients with acute coronary syndrome[J]. Prevention and Treatment of Cardiovascular Disease, 2025, 15(12): 46-51.

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