摘要
目的:探讨冠状动脉狭窄程度与A型行为评分之间的关系,了解冠心病患者A型行为分布情况。方法:①选择2001-04/2004-03在济宁医学院附属金乡医院心内科住院胸痛、胸闷或疑似胸痛患者186例,男133例,女53例。均自愿参加。将受试者根据冠状动脉造影结果分为两组,冠心病组(至少一支主要冠状动脉和/或分支直径狭窄≥50%)126例,对照组(任何一支冠状动脉直径狭窄<50%)60例。再根据冠状动脉狭窄程度将冠心病组分为3个亚组:轻度组(前降支或回旋支单支闭塞≥50%)44例;中度组(前降支、回旋支或右冠状动脉有两处病变,至少有一处闭塞≥70%,<90%)43例;重度组(前降支、回旋支及右冠状动脉有多处病变,至少有一处病变≥90%)39例。②评估冠心病患者行为类型采用A型行为问卷(包括3个分量表:时间匆忙感量表;竞争意识量表;掩饰量表,掩饰<7为有效问卷。根据时间匆忙感+竞争意识总分分为A型行为36～50,中间偏A型行为特征28～35,极端中间型27,中间偏B型行为特征19～26,B型行为特征1～18)。③对冠心病行为类型分布、A型行为评分与不同冠状动脉狭窄之间的关系进行分析。④计数资料的统计叙述用百分率表示,采用χ2检验,计量资料差异性测定采用方差分析,两两对比采用t检验。结果:冠心病患者186例均进入结果分析。①冠心病患者的A型行为分布:冠心病组A型行为比例高于对照组(34.1%,13.3%,P<0.01),重度狭窄组A型行为比例高于轻度狭窄组(49%,23%,P<0.05)。②A型行为模式问卷因子分比较结果:竞争意识因子和竞争意识+时间匆忙感因子得分随着冠状动脉狭窄程度的加重而明显升高(竞争意识因子:轻度狭窄组、中度狭窄组、重度狭窄组分别为14.25±3.15,16.13±4.78,18.03±3.12;竞争意识+时间匆忙感因子:轻度狭窄组、中度狭窄组、重度狭窄组分别为27.22±7.31,30.21±6.56,32.78±5.78,P<0.05),且均明显高于对照组(12.87±3.25,24.59±6.50,P<0.05)。中度狭窄组和重度狭窄组患者时间匆忙感因子得分明显高于对照组(P<0.05);重度狭窄组患者时间匆忙感因子得分明显高于轻度狭窄组(P<0.05)。结论:A型行为在冠心病患者中分布较多;A型行为性格特征越明显,冠状动脉病变程度越严重。
AIM： To investigate the relation between type A bebavior and degree of coronary artery stenosis so as to comprehend the distribution of type A behavior in patients with coronary heart disease. METHODS： ①Totally 186 patients hospitalized for chest pain, chest distress, or suspicious of chest pain were enrolled voluntarily at the Department of Cardiology, Jinxiang Hospital of Jining Medical College from April 2001 to March 2004. According to results of coronary arteriongraphy, all the subjects were divided into coronary heart disease group （n=126, at least one main coronary artery and/or branch with diameter stenosis ≥ 50%） and control group （n=60, any coronary artery with diameter stenosis 〈 50 %）. According to the degree of stenosis, coronary heart disease group were subdivided into mild group （n=44, anterior descending branch or rotation branch with single branch ≥ 50%）, moderate group （n=43, anterior descending branch, rotation branch or right coronary artery with two lesions and at least one site having stenosis ≥ 70 % ,〈 90 %）, and severe group （n=39, anterior descending branch, rotation branch or right coronary artery with many lesions, and at least one site having stenosis ≥ 90 %）. ② Type A behavior pattern scale consisted of three subseales： TH, CH, and L seales. If the scoreon Lscale was〈 7, thequestionnairewasconsideredasvalid. According to the total score of CH and TH patients with scores 36-50 were considered as having type A behavior, scores 28-35 as partial type A behavior, score 27 as having extreme medium type, scores 19-26 as having partial type B behavior, and scores 1-18 as having type B behavior. Distribution of behavior type and the relation between the scores of the type A behavior questionnaires and the degree of coronary artery stenosis were analyzed. Statistical analysis on enumeration data was expressed as percentage through chi-square analysis, and difference in measurement data was determined by analysis of variance, and intra-group comparison was conducted by t test. RESULTS： All the subjects were enrolled in the result analysis. Distribution of type A behavior： The ratio of type A behavior was higher in coronary heart disease group than in the control group （34.1% vs. 13.3%, P 〈 0.01）, and was also higher in severe stenosis group than in mild stenosis group （49% vs. 23%, P 〈 0.05）. Scores on subscales of type A behavior pattern scale： The scores on TH and CH ＋TH were increased along with the severity of coronary artery stenosis. The scores on CH were 14.25±3.15 in mild group,16.13±4.78 in moderate group,and 18.03±3.12 in severe group; the scores on CH＋TH were 27.22±7.31,30.21±6.56,32.78±5.78, respectively, in the three groups. All the scores were significantly higher than those in the control group （12.87±3.25,24.59±6.50,P 〈 0.05）. The mores on TH were higher in the mild control group （P 〈 0.05）, and were also and moderate groups than in the higher in the severe group than in the mild group （P 〈 0.05）. CONCLUSION： Type A behavior is very common in patients with coronary heart disease.The more remarkable the features of type A behavior are, the more severe the coronary artery lesion is.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期52-53,共2页
Chinese Journal of Clinical Rehabilitation
