CAJ | 학술논문

目的：分析患者在冠状动脉造影（CAG）前后是否存在焦虑及其变化情况，并探讨多种因素对围术期焦虑的影响，为CAG患者围术期的心理干预治疗提供依据。 　　方法：入选于2012-12至2013-12在阜外心血管病医院心内科行CAG的住院患者379例。术前采集患者基本信息，同时采用中国A型行为问卷（TABQ）及焦虑自评量表（SAS）了解患者的人格特征和焦虑水平；造影次日再次评价焦虑水平。分析性别、年龄、病程、文化程度、A型人格、造影结果及血运重建治疗方案对围术期焦虑水平的影响。 　　结果：CAG前及术后SAS评分高于中国常模，差异具有统计学意义（P<0.05）。CAG术前，女性SAS评分高于男性，差异具有统计学意义（P<0.05）；CAG术后女性、年龄＞50岁、病程＞1年、初中及以下学历者SAS评分较高，差异具有统计学意义（P<0.05）。术后SAS评分较术前明显下降，但冠状动脉旁路移植术患者SAS评分下降不明显。多元线性回归分析发现造影术后与术前SAS评分的差值与文化程度负相关（P<0.05），与病程正相关（P<0.05）。 　　结论：CAG检查可改善患者焦虑情绪，减轻患者心理负担，可有针对性的进行围术期心理干预。
목적：분석환자재관상동맥조영（CAG）전후시부존재초필급기변화정황，병탐토다충인소대위술기초필적영향，위CAG환자위술기적심리간예치료제공의거。 　　방법：입선우2012-12지2013-12재부외심혈관병의원심내과행CAG적주원환자379례。술전채집환자기본신식，동시채용중국A형행위문권（TABQ）급초필자평량표（SAS）료해환자적인격특정화초필수평；조영차일재차평개초필수평。분석성별、년령、병정、문화정도、A형인격、조영결과급혈운중건치료방안대위술기초필수평적영향。 　　결과：CAG전급술후SAS평분고우중국상모，차이구유통계학의의（P<0.05）。CAG술전，녀성SAS평분고우남성，차이구유통계학의의（P<0.05）；CAG술후녀성、년령＞50세、병정＞1년、초중급이하학력자SAS평분교고，차이구유통계학의의（P<0.05）。술후SAS평분교술전명현하강，단관상동맥방로이식술환자SAS평분하강불명현。다원선성회귀분석발현조영술후여술전SAS평분적차치여문화정도부상관（P<0.05），여병정정상관（P<0.05）。 　　결론：CAG검사가개선환자초필정서，감경환자심리부담，가유침대성적진행위술기심리간예。
Objective:To identify the risk factors of anxiety disorders among patients undergoing coronary angiography (CAG) and to determine whether the decision of revascularization affect anxiety level following coronary angiography. Methods:A total of 379 patients undergoing CAG in Fuwai Hospital from Dec. 2012 to Dec. 2013 were invited to participate this study. A data-collecting form, which included questions about demographic features, health history, Type A Behavior Questionnaire (TABQ) and Self Rating Anxiety Scale (SAS), was completed by the participants on the day before and the day after CAG. Result:Among these patients, SAS score of both before and the day after CAG were higher than Chinese normative SAS score. Female patients had a higher SAS score level than male patients (40.57±9.53 vs 38.26±9.61, P<0.05) before CAG. Patients with these factors of female, over 50 years old, duration of coronary artery disease over 1 year, lower education level had a higher SAS score after CAG. SAS score declined signiifcantly after CAG except those scheduled to receive CABG. Multivariable linear analysis found the D-value between SAS scores before and after CAG was negative correlated with degree of education and positive correlated with the duration of coronary artery disease. Conclusion:The anxiety level decreased after CAG, except those who need coronary revascularization surgery.