心肌桥患者躯体化症状及焦虑抑郁的调查分析

目的研究心肌桥患者的躯体化症状、焦虑及抑郁状态。方法连续入选2016年6~12月上海市某三甲医院心内科经冠状动脉造影(coronary angiography,CAG)确诊为心肌桥患者276例,其中,单纯心肌桥(无冠脉狭窄或狭窄<30%)151例,复杂心肌桥(合并冠脉狭窄且狭窄>30%)125例。并收集同一时间冠状动脉造影无心肌桥患者共1067例。采用躯体化症状自评量表(self-rating somatic symptom scale,SSS)、广泛性焦虑障碍量表(generalized anxiety disorder,GAD-7)及病人健康问卷抑郁自评量表(patient health questionnaire,PHQ-9)对患者进行心理测评,比较心肌桥组及非心肌桥组的躯体化症状及焦虑抑郁状态的发生率。结果心肌桥患者躯体化症状阳性率高于非心肌桥患者(35.86%,28.30%;P<0.05);躯体化症状与抑郁、焦虑存在相关关系,相关系数分别为0.629,0.565。心肌桥患者抑郁、焦虑阳性率均高于非心肌桥患者(抑郁23.91%,22.11%,P=0.47;焦虑17.02%,14.15%,P=0.22),但差异无统计学意义。男性患者及女性患者中,单纯心肌桥患者躯体化症状阳性率、抑郁及焦虑阳性率均高于复杂心肌桥患者,但差异无统计学意义。心肌桥患者中非特异性躯体症状最常见为疲劳乏力(64.5%),其次为睡眠障碍(63.8%),注意力下降(63.0%)。结论心肌桥患者的躯体化症状明显高于非心肌桥组患者,特别是对于伴非特异躯体症状的心肌桥患者,及早识别躯体化症状可能会对临床上进一步的合理治疗提供帮助。

Investigation and analysis of somatic symptom disorder and anxiety and depression in patients with myocardial bridge

Objective To investigate and analyze the somatic symptom disorder,anxiety and depression in patients with myocardial bridge.Methods A total of 276 patients with myocardial bridge diagnosed by coronary angiography(CAG)were enrolled in the department of cardiology of Renji hospital in Shanghai from June to December in 2016.There were 151 cases of simple myocardial bridge(no coronary stenosis or coronary artery stenosis<30%)and 125 cases of complex myocardial bridge(combined with coronary stenosis>30%).A total of 1067 patients with myocardial bridge without coronary angiography were collected at the same time.Self-rating somatic symptom scale(SSS),generalized anxiety disorder(GAD-7)and patient health questionnaire(PHQ-9)were given to these patients during hospitalization.At the same time,somatic symptoms disorder and anxiety and depression in the myocardial bridge group and non-myocardial bridge group were compared.Results The prevalence of somatic symptom disorder in patients with myocardial bridge was higher than that in non-myocardial bridge patients(35.86%vs 28.30%,P<0.05).There was significant correlation between somatic symptom disorder and depression and anxiety,with correlation coefficients of 0.629 and 0.565,respectively.The prevalence of depression and anxiety in myocardial bridge patients was higher than that in non-myocardial bridge patients(depression:23.91%vs 22.11%.P=0.467;anxiety:17.02%vs 14.15%,P=0.22),but there was no statistical difference.For male patients or female patients,the prevalence of somatic symptom disorder,depression and anxiety in the simple myocardial bridge patients were higher than those in the complex myocardial bridge patients,but there was no statistical difference.The most common non-specific somatic symptoms disorder in patients with myocardial bridge were fatigue(64.5%),followed by sleep disorders(63.8%)and decreased attention(63.0%).Conclusion The somatic symptom disorder in patients with myocardial bridge is significantly higher than that in non-myocardial bridge group.Especially for patients with myocardial bridge with non-specific somatic symptoms,early identification of somatic symptoms disorder of myocardial bridge patients will be beneficial to proper clinical invitation.