汉密尔顿焦虑量表在鉴别胸痛患者中的应用

目的研究主诉为＂胸闷、胸痛＂患者临床特点及焦虑情绪,以评价汉密尔顿焦虑量表在鉴别诊断此类患者中的应用。方法入选因主诉为＂胸闷、胸痛＂行冠状动脉造影患者共229例。其中男124例,年龄（63.2±7.5）岁,女105例,年龄（65.9±10.3）岁。根据冠脉造影结果,将以上患者分为冠心病组（130例）和非冠心病组（99例）,比较两组基本临床资料（年龄、性别、是否典型心绞痛症状、吸烟史、高血压病史、糖尿病史、高脂血症病史）和汉密尔顿焦虑量表（HAMA）评分。结果冠心病组年龄、男性比例、典型心绞痛症状、吸烟史、糖尿病史、高脂血症病史比例均明显高于非冠心病组（P〈0.05）。无冠心病组HAMA评分明显高于冠心病组（P〈0.01）。男性患者中HAMA≥14分36例（29.0%）,女性患者中HAMA≥14分68例（64.8%）,女性患者中焦虑障碍发病率明显高于男性（P〈0.01）。如以汉密尔顿焦虑量表评分〈14分作为冠心病诊断标准之一,按性别分组后,女性组中灵敏度为42.5%,特异度为82.3%;男性组中灵敏度为78.0%,特异度为32.3%。结论除已知冠心病危险因素及判断标准外,对主诉为＂胸闷、胸痛＂患者进行密尔顿焦虑量表评分,可及时发现病人焦虑症状,帮助鉴别诊断冠心病患者。

The significance of using Hamilton Anxiety Scale in patients with chest pain

Objective To investigate the significance of using Hamilton Anxiety Scale（HAMA） in patients with chest pain.Methods Two hundred and twenty-nine patients who suffered from chest pain were included in the study.Among them,there were 124 men（63.2±7.5 yrs） and 105 women（65.9±10.3 yrs）.Based on the results of coronary artery angiography,they were divided into coronary heart disease（CHD） group（n=130） and non-CHD group（n=99）.The clinical data such as age,sex and history of and scores of HAMA between the two groups were compared.Results The age,male proportion and history of typical angina pectoris,smoking,diabetes and hyperlipidemia were significantly higher in the CHD group and the non-CHD group（P〈0.05）.The HAMA score of the non-CHD group was significantly higher than the CHD group（P〈0.01）.There were 36 male patients（29.0%） whose HAMA was bigger than 14 while there were 68 female patients（64.8%）.The anxiety rate of female patients was significantly higher than that of the male（P〈0.01）.If HAMA score less than 14 was considered as a diagnostic indicator for CHD,after grouping,the sensitivity and hypersensitivity rates of the female group were 42.5% and 82.3%,respectively,while they were 78.0% and 32.3% of the male group.Conclusion Besides the recognized risk factors and criteria,the use of HAMA in patients whose major complaints are chest pains is helpful in identifying their anxiety symptoms and confirming whether they have CHD.