A型行为对心肌梗死范围及近期预后的影响

Ａ型行为(ＴｙｐｅＡＢｅｈａｖｉｏｒ,ＴＡＢ)已被认为是冠心病的独立危险因素[1],影响冠心病的发生、发展。Ｆｒｉｅｄｍａｎ提出,改变心肌梗死后的ＴＡＢ比改变其它易患因素更为重要[2]。本研究旨在研究ＴＡＢ对急性心肌梗死(ＡｃｕｔｅＭｙｏｃａｒｄｉａｌＩｎｆａｒｃｔｉｏｎ,ＡＭＩ)患者梗死范围及近期预后的影响。1　对象与方法1.1　对象　　选择1998年8月至1999年8月住院的ＡＭＩ患者90例,均为初次患心肌梗死,符合1979ＷＨＯ制订的ＡＭＩ诊断标准[3]。其中男63例,女27例,年龄44～76岁,所有患者均接受常规扩冠,抗凝治疗,符合溶栓适…

The Effect of Type A Behavior on Infarct Size and Short Term Prognosis of First Infarction

To study the influence of type A behavior (TAB) on infarct size and short-term prognosis of patients with acute myocardial infarction (AMI). Methods: 90 AMI patients were divided into TAB group (46 cases) and non-TAB group (34 cases) according to the TAB questionnaire. The infarct size was determined by peak level of CK and CK-MB as well as a QRS scoring system. The incidence rates of cardiac events during 4 weeks were also analyzed. Results: The peak value of CK and CK-MB as well as QRS score in TAB group were significantly higher than corresponding measures in non-TAB group (p<0.05). Rates of malignant ventricular arrythmia, post-infarction angina, reinfarction, heart failure and mortality were markedly higher in TAB group than in non-TAB group (26% versus 5.9%; 32.6% versus 8.8%; 19.6% versus 0%; 23.9% versus 2.9%; 17.4% versus 0%). Conclusion: TAB constituted a potentially contributing factor to enlargement of infarct size, affecting unfavorably the prognosis of patients with first AMI.