不稳定性心绞痛患者心理社会因素与血小板聚集功能关系的研究

摘要

目的：探讨不稳定性心绞痛(UAP)患者心理社会因素与血小板聚集功能的关系。方法：采用6个心理量表对46例UAP患者和46例健康人进行评定，并测定ADP诱导的血小板聚集率。结果：UAP组负性生活事件刺激量、消极应对、CH、焦虑和抑郁积分及血小板聚集率均高于对照组(均P＜0.01)，社会支持总分和积极应对分低于对照组(均P＜0.01)，UAP组A型行为、焦虑及抑郁分别占73.91％、82.6％和71.4％，高于对照组36.96％、34.8％和21.7％(均P＜0.01)。UAP患者焦虑、抑郁程度与负性生活事件刺激量、消极应对分、CH分及血小板聚集率正相关(P＜0.05或P＜0.01)，与社会支持总分负相关(均P＜0.05)，血小板聚集率与负性生活事件刺激量、CH分亦显著正相关(均P＜0.01)。结论：UAP患者由于处于心理应激状态，表现焦虑、抑郁情绪障碍，血小板聚集功能增强，对疾病的发展和预后可能产生不利影响。%Objective:To explore the relationship between psychosocial factors and platelet aggregation function in patients withunstable angina pectoris(UAP). Methods:Forty-six UAP patients and 46 healthy subjects were evaluated with 6 psychologi-cal scales,and their adenosine diphosphate(ADP)-induced platelet aggregation function was determined. Results: The scoresof negative life event stimuli,negative coping,CH, anxiety, depression and the rate of platelet aggregation function in UAPgroup were significantly higher than controls, whereas the scores of total social support and positive coping were markedlylower than controls(all P＜0.01). The prevalence of type A behavior, anxiety and depression in UAP group(73.91%,82.60% and 71.40% respectively)was higher than controls(36.96% ,34.80% and 21.70%respectively)(all P＜0.01).The scores of anxiety or depression in UAP group had a positive correlation with the scores of negative life event stimuli,negative coping,CH,anxiety,depression and the rate of platelet aggregation in UAP group (P＜0.05 or P＜0.01)and anegative correlation with the score of total social support( P ＜ 0.05). The rate of platelet aggregation had a positive correla-tion with the scores of negative life event stimuli and CH too ( all P ＜ 0.01 ). Conclusion: Emotional discord (such as anxietyor depression)and exaggerated platelet aggregation may affect the development and prognosis of UAP.