经桡动脉入径行冠状动脉介入治疗对老年急性心肌梗死患者的心理和临床疗效的影响

Psychological and clinical effect of transradial artery access for percutaneous coronary intervention on elderly patients with acute myocardial infarction

【摘要】目的探讨桡动脉途径直接经皮冠状动脉介入术(PCI)治疗对老年急性心肌梗死(AMI)患者心理和临床疗效的影响。方法2005年1月至2007年1月收治的年龄>65岁的老年急性ST段抬高型心肌梗死患者172例,随机分为经桡动脉组84例和经股动脉组88例。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)测试AMI患者PCI术前术后的心理变化,同时观察两组的临床治疗效果。结果两组术前SAS、SDS积分无显著差异,PCI术后1个月、6个月两组患者SAS、SDS积分较术前明显下降(P<0.05);同时,PCI术后1个月、6个月时,经桡动脉PCI组较经股动脉PCI组SAS、SDS积分进一步减低(P<0.05)。经统计学分析证实不同手术入径对AMI患者的焦虑或抑郁情绪造成不同程度影响。两组主要不良心脏事件未见显著性差异。结论经桡动脉途径直接PCI治疗AMI患者可以减少患者的焦虑及抑郁心理问题且安全、有效。

基金项目:

【Abstract】Objective To assess the psychological and clinical effect of transradial artery access for percutaneous coronary intervention(PCI) on elderly patients with acute myocardial infarction(AMI). Methods One hundred and seventy-two patients(>65years) with acute ST segment elevated myocardial infarction were enrolled from Jan,2005 to Jan, 2007.All the patients who underwent PCI were randomly divided into transradial artery group (n=84) and transfemoral artery group (n=88).The psychological changes of the subjects were determined by self-rating anxiety scale(SAS) and self-rating depression scale(SDS).The clinical outcome of the subjects were also observed.Results SAS and SDS indices were decreased significantly in transradial artery group compared to those in transfemoral artery group at 1,6 month after PCI procedure(P<0.05). Statistical analysis demonstrated that different approaches exerted different effects on depression or anxiety of AMI patients.There was no difference in major adverse cardiac events between the two groups. Conclusion Transradial artery access for percutaneous coronary intervention can significantly decrease the incidence of psychological problems in elderly patients with AMI.And also,it is safe and effective.