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1、综合医院急诊胸痛患者心理状态及临床特【摘要】目的:评估胸痛患者的心理状态，分析描述非心源性胸痛(non-cardiacchestpain,NCCP)的临床特征。方法:横断面研究。收集胸痛为主诉连续就诊的急诊患者711人，采用汉密顿焦虑量表(HamiltonAnxietyRatingScale,HAMA)和汉密顿抑郁量表(HamiltonDepressionRatingScale-17,HAMD-17)1平估患者心理状态上匕较NCCP与心源性胸痛的临床特点。结果:共231例同意合作的胸痛患者入选，年龄19-79岁，男性106o其中182例为NCCP,49例为有器质性心脏病者(心源性胸痛组
2、)b胸痛患者焦虑抑郁平均分均高于正常界值(HAMA得分邛4;HAMD-17得分),以焦虑症状更明显，NCCP组有明显焦虑症状的患者比例高于心源性胸痛组(64.3%vs.57.1%,P<0.01)o与心脏病患者相比，NCCP组年龄较小[(48.1±11.7)岁vs.(55.5±10.0)岁，Pv0.01],<45岁者较多(37.9%vs.16.3%,P<0.01),胸痛发作时更易出现死亡恐惧(59.3%vs.40.8%)、害怕(69.8%vs.34.7%)、失控感(31.9%vs.10.2%),过度换气(37.4%vs.16.3%)和手脚麻木(37.4%vs.14.3%)等伴随症状(Ps
3、vO.05);伴随症状成组出现(>4个)的比例更高(29.7%vs.10.2%,P<0.01),发作时心电图正常、病程月者更多(49.5%vs・30.6%,Pv0・05b结论:急诊胸痛患者焦虑症状明显，其中大多数为非心源性胸痛，主要临床特征为年龄较轻、心电图正常、发作时常有特征性伴随症状，或特征性伴随症状成组出现。【关键词】胸痛；焦虑；抑郁；急诊医学；横断面研究中图分类号：R749.92文献标识码：A文章编号：1000-6729(2010)012-0893-04doi:10.3969/j.issn.1000-6729.2010.12.省略[Abstract]Objective:Toev
4、aluatethementalstateanddelineatecharacteristicsofpatientswithchestpainintheemergencydepartmentofgeneralhospital.Methods:Thiscross-sectionalstudywasperformedintheemergencydepartment(ED)ofanurbantertiarycarehospital.Totally711consecutivepatientscomplainingofchestpainwereenrolledinthestudy.Thementa
5、lstatesofpatientswereassessedwiththeHamiltonAnxietyRatingScale(HAMA)andHamiltonDepressionRatingScale-17(HAMD-17).Results:Atotalof231patientspresentedtotheEDwithchestpainparticipatedinthestudy,including106malesand125females,aged19~79years.Amongthem,182patientswereconfirmedwithoutanyheartdisease,d
6、iagnosedwithnon-ca「diacchestpain(NCCP),and49wereconfirmedwithheartdisease.ThepatientswithchestpainhadhigherscoresofHAMAandHAMD-17,especiallyHAMA.TheNCCPgrouphadhigherproportionofthepatientswhoseHAMAscoreswere>14thantheheartdiseasegroup(64.3%vs.57.1%,P<0.01).ThepatientsinNCCPgroupwereyoungerthanp
7、atientswithcardiacdisease[(48.1±11.7)vs.(55.5±10.0),P<0.01)],andmoreofthemwere<45years(37.9%vs.16.3%,P<0.01).TheattacksofchestpainwithNCCPweremorefrequentlyaccompaniedbythepresenceofsomespecifiedsymptomsthanpatientswithcardi
