李益萍+王肖龙

[摘要] 我国冠心病的发病率与病死率逐年升高，经皮冠状动脉介入治疗（PCI）是诊断和治疗冠心病的重要方法之一。但对部分患者而言，冠心病疾病本身、手术治疗的风险、支架造成的经济问题及术后可能出现的再狭窄、支架内血栓等因素都会给患者身心带来负担，易产生焦虑、抑郁等情绪，甚至可影响PCI的疗效和患者的生存质量。因此，心内科医生在积极救治患者心脏疾患的同时，还应注重其可能伴随的心理问题，并及时干预才可能使患者得到心脏、心理的和谐统一。本文主要就PCI术后常见的心理问题、产生的原因、诊断及治疗等方面的相关研究进展作一简要概述。

[关键词] 冠心病；经皮冠状动脉介入治疗；焦虑；抑郁；双心治疗

[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210（2017）10（b）-0028-04

Clinical study and present situation of the treatment of heart disease and psychology to the patients with coronary heart disease after percutaneous coronary intervention

LI Yiping WANG Xiaolong▲

Department of Cardiovascular， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Institute of Cardiovascular Disease， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai 201203， China

[Abstract] The morbidity and mortality rate of coronary heart disease （CHD） is on the rise in China， and percutaneous coronary intervention （PCI） is one of the main methods to diagnose and treat CHD. However， for most patients， the risk of disease and surgical treatment， stent-induced economic problems， postoperative restenosis， stent thrombosis and other factors will give the patients physical and mental burden， which are easy to generate anxiety， depression and other emotion problems， severe cases can even affect the efficacy and quality of life. Therefore， while physicians treat patients with active heart diseases， they also need pay attention to psychological problems that may accompany the heart diseases. And timely intervention by heart physicians can make the patient get the heart， psychological harmony and unity. This article mainly gives a brief summary of the related research progress on the psychological problems， causes， diagnosis and treatment after PCI.

[Key words] Coronary heart disease； Percutaneous coronary intervention； Anxiety； Depression； Treatment of heart disease and psychology

我國冠心病的发病率与病死率逐年升高，目前，经皮冠状动脉介入治疗（PCI）是诊断和治疗冠心病的重要方法之一。我国每年PCI手术量已超过50万，成功率高达91%～97%。PCI可有效缓解冠心病症状，极大地降低冠心病患者的病死率，改善预后[1]。但对部分患者而言，冠心病疾病本身、手术治疗的风险、支架造成的经济问题及术后可能出现的再狭窄、支架内血栓等因素都会给患者身心带来负担，易产生焦虑、抑郁等情绪，甚至可影响PCI术的疗效和患者的生存质量。2014年欧洲心脏学会（ESC）认为抑郁是心血管疾病的独立危险因素之一。与此同时，美国心脏学会（AHA）在Circulation中也强调了抑郁对于急性冠脉综合征患者的危险性[2]。……