[Psychosomatic determinants of restenosis after percutaneous transluminal coronary angioplasty].

G Titscher, C Huber, O Ambros, M Gruska, G Gaul
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Abstract

Coronary Angioplasty (PTCA) has become one of the standard procedures in the therapy of coronary heart disease. One of the main issues is the 20-40% incidence of restenosis of the dilated vessel. Up to now, the subject of predictors of restenosis has not yet been sufficiently clarified. Our study is concerned with two questions; first, is it possible to prove any connections between the amount of restenosis and psychosocial factors? Second, is it possible to distinguish groups of patients with and without subsequent restenosis on the basis of psychosocial variables, even before the diagnostic coronary angiography? 138 (91m, 47f) patients were assessed before the diagnostic coronarangiography, the 25 PTCA-patients (20m, 5f) were furthermore reassessed three months after the PTCA (the time of the angiographic control). Somatic and social data were collected and a semistandardised interview was conducted. In addition, coping, stress-coping control over disease and health and life-contentment were determined. Highly significant correlations was found between the amount of restenosis and resignative stress-coping, self-pity, depressive coping and flight-tendency. With the help of stress-coping-subtests (which were given at the first examination) it was possible to separate the group of patients with restenosis from the group without it.

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[经皮腔内冠状动脉成形术后再狭窄的心身决定因素]。
冠状动脉成形术(PTCA)已成为冠心病治疗的标准手术之一。其中一个主要问题是20-40%的扩张血管再狭窄发生率。到目前为止,再狭窄的预测因素尚未得到充分的阐明。我们的研究涉及两个问题;首先,是否有可能证明再狭窄的数量与社会心理因素之间存在联系?第二,在诊断性冠状动脉造影之前,是否有可能根据社会心理变量来区分有和没有再狭窄的患者群体?138例(91m, 47f)患者在诊断性冠状动脉造影前进行评估,25例(20m, 5f) PTCA患者在PTCA后3个月(血管造影控制时间)再次进行评估。收集了身体和社会数据,并进行了半标准化访谈。此外,还测定了对疾病、健康和生活满意度的应对、压力应对控制。再狭窄的数量与顺从性压力应对、自怜、抑郁应对和逃跑倾向呈极显著相关。在压力应对亚测试(在第一次检查时进行)的帮助下,可以将再狭窄患者组与非再狭窄患者组分开。
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