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JACC:女性冠心病患者易受精神应激影响

2014-10-29 伊文 健康报网

JACC 上发表的一项研究发现,患有稳定型冠脉疾病的男性和女性患者应对精神应激所产生的生理和病理反应存在差异。如果该结论得以证实,将有助于解释为何女性冠心病患者(CAD)较男性更为严重,并为如何改善女性风险评估和治疗提供新的思路。 研究显示,完成三项应激性任务后,男性CAD患者较女性更容易发生血压和其他传统心血管疾病危险因素变化,而女性CAD患者更可能出现心脏血流灌注减少(例如精神应激诱

JACC 上发表的一项研究发现,患有稳定型冠脉疾病的男性和女性患者应对精神应激所产生的生理和病理反应存在差异。如果该结论得以证实,将有助于解释为何女性冠心病患者(CAD)较男性更为严重,并为如何改善女性风险评估和治疗提供新的思路。

研究显示,完成三项应激性任务后,男性CAD患者较女性更容易发生血压和其他传统心血管疾病危险因素变化,而女性CAD患者更可能出现心脏血流灌注减少(例如精神应激诱导心肌缺血)。另外,女性CAD患者激活血小板聚集增加更为明显,而且更易出现消极情绪。

在该探索性分析中,研究者发现了女性和男性对于精神应激明确的、可测量的以及不同的反应。由于精神应激诱导心肌缺血预后较差,因此本研究中观察到的女性发生率较高的现象需要进一步研究,因为这或许可以解释CAD患者中的“缺血悖论”——女性出现严重症状较少,但预后较差。

研究者认为,临床医生在评估患者心血管疾病风险时,应重视这些性别所导致的差异。同时,也需要更多的研究来进一步阐明心脏对精神应激反应的性别差异与长期临床转归之间的关系。

研究中纳入了56名女性和250名男性的数据。纳入研究的患者完成三项精神应激任务,分别是心算、反应追踪和愤怒回忆,随后进行踏车运动应激测试。另外,患者做评估抑郁、敌意、焦虑和社会应激的调查问卷,并在静息状态下和精神应激测试结束时采血测量血小板聚集。


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    2015-03-12 hbwxf
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