JAHA:急性冠脉综合症患者焦虑和疼痛药物治疗与创伤后应激障碍症状风险的关系

2021-01-12 MedSci原创 MedSci原创

尽管苯二氮卓类药物在ACS期间有短期抗焦虑作用,但可能会增加ACS诱导的PTSS风险,从而影响患者的生活质量和预后。

在急性冠脉综合征(ACS)期间给予苯二氮平类药物和吗啡以缓解焦虑和疼痛,β阻断剂也可减轻疼痛。ACS可诱发创伤后应激障碍(PTSD)症状(PTSS)。当在创伤期间而非急性冠脉综合征时服用苯二氮卓类药物会增加ACS的风险,但尚不清楚苯二氮卓类药物是否会增加ACS患者的PTSS风险。近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员分析了ACS期间此类药物暴露对PTSS发生发展的影响。

研究参与者为154名确诊的ACS患者,通过病史、心理测量评估和患者记录获得基线人口统计数据、临床变量和心理测量指标,并在线性回归分析中用作协变量。ACS三个月后,研究人员使用临床医生管理的PTSD量表评估了受试者PTSS的严重程度。

在ACS期间,37.7%的患者暴露于苯二氮卓类药物,而72.1%的患者暴露于吗啡,88.3%的患者暴露于β阻断剂,但只有7.1%的患者暴露于抗抑郁药物。18例(11.7%)患者出现临床PTSD。调整所有协变量后,苯二氮卓类药物的使用与临床医生管理的PTSD量表总严重程度评分显著相关(非标准化系数B[SE]为0.589 [0.274];部分r=0.18;P=0.032)。调整急性应激障碍症状后,暴露于苯二氮卓类药物的患者发生临床PTSD的相对风险增加了近4倍(比值比为3.75;95%可信区间为1.31-10.77)。吗啡、β受体阻滞剂和抗抑郁药物没有预测价值。

由此可见,尽管苯二氮卓类药物在ACS期间有短期抗焦虑作用,但可能会增加ACS诱导的PTSS风险,从而影响患者的生活质量和预后

原始出处:

Roland von Känel.et al.Pharmacotherapy in the Management of Anxiety and Pain During Acute Coronary Syndromes and the Risk of Developing Symptoms of Posttraumatic Stress Disorder.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.018762

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    2021-01-13 明天jing

    焦虑是当年年轻人的共同问题,需要认真对待。

    0

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