目的：探讨惊恐障碍与急性心肌梗死患者的心理社会因素特点，并分析二者的区别，以期为二者的鉴别、合理治疗提供理论依据。方法选取2012年1月—2014年11月就诊于福州神经精神病防治院的惊恐障碍患者和福建省立医院心内科的急性心肌梗死患者，按年龄、性别等进行1：1配对对照分为两组（即惊恐障碍组和急性心肌梗死组），共匹配成功48对。采用焦虑自评量表（SAS）、抑郁自评量表（SDS）、生活事件量表（LES）、社会支持评定量表（SSS）对两组患者的心理社会因素进行评估，并进行比较分析。结果两组正性生活事件得分间差异无统计学意义（P >0.05）；而惊恐障碍组负性生活事件得分及总分、焦虑得分均高于急性心肌梗死组，抑郁得分低于急性心肌梗死组，差异有统计学意义（P <0.05）。两组客观支持得分及总分间差异无统计学意义（P >0.05）；而惊恐障碍组主观支持、支持利用度得分低于急性心肌梗死组，差异有统计学意义（P <0.05）。结论惊恐障碍和急性心肌梗死患者发病前1年内均受到心理社会因素的影响；惊恐障碍患者受到的负性生活事件更多，且主观支持感及社会支持利用度差，焦虑情绪较重；急性心肌梗死患者抑郁情绪明显，但更善于利用社会支持。%Objective To investigate the psychosocial factors for patients with panic disorder and acute myocardial infarction and analyze the differences between the two diseases,in order to provide theoretical basis for the differentiation between them and rational treatment. Methods From January 2012 to November 2014,we enrolled patients with panic disorder from Fuzhou Neuro _ Psychiatric Hospital and patients with acute myocardial infarction from the Department of Cardiology of Fujian Provincial Hospital. Patients were assigned into panic disorder group and acute myocardial infarction group,forming 48 pairs based on 1: 1 match of age and gender. SAS,SDS,LES and SSS scales were used to evaluate the psychosocial factors for the patients,and comparison was made among the two groups. Results The two groups were not significantly different in the score of positive life events(P > 0. 05);panic disorder group was higher in the score of negative life events and total score,the score of anxiety and was lower in the score of depression than acute myocardial infarction group(P < 0. 05). The two groups were not significantly different in the score of objective support and total score(P > 0. 05);panic disorder group was lower than acute myocardial infarction group in the score of subjective support and the utilization degree of support(P < 0. 05). Conclusion Patients with panic disorder and acute myocardial infarction all had been influenced by psychosocial factors within one year before disease onset. Patients with panic disorder suffer from more negative life events,have worse use of the sense of subjective support and social support,and have severer anxiety. Patients with acute myocardial infarction have severer depression but have better use of social support.
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