Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction--the Swedish version

When people's health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also investigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach's alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R's seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception.     

替格瑞洛与氯吡格雷对急性STEMI患者急诊PCI术后炎症因子的影响

为比较替格瑞洛与氯吡格雷对急性ST段抬高型心肌梗死（STEMI）患者急诊经皮冠状动脉介入术（PCI）术后炎症因子的影响,将176例急性STEMI且行急诊PCI术的患者分为替格瑞洛组（A组）58例、氯吡格雷常规组（B组）58例、氯吡格雷强化组（C组）60例,分别测定术前、术后12小时、术后7天、术后1个月、术后3个月、6个月时炎症因子e反应蛋白（CRP）、白细胞介素-6（IL6）、髓过氧物酶（MPO）、可溶性CD40受体（sCD40L）的含量,比较3组患者各炎症因子在不同时间点有无统计学差异。结果显示c组和A组较B组明显降低（P〈0．05）,有统计学意义,而A组较c组稍降低（P〉0．05）,但两者无统计学意义。由此可见,替格瑞洛的抗炎作用较常规剂量氯吡格雷作用明显增强,和强化剂量氯吡格雷作用相仿。     

急性心肌梗死患者院前延误的影响因素

急性心肌梗死(AMI)患者的治疗关键在于早期诊断和及时开通闭塞的冠状动脉,患者在发病后能否及早到院接受再灌注治疗,对患者的治疗效果和预后有重要影响.院前延误时间(PDT)即为从患者出现症状至到达医院接受治疗的时间.AMI患者就医大多是延迟的,主要原因是患者不能决定自己的症状是否需要治疗,也就是患者决定就医时间延长.本研究目的是分析造成急性心肌梗死患者院前延误的相关影响因素,为患者赢得最佳治疗时间提供理论依据.     

Type D personality predicts poor medication adherence in myocardial infarction patients

Type D personality, the combination of negative affectivity (NA) and social inhibition (SI), is an emerging risk factor in cardiovascular disease. This study aimed to examine one possible behavioural mechanism to explain the link between Type D and ill-health. It was hypothesised that Type D personality would predict medication adherence in myocardial infarction (MI) patients. In a prospective study, 192 MI patients (54 females and 138 males) completed measures of Type D personality and provided demographic and medical information 1 week post-MI, and then 131 patients went on to complete a self-report measure of medication adherence 3 months post-MI. It was found that Type D personality predicts adherence to medication, after controlling for demographic and clinical risk factors. Critically, the constituent components of Type D, NA and SI, interact to predict medication adherence, after controlling for the effects of each component separately. Poor adherence to medication may represent one mechanism to explain why Type D cardiac patients experience poor clinical outcome, in comparison to non-Type D patients. Interventions, which target the self-management of medication, may be useful in these high-risk patients.     

PCI治疗对急性心肌梗死患者外周血CD34＋干细胞变化影响的研究

研究经皮冠状动脉内介入治疗（percutaneous coronary intervention,PCI）对急性心肌梗死（acute myocardial infarction,AMI）患者外周血单个核CD34＋细胞（Peripheral Blood CD34-positive mononuclear cells,MN...     

心血管疾病发生的生物钟现象与时间治疗学

生物钟是生物为了适应其生存环境周而复始的变化（如昼夜变化、四季变化等）在长期进化过程中形成的机体固有节律。研究表明生物钟节律的异常参与了心血管疾病的发生、发展。因此通过研究血管疾病的发生与生物钟的关系,建立新的治疗方法,即时间治疗学,来治疗和预防心血管痰病。     

溶栓后PCI,从不行到可行

再灌注治疗STEMI的方法有直接PCI和溶栓。我国各地医疗条件差别较大,只有12%的STEMI患者能够及时接受直接PCI,超过半数的患者仍行溶栓治疗,故溶栓在我国再灌注策略中占有重要地位。虽然溶栓后即刻PCI即易化PCI被证实不如直接PCI,但溶栓并非STEMI治疗的终点。目前国外循证证据显示溶栓后早期转运PCI优于溶栓失败后再转运行补救PCI,值得我国借鉴学习。     

急性心肌梗死发病年轻化的因果分析

越来越多的中青年人因急性心肌梗死住院甚至猝死,其发病具有原因和结果的必然联系。过劳、不良生活习惯、吸烟、大量饮酒等原因都会使冠状动脉内斑块形成或冠状动脉痉挛而诱发急性心肌梗死。患者及医务工作者都应针对病因及发病机制积极治疗并有效预防,从而提高全民的心血管健康水平。     

抗心肌缺血损伤潜在治疗新靶点——线粒体

缺血预处理可减轻缺血对心肌造成的损伤,提高病人的生存能力。近年来的研究发现,缺血预处理最终通过位于心肌线粒体内膜上的几种蛋白通道发挥作用。因此,研究可调控这些重要通道功能的特异药物,对于预防和治疗缺血性心肌病具有重要的临床意义。线粒体将会成为一个有潜力的重要的治疗缺血性心脏病的新的药物作用靶点。     

盐酸戊乙奎醚对心脏瓣膜置换术患者NF-κB表达的影响

为研究盐酸戊乙奎醚对心脏瓣膜置换术患者心肌NF-κB转录活性的影响,选取择期瓣膜置换术患者60例,随机分为对照组（C）、盐酸戊乙奎醚组1（P1）、盐酸戊乙奎醚组2（P2）,每组20例。结果心肌缺血再灌注后,P1、P2组NF-κB的转录活性明显下降,可见盐酸戊乙奎醚可以抑制心肌NF-κB的激活,在一定程度上具有心肌保护作用。