Effect and follow-up study of cognitive behavioral therapy on patients with acute myocardial infarction and post-PCI anxiety disorder
认知行为疗法干预急性心肌梗死PCI术后恐动症患者的效果及随访研究

摘要

目的 探讨标准化认知行为疗法（CBT）联合常规护理对急性心肌梗死（AMI）合并恐动症患者运动恐惧水平、疾病知信行能力及日常生活自理能力的干预效果。方法 连续选取2023年6月-2025年6月乌鲁木齐某三甲医院心脏中心100例AMI行PCI术后评估为恐动症患者，每组各50例。对照组行常规护理，干预组加用标准化CBT干预，周期3个月。对比关键指标。结果 干预后两组TSK-SV Heart评分下降，知信行及BI评分上升，干预组变化幅度优于对照组，组别×时间交互作用显著（P<0.001）。出院后各时间点，干预组TSK-SV Heart评分、恐动症发生率均低于对照组，知信行及BI评分均高于对照组（P<0.05），GEE分析显示组别×时间交互项对恐动症发生率影响显著（P<0.001）。结论 标准化CBT联合常规护理可有效缓解患者运动恐惧，降低恐动症发生率，提升疾病知信行水平及自理能力，效果稳定可持续，标准化程度高、可复制，具有临床推广价值。

Abstract

Objective To explore the intervention effect of standardized cognitive behavioral therapy (CBT) combined with routine care on the movement fear level, disease knowledge, belief and behavior, and daily living self-care ability of patients with acute myocardial infarction (AMI) and post-PCI anxiety disorder.
Methods A total of 100 patients with AMI who underwent PCI and were diagnosed with post-PCI anxiety disorder in the cardiac center of a tertiary hospital in Urumqi from June 2023 to June 2025 were selected. Each group consisted of 50 patients. The control group received routine care, and the intervention group received standardized CBT intervention. The intervention period was 3 months. Key indicators were compared.
Results After intervention, the TSK-SV Heart scores of both groups decreased, and the knowledge, belief and behavior scores and BI scores increased. The change amplitude of the intervention group was better than that of the control group, and the interaction effect of group × time was significant (P < 0.001). At each time point after discharge, the TSK-SV Heart scores and the incidence of post-PCI anxiety disorder of the intervention group were lower than those of the control group, and the knowledge, belief and behavior scores were higher than those of the control group (P < 0.05). GEE analysis showed that the interaction term of group × time had a significant effect on the incidence of post-PCI anxiety disorder (P < 0.001).
Conclusion   Standardized CBT combined with routine care can effectively alleviate patients' movement fear, reduce the incidence of post-PCI anxiety disorder, improve the knowledge, belief and behavior level of the disease and daily living self-care ability, with stable and sustainable effects, high standardization and replicability, and clinical promotion value.