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冠状动脉旁路移植术后的婚姻与长期生存。

Marriage and long-term survival after coronary artery bypass grafting.

机构信息

School of Nursing, University of Rochester, Rochester, NY 14642, USA.

出版信息

Health Psychol. 2012 Jan;31(1):55-62. doi: 10.1037/a0025061. Epub 2011 Aug 22.

Abstract

OBJECTIVE

To examine the effects of marital status and marital satisfaction on survival after coronary artery bypass grafting (CABG).

METHODS

Participants were 225 people who had CABG between 1987 and 1990. Marital status at the time of surgery and marital satisfaction 1 year after surgery were used to predict survival 15 years after surgery.

RESULTS

Married people were 2.5 times (p < .001) more likely to be alive 15 years after CABG than those who were not married. This finding was true for men and women, although the result for women was marginally significant adjusting for age. Those in high-satisfaction marriages were 3.2 times (p < .003) more likely to be alive 15 years after CABG compared with those reporting low marital satisfaction. Highly satisfied men were 2.7 times (p < .03) and highly satisfied women were 3.9 times (p < .15) more likely to be alive adjusting for age. Although the result was not significant for women, the effect size for marital satisfaction was actually larger for women than for men.

CONCLUSIONS

Being married, especially being in a highly satisfying marriage, offered a significant benefit to long-term survival after CABG. Why marital status and marital satisfaction have this effect on survival is surely mulitfactorial, most likely a combination of spousal support and survivor motivation to adopt a healthy lifestyle, along with the provision of emotional support to the survivor, which all could have the effect of modulating the physiologic mechanisms responsible for slowing the advancement of CVD.

摘要

目的

探讨婚姻状况和婚姻满意度对冠状动脉旁路移植术(CABG)后生存的影响。

方法

研究对象为 1987 年至 1990 年间接受 CABG 的 225 人。手术时的婚姻状况和手术后 1 年的婚姻满意度用于预测手术后 15 年的生存情况。

结果

已婚者在 CABG 后 15 年的存活率是未婚者的 2.5 倍(p<0.001)。这一发现对男性和女性均适用,尽管在调整年龄后,女性的结果仅略有统计学意义。处于高满意度婚姻中的患者在 CABG 后 15 年的存活率是报告低婚姻满意度的患者的 3.2 倍(p<0.003)。高满意度男性患者的存活率是低满意度男性患者的 2.7 倍(p<0.03),高满意度女性患者的存活率是低满意度女性患者的 3.9 倍(p<0.15),调整年龄后差异仍有统计学意义。尽管女性的结果没有统计学意义,但婚姻满意度对女性的影响实际上大于对男性的影响。

结论

已婚,尤其是处于高满意度婚姻中,对 CABG 后长期生存有显著获益。婚姻状况和婚姻满意度对生存产生影响的原因肯定是多方面的,最有可能是配偶的支持和幸存者保持健康生活方式的动力,以及为幸存者提供情感支持,这些因素都可能调节导致 CVD 进展缓慢的生理机制。

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