诊断学理论与实践

诊断学理论与实践 ›› 2020, Vol. 19 ›› Issue (03): 308-313.doi: 10.16150/j.1671-2870.2020.03.019

• 论著 • 上一篇    下一篇

经皮冠状动脉介入术术后患者的生活质量调查及相关影响因素

陈馨1,2, 刘莉莉2, 倪靖炜2, 徐刚1, 权薇薇2(), 张智若1()   

  1. 1.上海交通大学公共卫生学院,上海 200025
    2.上海交通大学医学院附属瑞金医院心脏科,上海 200025
  • 收稿日期:2019-01-05 出版日期:2020-06-25 发布日期:2020-06-25
  • 通讯作者: 权薇薇,张智若 E-mail:springqww@163.com;zhangzhiruo@sjtu.edu.cn
  • 基金资助:
    上海交通大学“医工交叉研究基金”(YG2013MS31);中华医学会临床医学专项资金(14010120549)

Survey on postoperative quality of life and influencing factors in patients treated with percutaneous coronary intervention

CHEN Xin1,2, LIU Lili2, NI Jingwei2, XU Gang1, QUAN Weiwei2(), ZHANG Zhiruo1()   

  1. 1. School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
    2. Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2019-01-05 Online:2020-06-25 Published:2020-06-25
  • Contact: QUAN Weiwei,ZHANG Zhiruo E-mail:springqww@163.com;zhangzhiruo@sjtu.edu.cn

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摘要：

目的： 探讨经皮冠状动脉介入术（percutaneous coronary intervention,PCI）对于冠状动脉粥样硬化性心脏病（冠心病）患者生活质量的影响。方法： 连续纳入我院2018年4月至12月接受PCI治疗的冠心病患者99例,分别在PCI术后1个月和6个月时采用西雅图心绞痛问卷（Seattle Angina Questionnaire,SAQ）和患者健康问卷9（Patient Health Questionnaire-9,PHQ-9）（即抑郁症筛查量表）对其进行生活质量评估。根据人均植入支架数量（≤2枚和>2枚）、PCI次数（1次和>1次）、SYNTAX评分等级（轻危、中危、高危）对患者进行分组,采用多因素重复测量方差分析的方法,分析PCI治疗对患者的生活质量产生的影响。结果： 研究发现,PCI术后6个月时患者的SAQ、PHQ-9评分均较术后1个月时有明显改善。在术后1个月时,患者的SAQ评分明显低于术后6个月时[（320.1±80.7）分比（380.3±46.8）分,P<0.01],而术后1个月时的PHQ-9得分明显高于术后6个月时[（6.7±5.3）分比（5.3±4.2）分,P<0.01）]。对植入支架数量、PCI次数及 SYNTAX评分与SAQ和PHA-9评分间的交互影响进行分析,结果显示,患者PCI术后6个月时SAQ的改善不受其植入支架数量、PCI次数及SYNTAX得分的影响;患者PCI术后PHQ-9评分受植入支架数量及PCI次数的影响,即植入支架>2枚或接受多次PCI治疗的患者术后6个月抑郁程度改善不明显。结论： 冠心病患者的生活质量在接受PCI术后6个月得到明显改善,SAQ评分的改善不受植入支架数量、PCI次数及SYNTAX评分的影响;PHQ-9评分则受支架植入数量及PCI次数的影响,植入多枚支架和多次接受PCI治疗的患者术后6个月的PHQ-9评分改善不明显。

关键词: 经皮冠状动脉介入术, 生活质量, 支架数量, 治疗次数, SYNTAX评分

Abstract:

Objective: To investigate the impact of percutaneous coronary intervention (PCI) on quality of life (QOL) in patients with coronary heart disease (CHD). Methods: A total of 99 patients with CHD treated with PCI from April to December 2018 were enrolled. The Seattle Angina Questionnaire (SAQ) and the Patient Health Questionnaire-9 (PHQ-9) were performed to evaluate the quality of life (QOL) at 1 month and 6 months after PCI. QOL was assessed in respect to number of stents implanted (≤2 and >2), times of PCI (1 or >1) and SYNTAX score (light, medium and severe) using multi-factors and multi-levels of repeated measurements. Results: Both scores of SAQ and PHQ-9 were significantly improved at 6 months than those at 1 month after PCI. SAQ score was significantly lower at 1 month than that at 6 months (320.1±80.7 vs. 380.3 ±46.8, P<0.01), while PHQ-9 score was significantly higher at 1 month than that at 6 months (6.7±5.3 vs. 5.3±4.2, P<0.01). Furthermore, the interactive effects of number of stents implanted, times of PCI and SYNTAX score on the SAQ and PHA-9 scores were analyzed. The results showed that score of SAQ was not affected by the number of stents implanted, times of PCI and SYNTAX score 6 months after discharged from hospital. However, PHQ-9 score was affected by number of stents implanted and times of PCI. In patients with more than 2 stents implanted or multiple times of PCI, depression was not improved significantly at 6 months. Conclusions: The QOL is significantly improved at 6 months in patients treated with PCI. The improvement of SAQ score is not affected by number of stents implanted, times of PCI and SYNTAX score, while PHQ-9 is affected by number of stents implanted and times of PCI. In patients with multiple stents implanted or multiple times of PCI, the depression mood is not differed significantly between 1 month and 6 months after PCI.

Key words: Percutaneous coronary intervention, Quality of life, SYNTAX score

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