收稿日期: 2019-01-05
网络出版日期: 2020-06-25
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
Received date: 2019-01-05
Online published: 2020-06-25
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。
陈馨, 刘莉莉, 倪靖炜, 徐刚, 权薇薇, 张智若 . 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[J]. 诊断学理论与实践, 2020 , 19(03) : 308 -313 . DOI: 10.16150/j.1671-2870.2020.03.019
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.
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