冠心病患者经皮冠状动脉介入治疗后生活质量及其影响因素分析

摘要

Objective To study the quality of life and influence factors in the patients with coronary heart disease(CHD) after intracoronary setting.Methods 210 patients who had undergone successful percutaneous coronary intervention(PCI)were enrolled, including 58 females and 152 males. General information including gender, age, marital status, whether on duty, education, the payment method and the type of complication were collected before and past the operation. The Medical Outcomes Study Short-Form 36(SF-36) and the Seattle Angina Questionnaire(SAQ) were used to evaluate the quality of life(QOL) of those patients. The form was filled a day before and three months after PCI. The data were collected by telephone and structured interview. Variation of quality of life and influence factors were analyzed.Results There were totally 197 effective questionnaires, response rate was 93.8%. The score of SAQ of patients after PCI for three months were higher than that before PCI in all aspects (physical limitation, anginal stability, anginal frequency, quality of life) except treatment satisfaction (P<0.05). The scores of SF-36 of patients after PCI for three months are higher than that of patients before PCI in all factors (P<0.05). Age, education, and the amount of complications are the influence factors of quality of life before and after 3 months of PCI based on univariate analysis. Multiple factors analysis results showed that age and number of complications were associated with SF-36 and SAQ total score; SF-36 and SAQ are influence factors of total score, and whether convenient for medical treatment effect the influence factors of total score SAQ, convenient treatment was promoting factor of SAQ (P<0.05).Conclusions Internal carotid stenting could obviously improve the quality of life and reduce incident of angina. Age, culture level and the number of complications is the influence factors of CHD patients’ quality of life.%目的：探讨冠状动脉粥样硬化性心脏病（冠心病，CHD）患者经皮冠状动脉支架置入术后的生活质量及其影响因素。方法选取经皮冠状动脉介入治疗（PCI）的冠心病患者210例，其中女性58例，男性152例。在患者行PCI术前1 d收集患者一般资料，包括性别、年龄、婚姻状况、是否在职、文化程度、医疗付费方式、合并症种类，采用健康调查表SF-36（SF-36）及西雅图心绞痛问卷（SAQ）进行问卷调查，术后3个月门诊复查或电话随访，将术前、术后的生活质量积分进行对比，观察患者生活质量改变的情况。结果共回收有效问卷197份，应答率93.8%。与支架置入术前相比，SAQ除治疗满意程度这一维度外，其他四个维度（躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、疾病认知程度）的术后评分均比术前高，且差异均有统计学意义（P＜0.05）。健康调查表SF-36显示，术后各个维度的评分均比术前高，且治疗前后差异均有统计学意义（P＜0.05）。单因素分析显示，影响术前与术后3个月生存质量变化的因素有年龄、文化程度和合并症的数量。多因素分析显示年龄及合并症数量与SF-36及SAQ总评分均有关，是SF-36及SAQ总评分的影响因素，而是否方便就医如交通便利是影响SAQ总评分的影响因素，方便就医是SAQ的促进因素（P＜0.05）。结论行冠状动脉内支架置入术的患者，术后3个月内可减少心绞痛发生，生活质量明显改善。年龄、文化程度和合并症的数量是CHD患者生活质量的影响因素。