Objective To explore the impact of outside-hospital treatment compliance on long-term prognosis and quality of life of patients with acute myocardial infarction(AMI).Methods A total of 526 patients with AMI were selected in North Hospital of Xi′an from June 2008 to June 2011,and their clinical data was retrospectively analyzed,including heavy smoking rate,heavy drinking rate,incidence of hypertension,diabetes and hyperlipemia,and outside-hospital treatment compliance;all of the patients were followed up for 5 years,until to June 2016.Influencing factors of long-term prognosis of patients with AMI were analyzed by multivariate Cox regression analysis,and WHOQOL-BREF score were compared in patients with different outside-hospital treatment compliance.Results A total of 23 cases loss to follow-up,a total of 46 died due to non-cardiac causes,thus a total of 457 cases completed the follow-up,the 5-year survival rate was 68.0%(311/457).All of the 457 cases were divided into survival group(n=311)and death group(n=146)according to the prognosis,into A group(with good outside-hospital treatment compliance,n=381)and B group(with poor outside-hospital treatment compliance,n=76).No statistically significant differences of heavy smoking rate,heavy drinking rate or incidence of hyperlipemia was found between survival group and death group(P>0.05);incidence of hypertension and diabetes of survival group was statistically significantly lower than that of control group,respectively,while proportion of patients with good outside-hospital treatment compliance of survival group was statistically significantly higher than that of control group(P<0.05).Multivariate Cox regression analysis results showed that,hypertension〔RR=1.583,95%CI(1.114,2.254)〕 was independent risk factor of long-term prognosis of patients with AMI,while good outside-hospital treatment compliance 〔RR=0.234,95%CI(0.323,0.643)〕 was the independent protective factor(P<0.05).Physical domain score,psychological domain score,social relation domain score,environmental domain score and overall sensory score of A group were statistically significantly higher than those of B group(P<0.05).Conclusion Good outside-hospital treatment compliance is the independent protective factor of long-term prognosis of patients with AMI,meanwhile quality of life of AMI patients with good outside-hospital treatment compliance is relatively high.%目的 探讨院外治疗依从性对急性心肌梗死(AMI)患者长期预后及生存质量的影响.方法 选取2008年6月-2011年6月西安市北方医院收治的AMI患者526例,回顾性分析其临床资料,包括嗜烟率、嗜酒率、高血压发生率、糖尿病发生率、高脂血症发生率及院外治疗依从性;对所有患者随访5年,随访截至2016年6月,AMI患者长期预后的影响因素分析采用多元Cox回归分析;比较不同院外治疗依从性AMI患者世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分.结果 随访过程中失访23例,因非心因性原因死亡46例,共457例患者完成随访,其5年生存率为68.0%;根据预后将所有患者分为生存组311例和死亡组146例,根据院外治疗依从性将所有患者分为A组381例(院外治疗依从性良好)和B组76例(院外治疗依从性差).生存组与死亡组患者嗜烟率、嗜酒率及高脂血症发生率比较,差异无统计学意义(P>0.05);生存组患者高血压和糖尿病发生率低于死亡组,院外治疗依从性良好者所占比例高于死亡组(P<0.05).多元Cox回归分析结果显示,高血压〔RR=1.583,95%CI(1.114,2.254)〕是AMI患者长期预后的独立危险因素,院外治疗依从性良好〔RR=0.234,95%CI(0.323,0.643)〕是AMI患者长期预后的独立保护因素(P<0.05).A组患者生理领域、心理领域、社会关系领域、环境领域及总的感觉评分均高于院外治疗依从性差组(P<0.05).结论 院外治疗依从性良好是AMI患者长期预后的保护因素,且院外治疗依从性良好的AMI患者生存质量较高.
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