西雅图心绞痛问卷对冠心病患者生活质量的评估

Assessment of quality of life in patients with coronary artery disease with seattle angina questionnaire

目的采用西雅图心绞痛问卷（SAQ）对有心绞痛症状的冠心病患者生活质量进行评估，探讨影响患者生活质量的因素。方法以2007年12月至2008年12月在北京协和医院心内科住院并进行冠状动脉造影，且在就诊前1个月自觉有心绞痛症状的513例患者为研究对象，根据Judkins评分分为轻度，中度和重度病变组，比较不同组患者生活质量的差异。以SAQ各项指标得分为因变量，以年龄、性别、心肌梗死、心绞痛、高血压、糖尿病、左心室射血分数等进行多因素逐步回归分析，找出影响冠心病患者生活质量的因素。结果轻度、中度和重度病变组，活动受限程度评分分别为（80±16）分、（79±19）分和（71±22）分，差异有统计学意义（P〈0．01）。对于生活质量SAQ的5个指标，活动受限程度的影响因素为年龄（P〈0．01）、性别（P〈0．01）和冠脉病变程度（P〈0．01）；心绞痛稳定程度的影响因素为心肌梗死（P=0．03）；心绞痛发生情况的影响因素为心肌梗死（P=0．01）、性别（P=0．04）；治疗满意程度的影响因素为冠脉病变程度（P=0．03）；疾病认知程度的影响因素为糖尿病（P=0．03）。结论年龄、性别、心肌梗死、糖尿病、冠脉病变程度等是影响冠心病患者生活质最的主要因素。

Objective To evaluate quality of life （QOL） of patients with different severity of coronary artery disease using Seattle angina questionnaire（SAQ）. Methods A total of 513 hospitalized patients undergoing coronary angiography from December 2007 to December 2008 were included. QOL of these patients was measured with SAQ and their demographic and clinical data were collected. Patients were divided into 3 groups according to the severity of coronary artery disease by coronary angiography. And comparisons of traditional risk factors and QOL were made among these groups. Multiple linear regression analysis was conducted to identify the variables associated with QOL. Results The scores of physical limitation were significantly different among 3 groups according to the severity of coronary artery disease by coronary angiography（80± 16,79 ± 19 and 71 ± 22, P 〈 0. 01 ）. Multiple linear regression analysis showed that physical limitation of the patients was affected by age （ P 〈 0. 01 ）, gender（ P 〈 0. 01 ）and severity of coronary artery disease（P 〈0. 01 ）. Angina stability was affected by the history of myocardial infarction（P = 0. 03）. Angina frequency was affected by the history of myocardial infarction （ P = 0. 01 ） and gender（ P = 0. 04）. Treatment satisfaction was affected by the severity of coronary artery disease（ P=0. 03 ）and disease perception by the history of DM （P = 0. 03）. Conclusion Age, gender, history of myocardial infarction, history of DM and severity of coronary artery disease are independent predictors of QOL in patients with coronary artery disease.