冠状动脉介入术对冠心病患者生活质量影响的协方差分析

Covariance analysis on the change of quality of life affected by percutaneous coronary intervention for patients with coronary heart disease

目的联合使用丽种生活质量问卷SF-36和QOL-35，评价冠心病患者经皮冠状动脉腔内成形术（PCI）后3个月生活质量变化，探讨PCI对冠心病患者生活质量的影响。方法连续观察2008年3月在北京协和医院心内科住院患者61例，按照是否行PCI将患者分为两组。使用SF-36和QOL-35对患者生活质量进行评估，3个月后随访患者并再次评测生活质量，采用多元协方差分析评估PCI对冠心病患者生活质量的影响。结果24例非PCI组患者和37例PCI组患者性别（P=0．005）、心绞痛发作史（P=0．015）、吸烟史（P=0．037）和冠状动脉狭窄程度Judkins分级（P=0．001）的差异有统计学意义，其他临床基线资料的差异无统计学意义。用多元协方差分析控制基础水平的差异后，比较PCI对患者生活质量的影响，PCI对两组SF-36总分（P=0．044）、精神健康领域得分（P=0．003）、QOL-35总分（P=0．039）、社会功能领域得分（P=0．007）影响的差异有统计学意义。结论PCI能提高冠心病患者的生活质量。

Objective To compare changes of quality of life at 3 months from baseline among patients who underwent and did not undergo percutaneous coronary intervention （PCI）. Methods Sixty one patients with coronary artery disease, who were hospitalized in Cardiology Department in March 2008, were followed-up for 3 months after being discharged. SF-36 and QOL-35 were administered before PCI and at 3 months, Patients were divided into 2 groups according to whether they underwent PCI. Changes of quality of life scores between PCI and non-PCI groups were compared using analysis of covariance. Results There were 24 cases in non-PCI group and 37 in PCI group. Baseline characteristics were well balanced between PCI and non-PCI groups except gender （67.6% vs. 28.6% for male, P=0.005） , history of angina （56.8% vs. 23.8%, P=0.015） , smoking history（51.4% vs.23.8% ,P=0.037） and Judkins classification of coronary artery（P=0.001）. Multivariate analysis of covariance showed that the change of life quality between non-PCI group and PCI group in 3-months after discharge had statistical differences in total scores （P=0.044） and mental health scores （P= 0.003） of SF-36, total scores （P= 0.039） and social function scores （P= 0.007） of QOL-35. Conclusion PCI can improve life quality in patients with coronary artery disease.