急性心肌梗死患者PCI术后生活质量影响因素分析

Study on factors affecting the quality of life after discharge in acute myocardial infarction patients undergoing PCI

目的探讨急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗(PCI)出院后生活质量的相关影响因素。方法收集2015年4月—2016年4月心内科收治的108例行PCI治疗的AMI患者的临床资料。患者出院后3~6个月内门诊复查时行心肌梗死多维度评估量表(MIDAS)调查。对调查结果进行统计,分别进行单因素分析和多因素分析。结果就诊时间≤6 h、无合并症、无吸烟史、遵从医嘱的患者出院后MIDAS评分较低,差异有统计学意义(P<0.05或P<0.01)。以AMI患者出院后MIDAS评分为因变量,将性别、年龄、受教育程度、就诊时间、合并症、家庭人均月收入、吸烟史、合并心力衰竭、遵医行为这9个因素作为自变量,进行逐步回归分析,结果显示遵医行为与AMI患者出院后MIDAS评分存在复相关关系。结论遵医行为是影响AMI行PCI术患者出院后生活质量的主要影响因素。

Objective To investigate potential factors affecting the quality of life after discharge in patients with acute myocardial infarction（ AM I） receiving percutaneous coronary intervention（ PCI）. Methods Clinical data of 108 AM I patients receiving PCI from April 2015 to April 2016 were collected. M yocardial Infarction Dimensional Assessment Scale（ M IDAS） investigation was conducted during outpatient reviewafter discharge. Investigation findings were Statistical analyzed by univariate analysis and multivariate analysis. Results Patients with visiting time≤6h,in compliance with doctor＇s orders and without complications and smoking history got lower M IDAS score after discharge,and the difference was statistically significant（ P〈0. 05 or P〈0. 01）. A method of stepwise regression analysis was conducted on the patients discharged with AM I,in which M IDAS score was taken as the dependent variable,and nine factors including gender,age,education level,treatment time,complications,family income,smoking history,heart failure,compliance behavior were taken as independent variables. The results showed compliance behavior was in multiple correlation with M IDAS score after patients were discharged with AM I.Conclusion Compliance behavior is the main factor affecting the quality of life after discharge in patients with AM I receiving PCI.