家庭动力对慢性心力衰竭患者出院后生活质量及心功能的影响

Effect of family dynamics on quality of life and cardiac function in patients with chronic heart failure for discharged patients

目的探讨家庭动力对慢性心力衰竭(CHF)出院患者生活质量及心功能的影响。方法选取2016年5月-2017年12月在新疆医科大学第一附属医院心脏中心就诊的539例CHF患者作为研究对象。采用家庭动力学评分将患者分为高家庭动力学组及低家庭动力学组。2组患者分别于出院时至出院6个月内每月采用明尼苏达心力衰竭生活质量问卷(MLHFQ)测量其生活质量,并对2组不同心功能患者出院及出院后每月血清N末端脑钠肽(NT-proBNP)水平及2组患者治疗规范率、再入院率进行比较。结果不同心功能分级的低家庭动力组和高家庭动力组患者生活质量得分比较差异无统计学意义(P均>0.05)。出院6个月后各心功能分级的低家庭动力组患者生活质量得分均高于高家庭动力组患者生活质量得分,差异均具有统计学意义(P均<0.05)。心功能Ⅱ级患者第4、5、6个月高家庭动力组血清NT-proBNP水平低于低家庭动力组,差异具有统计学意义(P均<0.05)。心功能分别为Ⅲ、Ⅳ级患者出院第3、4、5、6个月高家庭动力组血清NT-proBNP水平均低于低家庭动力组,差异具有统计学意义(P均<0.05)。高家庭动力组患者规范化治疗率明显高于低家庭动力组患者且再入院率明显低于低家庭动力组,差异具有统计学意义(P均<0.05)。结论高家庭动力学可改善慢性心力衰竭患者的生活质量、心功能,提高患者治疗规范率,减少再入院率。

Objective To explore the effects of family dynamics on quality of life and cardiac function in chronic heart failure(CHF) patients after discharge. Methods A total of 539 CHF patients were enrolled from May 2016 to December 2017 in the Heart Center of the First Affiliated Hospital of Xinjiang Medical University. The patients were divided into high family dynamics group and low family dynamics group by family dynamics score. The quality of life(QOL) was measured by Minnesota Heart Failure Quality of Life Questionnaire(MLHFQ) every month from discharge to half a year after discharge, and the levels of serum N-terminal brain natriuretic peptide(NT-proBNP) were compared between the two groups. Results There was no significant difference in quality of life between low and high family dynamics groups with different cardiac function classifications(P>0.05). Six months after discharge, the scores of QOL in low family dynamics group were higher than those in high family dynamics group(P<0.05). The serum NT-proBNP level of the high family dynamics group was lower than that of the low family dynamics group in the 4 th, 5 th and 6 th month of cardiac function class II patients, and the difference was statistically significant(P<0.05). The levels of NT-proBNP in the high family dynamics group were lower than those in the low family dynamics group(P<0.05). The standardized treatment rate of the high family dynamics group was significantly higher than that of the low family dynamics group, and the readmission rate was significantly lower than that of the low family dynamics group(P<0.05). Conclusion High family dynamics can improve the quality of life and cardiac function of patients with chronic heart failure, improve the standard rate of treatment and reduce readmission rate.