经皮冠状动脉介入术术后患者的生活质量调查及相关影响因素

Survey on postoperative quality of life and influencing factors in patients treated with percutaneous coronary intervention

目的:探讨经皮冠状动脉介入术(percutaneous coronary intervention,PCI)对于冠状动脉粥样硬化性心脏病(冠心病)患者生活质量的影响。方法:连续纳入我院2018年4月至12月接受PCI治疗的冠心病患者99例,分别在PCI术后1个月和6个月时采用西雅图心绞痛问卷(Seattle Angina Questionnaire,SAQ)和患者健康问卷9(Patient Health Questionnaire-9,PHQ-9)(即抑郁症筛查量表)对其进行生活质量评估。根据人均植入支架数量(≤2枚和>2枚)、PCI次数(1次和>1次)、SYNTAX评分等级(轻危、中危、高危)对患者进行分组,采用多因素重复测量方差分析的方法,分析PCI治疗对患者的生活质量产生的影响。结果:研究发现,PCI术后6个月时患者的SAQ、PHQ-9评分均较术后1个月时有明显改善。在术后1个月时,患者的SAQ评分明显低于术后6个月时[(320.1±80.7)分比(380.3±46.8)分,P<0.01],而术后1个月时的PHQ-9得分明显高于术后6个月时[(6.7±5.3)分比(5.3±4.2)分,P<0.01)]。对植入支架数量、PCI次数及SYNTAX评分与SAQ和PHA-9评分间的交互影响进行分析,结果显示,患者PCI术后6个月时SAQ的改善不受其植入支架数量、PCI次数及SYNTAX得分的影响;患者PCI术后PHQ-9评分受植入支架数量及PCI次数的影响,即植入支架>2枚或接受多次PCI治疗的患者术后6个月抑郁程度改善不明显。结论:冠心病患者的生活质量在接受PCI术后6个月得到明显改善,SAQ评分的改善不受植入支架数量、PCI次数及SYNTAX评分的影响;PHQ-9评分则受支架植入数量及PCI次数的影响,植入多枚支架和多次接受PCI治疗的患者术后6个月的PHQ-9评分改善不明显。

Objective:To investigate the impact of percutaneous coronary intervention(PCI)on quality of life(QOL)in patients with coronary heart disease(CHD).Methods:A total of 99 patients with CHD treated with PCI from April to December 2018 were enrolled.The Seattle Angina Questionnaire(SAQ)and the Patient Health Questionnaire-9(PHQ-9)were performed to evaluate the quality of life(QOL)at 1 month and 6 months after PCI.QOL was assessed in respect to number of stents implanted(≤2 and>2),times of PCI(1 or>1)and SYNTAX score(light,medium and severe)using multi-factors and multi-levels of repeated measurements.Results:Both scores of SAQ and PHQ-9 were significantly improved at 6 months than those at 1 month after PCI.SAQ score was significantly lower at 1 month than that at 6 months(320.1±80.7 vs.380.3±46.8,P<0.01),while PHQ-9 score was significantly higher at 1 month than that at 6 months(6.7±5.3 vs.5.3±4.2,P<0.01).Furthermore,the interactive effects of number of stents implanted,times of PCI and SYNTAX score on the SAQ and PHA-9 scores were analyzed.The results showed that score of SAQ was not affected by the number of stents implanted,times of PCI and SYNTAX score 6 months after discharged from hospital.However,PHQ-9 score was affected by number of stents implanted and times of PCI.In patients with more than 2 stents implanted or multiple times of PCI,depression was not improved significantly at 6 months.Conclusions:The QOL is significantly improved at 6 months in patients treated with PCI.The improvement of SAQ score is not affected by number of stents implanted,times of PCI and SYNTAX score,while PHQ-9 is affected by number of stents implanted and times of PCI.In patients with multiple stents implanted or multiple times of PCI,the depression mood is not differed significantly between 1 month and 6 months after PCI.