术前SYNTAX积分与80岁及以上老年冠心病患者经皮冠状动脉介入前后生活质量改善的相关性研究

Predictive value of preoperative SYNTAX score on quality of life in over 80 years old patients with coronary atherosclerotic heart disease after percutaneous coronary intervention

目的探讨术前SYNTAX积分与80岁及以上冠心病(冠状动脉粥样硬化性心脏病)患者行经皮冠状动脉介入(PCI)前后生活质量改善的相关性。方法选择2015年1月至2016年12月在首都医科大学附属北京安贞医院住院并行PCI治疗的80岁及以上冠心病患者73例,在术前及PCI术后1年随访时采用西雅图心绞痛问卷(SAQ)对其进行生活质量评估。根据SYNTAX积分将患者分为低危组(51例,0~22分),中危组(14例,23~32分),高危组(8例,>32分)。分析术前SYNTAX积分与患者PCI治疗1年后SAQ量表各维度评分改善的相关性。结果术前高危组患者SAQ量表心绞痛稳定状态维度评分明显低于低危组和中危组,低危组患者心绞痛发作频次(AF)维度评分明显高于中危组和高危组(均P<0.05)。低危组术后1年SAQ量表AF维度评分改善程度明显低于中危组和高危组[(2±6)分比(15±25)、(19±12)分],差异有统计学意义(P<0.05)。多因素回归分析显示,SYNTAX积分与PCI术后1年SAQ量表的AF维度评分改善有关,SYNTAX积分每升高1分,AF维度评分改善0.409分(β=0.409,P<0.05)。结论术前SYNTAX积分与80岁及以上冠心病患者PCI术后1年SAQ量表AF维度评分改善有一定的相关性。

Objective To investigate the correlation between preoperative SYNTAX score and the improvement of quality of life in over 80 years old patients with coronary atherosclerotic heart disease(CHD)before and after percutaneous coronary intervention(PCI).Methods From January 2015 to December 2016,73 patients over 80 years old with CHD were enrolled in Beijing Anzhen Hospital,Capital Medical University.The quality of life was assessed by Seattle Angina Questionnaire(SAQ)before and 1 year after PCI.The patients were divided into low-risk group(n=51,0-22 scores),medium-risk group(n=14,23-32 scores)and high-risk group(n=8,>32 scores)according to SYNTAX score.The predictive value of SYNTAX score on the improvement of quality of life of patients before and after PCI was analyzed.Results Before operation,the anginal stability dimension score of SAQ in high-risk group was significantly lower than that in low-risk group and medium-risk group,and the anginal frequency(AF)dimension score in low-risk group was significantly higher than that in medium-risk group and high-risk group(all P<0.05).The improvement degree of AF dimension score of SAQ scale in low-risk group was significantly lower than that in medium-risk group and high-risk group[(2±6)vs(15±25),(19±12)],and the difference was statistically significant(P<0.05).Multivariate regression analysis showed that SYNTAX score was related to the improvement AF score of SAQ one year after PCI.For every 1 point increase in SYNTAX score,AF score improved by 0.409(β=0.409,P<0.05).Conclusion There is a certain correlation between preoperative SYNTAX score and AF dimension score of SAQ scale in over 80 years old patients with CHD after PCI.