心力衰竭患者希氏束起搏术后的生活质量及精神状态调查分析

A survey on quality of life and mental state in patients with heart failure after His bundle pacing

目的探讨心力衰竭(下称心衰)患者希氏束起搏(HBP)术后生活质量变化及精神状态。方法选择2017年1月至2019年9月温州医科大学附属第一医院行HBP治疗的心衰患者109例,术前及术后1年应用中文版明尼苏达心衰生活质量量表(MLHFQ)进行生活质量评估。术后1年评估HBP特异相关的心理行为(HBP-SPB)。应用多元逐步回归分析MLHFQ总分的影响因素。结果与HBP术前比较,术后的身体领域评分、其他评分和MLHFQ总分均显著降低(均P<0.01),但情绪领域评分无明显降低。术后1年HBP-SPB评分为(45.5±7.6)分,90例(84.9%)患者HBP-SPB评分≥36分。多因素分析显示,文化程度低、无规律运动、合并糖尿病、缺血性心衰和纽约心脏协会(NYHA)心功能分级高是MLHFQ总分较高的独立影响因素(均P<0.05)。结论HBP有助于改善患者体质状态而非精神状态。

Objective To evaluate changes of quality of life and mental state in patients with heart failure after His bundle pacing(HBP).Methods A total of 109 heart failure patients underwent HBP treatment in the First Affiliated Hospital of Wenzhou Medical University from January 2017 to September 2017 were selected.The Chinese version of Minnesota living with heart failure questionnaire(MLHFQ)was used to evaluate the quality of life before and one year later after HBP.HBP-specific psychology and behavior(HBP-SPB)questionnaire was surveyed one year later.Multiple stepwise regression analysis was applied to explore the influencing factors of MLHFQ total score.Results The physical domain score,other score and MLHFQ total score,but not emotional domain score,were significantly lower post-HBP procedure than pre-HBP procedure(all P<0.01).The HBP-SPB score at 1 year after HBP was 45.5±7.6,and 90 patients(84.9%)showed HBP-SPB score≥36.Multivariate analysis showed that low education level,irregular exercise,diabetes,ischemic heart failure and high NYHA class were independent factors for higher MLHFQ score.Conclusion HBP may improve physical condition but not mental state of patients.