冠心病患者自我报告的生活质量现状及其影响因素分析

Self-reported quality of life in patients with coronary heart disease and analysis of the associated factors

目的:了解我国冠心病患者生活质量并分析其影响因素。方法:在2020年6月至9月对我国25个省市的冠心病患者进行横断面研究,使用问卷收集冠心病患者的一般资料,欧洲五维健康量表(EQ-5D)调查患者生活质量,多元线性回归探讨影响生活质量的因素。结果:共回收符合要求的调研问卷1075份,中位年龄60(52,67)岁,男性占74.1%(797例)。总人群EQ-5D指数中位得分0.7(0.5,0.8);EQ-视觉模拟量表(VAS)中位得分60.0(40.0,80.0)。在五个维度中,报告焦虑/抑郁的比例最高,为59.8%,自我照顾问题的比例最低,为35.8%。多元线性回归显示,女性、中老年、肥胖、有合并症、有焦虑抑郁、社交媒体渠道、冠状动脉旁路移植(CABG)治疗与EQ-5D评分呈负关联(均P<0.05);老年、有合并症、有抑郁、焦虑合并抑郁、社交媒体渠道、CABG治疗与EQ-VAS评分呈负关联(均P<0.05)。结论:我国冠心病患者一半以上生活质量评分偏低,与性别、年龄、肥胖、治疗方式、有无合并症、情绪状态有关。临床除关注传统社会人口学因素对生活质量的不良影响,也应多关注患者心理状态。同时,医患交流群可改善冠心病患者生活质量。

Objective To investigate the quality of life and associated factors in patients with coronary heart disease(CHD)in China.Methods A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020.A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD,while the European Five-dimensional Quality of Life Scale(EQ-5D)was used to assess the quality of life.Multiple linear regression model was performed to analyze the associated factors.Results The median age of the 1075 responders was 60(52,67)years,and 797(74.1%)were men.The EQ-5D and EQ-VAS indices were 0.7(0.5,0.8)and 60.0(40.0,80.0).Among the five dimensions in the quality of life scale,the frequency of anxiety/depression was the highest(59.8%),while problems in self-care was the lowest(35.8%).In the multiple linear regression model,female,increasing age,obesity,comorbidity(ies),anxiety/depression,social media channels,and receiving the CABG therapy were associated with the lower EQ-5D index(all P<0.05).In addition,increasing age,obesity,comorbidity(ies),depression,anxiety and depression,social media channels,and receiving the CABG therapy were associated with lower EQ-VAS index(all P<0.05).Conclusion Over half of the patients with CHD in China have a low quality of life,which is related to gender,age,obesity,treatment pathway,the presence or absence of comorbidity(ies),and psychological state.In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life,clinical practices should pay attention to the psychological state of patients.Moreover,establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.