152例非急性心肌梗死患者完全血运重建介入治疗后疲劳程度的影响因素

Factors influencing the degrees of fatigue after complete revascularization interventions in 152 patients with nonacute myocardial infarction

目的 调查研究完全血运重建介入治疗后非急性心肌梗死冠心病患者疲劳程度的影响因素。方法 收集152名完全血运重建介入治疗后第3个月患者的临床资料及心理自评量表,根据多维疲劳量表(MFI-20)将疲劳程度划为3个等级:轻度(20<MFI-20≤40),中度(40<MFI-20≤60),重度(MFI-20>60)。按观测指标在3个组间的频数分布进行单因素分析,有统计学意义及临床研究价值的指标纳入有序Logistic回归中分析影响因素。结果 以轻度疲劳组作为比较基线组,在调整性别、年龄和各项检查结果后,疲劳程度增加的危险因素为:Gensini评分(OR=0.984,95%CI:0.969~1.000,P=0.048)、糖化血红蛋白(OR=0.795,95%CI:0.651~0.971,P=0.025)、焦虑状态(OR=0.379,95%CI:0.122~0.850,P=0.043)、抑郁状态(OR=0.461,95%CI:0.205~0.965,P=0.041);疲劳程度减低的保护因素为:促甲状腺素(OR=1.251,95%CI:1.025~1.528,P=0.028)、血红蛋白(OR=1.027,95%CI:1.002~1.052,P=0.034)、睡眠质量(OR=13.531,95%CI:5.317~34.432,P<0.001)、运动等级(OR=7.389,95%CI:2.895~18.878,P<0.001)。结论 研究表明提高睡眠质量、增加运动等级、缓解焦虑抑郁状态、控制糖化血红蛋白、改善血液携氧状态及甲状腺功能可能改善疲劳症状,其中以改善睡眠质量及运动等级最为重要。

Objective To investigate the factors influencing the degrees of fatigue in patients with nonacute myocardial infarction after complete revascularization interventions.Methods Clinical data and psychological self-assessment scales were collected from 152 patients at the third month after complete revascularization interventions.Fatigue was classified into 3 levels according to the Multidimensional Fatigue Inventory(MFI-20):mild(20MFI-20≤40),moderate(40MFI-20≤60),and severe(MFI-2060).The observation indicators were assessed with univariate analysis,and those with statistical and clinical significance were included to Logistic regression model toidentify the influencing factors.Results With the mild fatigue group as the baseline group for comparison,after adjustment of gender,age and examination findings,the risk factors for increasing fatigue included Gensini score(OR=0.984,95%CI:0.969-1.000,P=0.048),glycosylated hemoglobin(OR=0.795,95%CI:0.651-0.971,P=0.025),anxiety status(OR=0.379,95%CI:0.122-0.850,P=0.043),and depressive status(OR=0.461,95%CI:0.205-0.965,P=0.041);protective factors for decreasing fatigue were thyrotropin(OR=1.251,95%CI:1.025-1.528,P=0.028),hemoglobin(OR=1.027,95%CI:1.002-1.052,P=0.034),sleep quality(OR=13.531,95%CI:5.317-34.432,P<0.001),and grade of physical exercise(OR=7.389,95%CI:2.895-18.878,P<0.001).Conclusion Improving sleep quality and increasing exercise grade,together with relieving anxiety and depression,controlling glycated hemoglobin,and improving blood oxygenation and thyroid function may improve fatigue symptoms.