老年冠心病PCI术后患者事件影响程度现状及其影响因素的Logistic回归分析

Logistic regression analysis of the current status of the degree of impact of events and its influencing factors in elderly patients after PCI for coronary artery disease

目的调查老年冠心病经皮冠状动脉介入(PCI)术后患者事件影响程度现状,进一步分析其影响因素,为制定针对性干预措施提供依据。方法选取2016年12月—2021年12月老年冠心病PCI术后患者200例,问卷调查事件影响程度现状,Logistic回归分析寻找事件影响程度的危险因素,运用LMG法对影响因素重要性进行排序;进一步运用依次检验法评价变量间的中介效应。结果①事件影响程度量表修订版(IES-R)总分为(33.25±6.78)分。②文化程度、家庭平均月收入、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、有需要处理的残余狭窄、社会支持评定量表(SSRS)评分、创伤后成长问卷(PTGI)评分是影响老年冠心病PCI术后患者事件程度的危险因素(P<0.05)。③PTGI评分与SSRS评分呈正相关(P<0.05);PTGI评分、SSRS评分与IESR评分均呈负相关(P<0.05)。④社会支持在创伤后成长与事件影响程度间发挥中介效应(β=0.463,P<0.05),中介效应占总效应比值的78.21%,故需重视社会支持这一中介变量和变量间的相互效应。结论冠心病、PCI术作为应激事件,对老年患者身心造成沉重打击,根据事件影响程度的影响因素,及时采取科学合理、有针对性的干预措施,进一步降低事件影响程度,可能对改善患者预后具有良好作用。

Objective To investigate the current status of event impact degree in elderly patients undergoing percutaneous coronary intervention(PCI),and further to analyze the influencing factors,so as to provide a basis for developing interventions to reduce the hazard of event impact degree.Methods 200 elderly patients with PCI from December 2016 to December 2021 were selected to investigate the current status of event impact degree by questionnaire,the independent risk factors of event impact degree were found by logistic regression analysis,and the importance of impact factors were ranked using LMG method;the mediating effect between variables were further evaluated using the sequential test.Results(1)Total IES-R score was(33.25±6.78).(2)Education level,mean monthly household income,SAS score,SDS score,presence of residual stenosis,SSRS score,and PTGI score were factors influencing the degree of event impact in elderly patients after PCI for coronary artery disease(P<0.05).(3)PTGI score was positively correlated with SSRS score(P<0.05);PTGI score,SSRS score and IES-R score were negatively correlated(P<0.05).(4)Social support played a mediating effect between post-traumatic growth and the degree of event impact(β=0.463,P<0.05),and the mediating effect accounted for 78.21%of the total effect ratio,so the mediating variable of social support and the interaction effect between variables need to be paid attention to.Conclusion Coronary heart disease and PCI as stressful events bring heavy blows to elderly patients physically and mentally,and timely scientific and reasonable interventions with targeted measures to further reduce the degree of event impact according to the influencing factors of the degree of event impact may have a good effect on improving the prognostic outcome of patients.