老年冠脉支架植入术后心脏康复质量的影响因素

目的探讨影响老年冠脉支架植入术后心脏康复质量的相关因素。方法回顾性分析冠脉支架植入术治疗的168例老年患者的临床资料,术后6个月,上述入选者均需填写中国心血管患者生活质量评定问卷(CQQC),依据评估结果将其分为心脏康复质量良好组(143例)与心脏康复质量不良组(25例),记录其一般资料,分析影响老年冠脉支架植入术后心脏康复质量的相关因素。结果心脏康复质量不良组CQQC中体力、病情、医疗状况、一般生活、社会心理状况、工作状况、总分均明显低于心脏康复质量良好组,差异有统计学意义(P<0.05);两组介入支架个数、合并糖尿病、合并高脂血症、合并高血压、术后心肌梗死占比对比,差异无统计学意义(P>0.05);心脏康复质量不良组年龄(≥80岁)、累及冠状动脉血管支数(≥3支)、介入治疗次数(≥3次)、不合理饮食、缺乏运动、吸烟、便秘占比均明显高于心脏康复质量良好组,差异有统计学意义(P<0.05);通过Logistic回归分析发现,年龄(≥80岁)、累及冠状动脉血管支数(≥3支)、介入治疗次数(≥3次)、不合理饮食、缺乏运动、吸烟、便秘为影响老年冠脉支架植入术后心脏康复质量的危险因素(OR>1,P<0.05)。结论年龄、累及冠状动脉血管支数、介入治疗次数、不合理饮食等均为影响老年冠脉支架植入术后心脏康复质量的相关因素,临床可通过加强饮食、运动指导等方式帮助患者提高心脏康复质量。

Safety and predictors of adherence of a new rehabilitation program for older women with congestive heart failure

Objectives To assess the safety of a cardiac rehabilitation program for older women with Congestive Heart Failure （CHF） and determine if certain factors influence adherence. Methods Women over the age of 65 with CHF attended an exercise program supervised by a physiotherapist. Quality of life was measured by the Minnesota Living with Heart Failure Questionnaire （MLHFQ） and severity of disease by the New York Heart Association （NYHA） Class. Subjects were classified into those who attended 90% or more of the sessions and those who attended less than 90% of the sessions. Results Fifty-one subjects were studied. Eight subjects did not attend any sessions. Of the 43 attendees, the average percentage of sessions attended was 87%. There were no significant differences between the two groups in age, MLHFQ or NYHA Class. There was only one adverse event out of 280 participant attendances. Conclusions The program had a high level of adherence in this population. Age, MLHFQ or NYHA Class did not impact on session attendance. Our data suggests this program is safe for this population. Further research is needed to determine other predictors of attendance and the examination of safety issues and long-term adherence to exercise in this population.