急诊因素对急性心肌梗死患者发病后6个月生存质量的影响  

Clinical research on the emergency factors associated with health-related quality of life six months after acute myocardial infarction

作　　者：叶珩[1] 廖洪涛[2] 陈纯波[1] 曾红科[1] 方明[1] 何楷然[1] 黄国华[1] 詹伟锋[1] 胡北[1] 柳学[1] 林晓军[1] 孙诚[1] 

机构地区：[1]广东省人民医院急危重症医学部,广州510080 [2]广东省人民医院心内部,广州510080

出　　处：《中国实用内科杂志》2008年第1期28-31,共4页Chinese Journal of Practical Internal Medicine

基　　金：广东省科技计划项目(2003C30606)

摘　　要：目的探讨急诊因素对急性心肌梗死(AMI)患者发病后6个月健康相关生存质量的影响。方法应用SF-36量表对2003年10月至2005年12月广东省人民医院收治的89例急诊AMI患者发病后6个月的生存质量进行调查,通过多元线性回归分析和协方差分析筛选出影响AMI患者生存质量的急诊相关因素。结果SF-36量表总评分和躯体功能、躯体角色、一般健康状况、心理健康等维度评分与年龄呈负线性关系(P<0.05)。总评分和肌体疼痛、一般健康状况、生命力、情感角色、心理健康等维度评分与平均动脉压有正线性关系(P<0.05)。社会功能评分与干预时间呈负线性关系(P<0.05)。3个部位梗死患者的躯体角色评分低于单个、2个部位梗死患者(P<0.05);3个部位梗死患者的社会功能评分低于单个部位梗死患者(P<0.05);单个部位梗死患者的总评分高于2个部位梗死患者(P<0.05),也高于3个部位梗死患者(P<0.01)。直接介入治疗患者的生命力评分高于溶栓治疗患者(P<0.05)。结论急诊AMI患者发病时年龄大、平均动脉压低和梗死范围广与发病后6个月生存质量较低有关;尽早治疗和直接介入治疗与发病后6个月生存质量较高有关。Objective To identify the emergency factors associated with health-related quality of Iife（HRQOL）6 months after acute myocardial infarction. Methods HRQOL was assessed in 89 emergency patients 6 months after acute myocardial infarction,using the SF-36 health survey questionnaire. Multivariate linear regression analysis and analysis of covariance were＇ applied to data analysis to identify the emergency factors associated with HRQOL. Results The sum scores of the SF-36 health survey and scores on 4 of the 8 dimensions showed negative linear correlation with age （P 〈 0. 05）. The sum scores and scores on 5 of the 8 dimensions showed positive linear correlation with mean arterial pressure（ P 〈 0. 05）. The scores on social function dimension showed negative linear correlation with the time to treatment （ P 〈 0. 05 ）. The scores on role physical dimension of the patients with three locations infarct were lower than those of the patients with single location infarct or two locations infarct（P 〈0. 05）. The scores on social function dimension of the patients with single location infarct were higher than those of the patients with three locations infarct（P 〈0. 05）. The sum scores of the patients with single location infarct were higher than those of the patients with two locations infarct（P 〈0. 05）or three locations infarct（ P 〈 0. 01 ）. The scores on vitality dimension of the patients who received primary PCI were higher than those of the patients who received thrombolysis therapy（ P 〈 0. 05 ）. Conclusion Advanced age ,low mean arterial pressure and large infarct size are the emergency factors associated with poor HRQOL 6 months after acute myocardial infarction. Early treatment and primary PCI are the emergency factors associated with high HRQOL.

关 键 词：急诊 急性心肌梗死 健康相关生存质量 SF-36量表 

分 类 号：R5[医药卫生—内科学]