冠心病患者PCI术后全因死亡率、再入院率及其影响因素分析  

All-cause mortality,readmission rate and its influencing factors of patients with coronary heart disease after percutaneous coronary intervention

作　　者：赖敏华 李静芝 陈凌 申铁梅 崔虹 霍培霞 LAI Minhua;LI Jingzhi;CHEN Ling;SHEN Tiemei;CUI Hong;HUO Peixia(School of Nursing,Guangdong Pharmaceutical University,Guangzhou 510310,China;不详)

机构地区：[1]广东药科大学护理学院,广州510310 [2]广东省人民医院广东省医学科学院护理部,广州510080 [3]广东省人民医院广东省医学科学院心内七区,广州510080

出　　处：《实用医学杂志》2020年第6期801-807,共7页The Journal of Practical Medicine

基　　金：广东省大学生科技创新项目(编号:pdjhb0274)。

摘　　要：目的探索冠心病患者PCI术后1年的全因死亡率、再入院率及其影响因素。方法2018年3月至8月于广东某三级甲等综合医院心内科对166例住院冠心病患者进行问卷调查,采用自制的一般资料调查问卷收集其人口学及临床资料,采用抑郁自评量表(SDS)调查其抑郁水平现状,并记录患者出院前心肌二项、血脂四项等检验指标及B超下左心室心脏射血分数(LVEF)。2019年8月至9月对这166例患者进行电话访问,统计其PCI术后1年的全因死亡率和再住院率,并分析其影响因素。结果166例冠心病患者中,145例患者完成电话访问,PCI术后1年的全因死亡率为4.1%,其中心源性死亡率为2.1%。PCI术后1年的再入院率为6.2%,均为心源性再入院。冠心病患者的抑郁情绪阳性检出率为16.6%。Logistic回归分析结果显示,冠心病患者PCI术后1年的全因死亡率的影响因素为三酰甘油水平(TG)(OR=10.642,95%CI:1.083~104.584),PCI术后1年的再入院率的影响因素为四肢功能(OR=26.043,95%CI:2.328~291.330)。结论目前冠心病患者PCI术后1年的全因死亡率及再入院率不容乐观,相关因素是多方面的。三酰甘油水平异常是冠心病患者PCI术后1年全因死亡的危险因素,而四肢乏力是其PCI术后1年再入院的危险因素。提示临床医护人员在PCI术后护理及随访过程中应多关注冠心病患者的三酰甘油水平和四肢功能状况,及时发现不利因素,进而采取有效措施,以改善患者的预后结局和减少不必要的医疗费用支出。Objective To explore the all-cause mortality,readmission rate and its influencing factors of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods A total of166 CHD patients after PCI were recruited by convenience sampling from March to August 2018 in Guangdong Provincial People′s Hospital(GPPH).Self-rating depression scale(SDS)was used to assess the incidence of depression.Besides,a self-developed questionnaire was used for influencing factors evaluation.Follow-up was conducted by telephone calls.Clinical characteristics and clinical outcomes were analyzed.Results A total of 145 CHD patients completed the follow-up.Among them,6 patients died during the follow-up period,3 of whom died from cardiovascular diseases.The all-cause mortality rate was 4.1%and cardiogenic mortality rate was 2.1%.The one-year readmission rate after PCI was 6.2%,all of which were cardiogenic readmission.The positive rate of depression in CHD patients was 16.6%.According to the results of logistic regression analysis,differences were significant on triglyceride(OR=10.642,95%CI:1.083~104.584)in all-cause mortality and the influencing factor of the readmission rate was limb function(OR=26.043,95%CI:2.328~291.330).Conclusions The status of all-cause mortality rate and readmission rate of CHD patients after PCI is not optimistic among a Chinese sample and the influencing factors are multiple.Abnormal triglyceride levels are risk factors for all-cause death in CHD patients after one year of PCI,and limb weakness is a risk factor for re-admission after one year of PCI.It is suggested that clinical staff should pay more attention to the triglyceride level and limb function status of CHD patients during PCI postoperative care and follow-up,and take effective measures to improve the prognosis outcome and reduce unnecessary medical expenses.

关 键 词：冠心病 经皮冠状动脉介入治疗 全因死亡率 再入院率 抑郁 

分 类 号：R541.4[医药卫生—心血管疾病]