PCI对冠状动脉多支病变患者部分血运重建后短期生活质量的影响  

Impact of PCI on the short-term quality of life after incomplete revascularization in patients with multi-vessel coronary artery disease

作　　者：赵帅[1] 张政[1] 汪钦 杨茂森 朱伯达 李雅菁 徐绥宁 文亮 廉坤 李成祥[3] ZHAO Shuai;ZAHNG Zheng;WANG Qin;YANG Maosen;ZHU Boda;LI Yajing;XU Suining;WEN Liang;LIAN Kun;LI Chengxiang(Cadet Brigade,College of Basic Medicine,Air Force Medical University,Xi’an,Shaanxi 710032,China;Department of Biological Pharmacy,College of Pharmacy,Air Force Medical University,Xi'an,Shaanxi 710032,China;Department of Cardiology,Xijing Hospital,Air Force Medical University,Xi'an,Shaanxi 710032,China;Department of Cardiology,the First Affiliated Hospital of Xi'an Medical University,Xi'an,Shaanxi 710032,China)

机构地区：[1]中国人民解放军空军军医大学基础医学院学员队,陕西省西安市710032 [2]中国人民解放军空军军医大学药学系生物制药学教研室,陕西省西安市710032 [3]中国人民解放军空军军医大学西京医院心血管内科,陕西省西安市710032 [4]西安医学院第一附属医院心内科,陕西省西安市710032

出　　处：《中国动脉硬化杂志》2021年第6期468-474,共7页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金面上项目(81670229、81570210);国家自然科学基金青年项目(81600356、81702733);陕西省自然科学基金项目(2017JM8132);白求恩-默克糖尿病研究基金;陕西省科学技术研究发展计划项目(2016SF-034);陕西省重点研发计划一般项目-社会发展领域(2018SF-153)。

摘　　要：目的评价冠状动脉多支病变(MVD)患者接受经皮冠状动脉介入治疗(PCI)实现部分血运重建(IR)后短期生活质量的改善程度。方法连续纳入2018年4月—2019年11月在西京医院心血管内科成功行PCI的冠心病患者590例。依据冠状动脉造影(CAG)表现分为单支病变(SVD)组(n=138)和MVD组(n=452)。术前48 h应用SF-12量表和西雅图心绞痛量表(SAQ)对患者进行面对面的问卷调查,并且记录患者院内的基线数据包括年龄、性别、体质量指数(BMI)、血压、心率、主要诊断、既往病史、实验室数据及术后用药情况;术后1个月采用SF-12量表和SAQ进行电话随访问卷调查。通过比较两组患者PCI术前、术后量表得分来评价PCI对MVD患者部分血运重建后1个月的生活质量改善程度。结果与SVD组相比,MVD组患者年龄更大、急性冠状动脉综合征(ACS)发生率更高且患者有糖尿病史和脑血管病史的比例更高;空腹血糖、心肌肌钙蛋白I(cTnI)和N端脑钠肽前体(NT-proBNP)水平更高,术中造影剂用量更多(P<0.05);术后1个月,两组主要不良心血管事件(MACE)发生率相似(P>0.05)、NYHA心功能分级都显著改善(P<0.05),且两组患者PCI术后SF-12量表和SAQ的各个维度得分都较术前有显著升高,即患者的心绞痛症状和生活质量都出现了明显改善(P<0.05)。结论成功PCI治疗对MVD患者实现IR后短期生活质量有显著改善。Aim To evaluate the short-term improvement of quality of life in patients with multi-vessel coronary artery disease(MVD)one month after incomplete revascularization(IR)by percutaneous coronary intervention(PCI).Methods A total of 590 patients with coronary artery disease who underwent PCI successfully in Department of Cardiology of Xijing Hospital from April 2018 to November 2019 were included continuously in this study.According to the results of coronary angiography(CAG),the patients were divided into the single-vessel coronary artery disease(SVD)group(n=138)and the MVD group(n=452).SF-12 health survey and seattle angina questionnaire(SAQ)were used to conduct face-to-face questionnaire survey on the patients 48 hours before the operation.Meanwhile,the baseline data of the patients during hospitalization were recorded,including age,gender,body mass index(BMI),blood pressure,heart rate,main diagnosis,medical history,laboratory data and medicine.One month after PCI,SF-12 health survey and SAQ were used to conduct telephone follow-up questionnaire survey.By comparing the preoperative and postoperative scores of patients in the two groups,the improvement degree of quality of life in MVD patients was evaluated.Results Compared with SVD group,the patients in MVD group were older,had a higher incidence of acute coronary syndrome(ACS),a higher content of fasting blood glucose,cardiac troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP),a higher dosage of contrast agent,and a percentage of patients with diabetes history and cerebrovascular history(P<0.05).One month after PCI,the incidence of major adverse cardiac events(MACE)was similar in the two groups(P>0.05),and the NYHA cardiac functional classification was significantly reduced(P<0.05).Moreover,the scores of SF-12 health survey and SAQ in each dimension of the two groups were significantly higher than those before PCI,namely,the angina symptom and quality of life were significantly improved(P<0.05).Conclusion Successful PCI can significantly impr

关 键 词：冠状动脉多支病变 经皮冠状动脉介入治疗 生活质量 

分 类 号：R5[医药卫生—内科学]