冠心病患者自我报告的生活质量现状及其影响因素分析  

Self-reported quality of life in patients with coronary heart disease and analysis of the associated factors

作　　者：刘业发 丁荣晶[1,2] 孟晓萍 王乐民[4] 申晓彧[5] 沈琳[6] 才晓君[7] 岳瑞华[8] 沈玉芹[4] 许丹焰 胡大一[1,2] Liu Yefa;Ding Rongjing;Meng Xiaoping;Wang Lemin;Shen Xiaoyu;Shen Lin;Cai Xiaojun;Yue Ruihua;Shen Yuqin;Xu Danyan;Hu Dayi(Heart Center,Peking University People′s Hospital,Beijing 100044,China;Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction,Beijing 100085,China;the First Hospital of Changchun Chinese Medicine University,Changchun 130000,China;Department of Cardiac Rehabilitation,Tongji Hospital Affiliated to Tongji University,School of Medicine,Tongji University,Shanghai 200092,China;Department of Cardiology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Geriatric Medicine,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Cardiology,Jinan Central Hospital,Jinan 250013,China;Department of Cardiology,the Medical Emergency Center of Chongqing City,Chongqing 400014,China;Department of Cardiology,Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]北京大学人民医院心脏中心,北京100044 [2]急性心肌梗死早期预警和干预北京市重点实验室,北京100085 [3]长春中医药大学附属医院心内科心脏康复中心,长春130000 [4]同济大学医学院同济大学附属同济医院心脏康复科,上海200092 [5]山西医科大学附属第二医院心血管内科,太原030001 [6]山东大学齐鲁医院老年医学科,济南250012 [7]济南市中心医院心内科,济南250013 [8]重庆市急救医疗中心心内科,重庆400014 [9]中南大学湘雅二医院心内科,长沙410011

出　　处：《中华内科杂志》2023年第4期384-392,共9页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金(81772446);北京大学人民医院研究与发展基金(RDL2021-06)。

摘　　要：目的:了解我国冠心病患者生活质量并分析其影响因素。方法:在2020年6月至9月对我国25个省市的冠心病患者进行横断面研究,使用问卷收集冠心病患者的一般资料,欧洲五维健康量表(EQ-5D)调查患者生活质量,多元线性回归探讨影响生活质量的因素。结果:共回收符合要求的调研问卷1075份,中位年龄60(52,67)岁,男性占74.1%(797例)。总人群EQ-5D指数中位得分0.7(0.5,0.8);EQ-视觉模拟量表(VAS)中位得分60.0(40.0,80.0)。在五个维度中,报告焦虑/抑郁的比例最高,为59.8%,自我照顾问题的比例最低,为35.8%。多元线性回归显示,女性、中老年、肥胖、有合并症、有焦虑抑郁、社交媒体渠道、冠状动脉旁路移植(CABG)治疗与EQ-5D评分呈负关联(均P<0.05);老年、有合并症、有抑郁、焦虑合并抑郁、社交媒体渠道、CABG治疗与EQ-VAS评分呈负关联(均P<0.05)。结论:我国冠心病患者一半以上生活质量评分偏低,与性别、年龄、肥胖、治疗方式、有无合并症、情绪状态有关。临床除关注传统社会人口学因素对生活质量的不良影响,也应多关注患者心理状态。同时,医患交流群可改善冠心病患者生活质量。Objective To investigate the quality of life and associated factors in patients with coronary heart disease(CHD)in China.Methods A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020.A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD,while the European Five-dimensional Quality of Life Scale(EQ-5D)was used to assess the quality of life.Multiple linear regression model was performed to analyze the associated factors.Results The median age of the 1075 responders was 60(52,67)years,and 797(74.1%)were men.The EQ-5D and EQ-VAS indices were 0.7(0.5,0.8)and 60.0(40.0,80.0).Among the five dimensions in the quality of life scale,the frequency of anxiety/depression was the highest(59.8%),while problems in self-care was the lowest(35.8%).In the multiple linear regression model,female,increasing age,obesity,comorbidity(ies),anxiety/depression,social media channels,and receiving the CABG therapy were associated with the lower EQ-5D index(all P<0.05).In addition,increasing age,obesity,comorbidity(ies),depression,anxiety and depression,social media channels,and receiving the CABG therapy were associated with lower EQ-VAS index(all P<0.05).Conclusion Over half of the patients with CHD in China have a low quality of life,which is related to gender,age,obesity,treatment pathway,the presence or absence of comorbidity(ies),and psychological state.In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life,clinical practices should pay attention to the psychological state of patients.Moreover,establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.

关 键 词：冠心病 生活质量 影响因素 

分 类 号：R541.4[医药卫生—心血管疾病]