高龄慢性心力衰竭患者负面情绪、生活质量及不良心血管事件现状及影响因素  

Current status and influencing factors of negative emotions,quality of life and major adverse cardiovascular events in elderly patients with chronic heart failure

作　　者：段咏梅[1] 安园园[2] 王洁 Duan Yongmei;An Yuanyuan;Wang Jie(Second Department of Coronary Heart Disease,Cardiology Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;First Department of General Medicine,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心血管疾病中心冠心病二科,乌鲁木齐830054 [2]新疆医科大学第一附属医院综合内一科,乌鲁木齐830054

出　　处：《中华老年多器官疾病杂志》2023年第11期852-856,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：新疆维吾尔自治区卫生计生委青年医学科技人才专项科研(WJWY-201835)。

摘　　要：目的调查高龄慢性心力衰竭患者负面情绪、生活质量及不良心血管事件(MACE)现状并分析其影响因素。方法将2021年1月至2022年6月新疆医科大学第一附属医院收治的180例高龄住院心力衰竭患者纳为研究对象。采用明尼苏达心力衰竭生活质量问卷(MLHFQ)调查其负面情绪及生活质量。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、方差分析及χ^(2)检验。采用Pearson或Spearman分析高龄心力衰竭患者不良情绪、生活质量以及MACE事件的相关性;采用多元线性回归分析了解影响高龄心力衰竭患者生活质量的相关因素。结果问卷有效回收率为96.11%(173/180)。调查发现,高龄心力衰竭患者MLHFQ总得分(55.67±10.24)分,焦虑、抑郁检出率分别为50.87%(88/160)及41.62%(88/160)。多元线性回归分析提示,慢性心力衰竭病程>5年、合并症>3种、心功能分级Ⅳ级是高龄患者MLHFQ得分的影响因素(Β=6.435,5.151,4.022;均P<0.05)。随访发现,发生MACE事件患者36例(22.50%)。相关性分析提示,焦虑/抑郁与高龄心力衰竭患者MLHFQ得分及MACE事件发生率呈正相关(r=0.377,0.352;P<0.05);MLHFQ得分与MACE事件发生率之间亦呈正相关(r=0.356;P<0.05)。结论高龄心力衰竭患者生活质量水平整体不高,焦虑、抑郁症状普遍,患者生活质量及焦虑/抑郁症状相互影响,并与其出院后MACE事件密切相关。Objective To investigate the current states of negative emotions,quality of life and major adverse cardiovascular events(MACE)in advanced elderly patients with chronic heart failure(CHF)and analyze the influencing factors.Methods A total of 180 very old hospitalized patients(80 years old and over)with heart failure from January 2021 to June 2022 in the First Affiliated Hospital of Xinjiang Medical University were enrolled as the study subjects.Minnesota living heart failure questionnaire(MLHFQ)was used to investigate the negative emotions and quality of life of the participants.SPSS statistics 20.0 was used for statistical analysis.Data comparison between two groups was performed using student′s t test,analysis of variance or Chi-square test depending on data type.Pearson or Spearman correlation analyses were applied to analyze the correlations of negative emotions and quality of life with occurrence of MACE.Multivariate linear regression model was constructed to analyze the related factors affecting the quality of life in the advanced elderly patients with heart failure.Results The effective recovery rate of questionnaires was 96.11%(173/180).Our survey found that the total score of MLHFQ was(55.67±10.24)points,and the detection rates of anxiety and depression were 50.87%(88/160)and 41.62%(88/160),respectively,in the subjected advanced elderly patients.Multivariate linear regression analysis showed that the course of CHF>5 years,number of comorbidities>3,and cardiac function gradeⅣwere influencing factors affecting the MLHFQ score of the patients(Β=6.435,5.151,4.022;all P<0.05).Follow-up revealed that 36 patients(22.50%)experienced MACE events.Correlation analyses indicated that anxiety/depression was positively correlated with MLHFQ score and incidence of MACE events(r=0.377,0.352;P<0.05),and MLHFQ score was also positively correlated with the incidence of MACE events(r=0.356;P<0.05).Conclusion The advanced elderly patients with heart failure had overall poor quality of life,and anxiety and depression are

关 键 词：老年人 高龄 心力衰竭 生活质量 焦虑 抑郁 不良心血管事件 

分 类 号：R259.416[医药卫生—中西医结合]