冠状动脉慢性完全闭塞合并多支血管病变患者经皮冠状动脉介入治疗术后的性别相关症状及生活质量差异分析  

Gender-related differences in symptoms and quality of life of patients with chronic total occlusion and multi-vessel disease after percutaneous coronary intervention

作　　者：魏志宏 朱伯达 禹天同 陈焱 韩鹏 张博晖 张玺 赵帅 李成祥 廉坤 WEI Zhi-hong;ZHU Bo-da;YU Tian-tong;CHEN Yan;HAN Peng;ZHANG Bo-hui;ZHANG Xi;ZHAO Shuai;LI Cheng-xiang;LIAN Kun(Department of Cardiology,Xijing Hospital,Air Force Medical University,Xi’an 710000,China;Primary Flight Training Base,Air Force Aviation University,Harbin 150100,China;Department of Cardiology,Number 971 Hospital of the PLA Navy,266000 Qingdao,China;Department of Cardiology,981 Hospital of Joint Logistics Support Force,Chengde 067000,China;Department of Cardiology,Air Force Hospital of Western Theater Command,Chengdu 610000,China)

机构地区：[1]空军军医大学第一附属医院心血管内科,陕西省西安市710000 [2]空军航空大学初级飞行训练基地 [3]中国人民解放军海军第九七一医院心血管内科 [4]联勤保障部队981医院心血管内科 [5]西部战区空军医院心血管内科

出　　处：《中国心血管病研究》2025年第1期22-28,共7页Chinese Journal of Cardiovascular Research

基　　金：陕西省重点研发计划重点产业创新链项目(2024SF-YBXM-004);青岛市医药卫生科研指导项目(2023-WJZD244);陕西省重点研发计划一般项目(2024GX-YBXM-136);西京医院医务人员培养助推项目(XJZT24LY39);空军军医大学临床研究项目(2022LC2208)。

摘　　要：目的评估成功行经皮冠状动脉介入治疗(PCI)后冠状动脉慢性完全闭塞(CTO)-多支血管病变(MVD)患者的性别相关症状和生活质量改善的差异。方法连续纳入2018年4月至2021年5月在空军军医大学第一附属医院行PCI的CTO-MVD患者,并将其分为男性组和女性组。收集患者的基线资料、呼吸困难和心绞痛症状和生活质量,分别采用Rose呼吸困难量表(RDS)和西雅图心绞痛问卷(SAQ)、SF-12量表、欧洲五维健康量表(EQ-5D)评估、手术资料以及1个月和1年随访资料。结果931例患者中男性占比87.11%,在1个月和1年的随访中,两组的症状均显著改善(P<0.01),男性患者的改善程度与女性相似(P>0.05)。同样,成功行PCI的患者在1个月和1年随访时显著提高了两组的生活质量(P<0.01),且两组的改善程度相似。但是,女性CTO-MVD患者在1年随访期间的全因死亡率高于男性(6.3%比12.6%,P=0.019)。结论尽管在1年随访时发现女性CTO-MVD患者的全因死亡率较高,但PCI仍可作为一种有效的策略,对男性和女性CTO-MVD患者的症状、生活质量和主要不良心血管事件(MACE)带来同等的益处。Objective To evaluate the differences in gender-related symptom and quality of life quesimprovements in patients with chronic total occlusion(CTO)-multi-vessel disease(MVD)following successful percutaneous coronary intervention(PCI).Methods Patients with CTO-MVD who underwent PCI at The First Affiliated Hospital of Air Force Medical University from April 2018 to May 2021 were consecutively included and divided into the male and female group.The baseline data,symptoms of dyspnea and angina,and quality of life were collected using the Rose dyspnea scale(RDS),Seattle angina questionnaire(SAQ),SF-12 scale,European quality of life-5 dimensions(EQ-5D),surgical data,and 1-month and 1-year follow-up data.Results Among 931 patients,the males accounted for 87.11%.At 1-month and 1-year follow-ups,symptoms in both the groups showed significant improvement(P<0.01),with the male patients showing similar levels of improvement as the females(P>0.05).Similarly,successful PCI significantly enhanced quality of life in the both groups at 1-month and 1-year follow-ups(P<0.01),with similar degrees of improvement observed between the 2 groups.However,the female CTO-MVD patients had a higher all-cause mortality rate during the 1-year follow-up period compared to the males(6.3%vs.12.6%,P=0.019).Conclusion Despite finding a higher all-cause mortality rate in the female CTO-MVD patients at the 1-year follow-up,PCI remains an effective strategy that provides equivalent benefits in terms of symptoms,quality of life and major adverse cardiovascular events(MACE)for both the male and female CTO-MVD patients.

关 键 词：慢性完全闭塞 多支血管病变 经皮冠状动脉介入治疗 性别相关差异 生活质量 

分 类 号：R54[医药卫生—心血管疾病]