知觉压力在衰弱与老年冠心病患者PCI术后主要不良心血管事件间的中介效应  

Mediating effect of perceived stress between frailty and major adverse cardiovascular events in elderly patients with CHD after PCI

作　　者：左圆圆 孙亚召 ZUO Yuan-yuan;SUN Ya-zhao(Department of Cardiology,Cangzhou People's Hospital,Cangzhou,Hebei,061000,China)

机构地区：[1]沧州市人民医院心内科,河北沧州061000

出　　处：《心血管康复医学杂志》2025年第2期179-184,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:调查老年冠心病经皮冠状动脉介入治疗(PCI)患者知觉压力在衰弱与术后主要不良心血管事件(MACE)之间的中介作用。方法:采用便利抽样的方法选择2021年10月至2022年2月于沧州市人民医院心内科首次确诊冠心病且行PCI的270例老年患者,利用一般资料调查问卷、Fried衰弱表型、中文版知觉压力量表(CPSS),以及随访调查问卷对其进行调查。采用Logistic回归模型分析衰弱、CPSS评分与MACE之间的关系。采用双尾Spearman相关分析探索CPSS评分与衰弱以及MACE的相关性。采用R 4.2.2软件对知觉压力的中介效应进行检验。结果:PCI术后1年内MACE发生率为13.70%。多因素Logistic回归分析显示衰弱(OR=3.554,95%CI 1.332~9.485,P=0.011)、CPSS评分(OR=1.095,95%CI 1.038~1.154,P<0.001)是PCI术后老年冠心病患者发生MACE的独立危险因素。Spearman相关分析表明,CPSS评分与衰弱以及MACE均呈显著正相关(r=0.506、0.346,P均<0.001)。知觉压力在衰弱与PCI术后MACE之间起部分中介作用,中介效应占总效应的38.03%。结论:衰弱不仅直接影响老年冠心病患者PCI术后发生MACE,还可通过知觉压力间接影响MACE,临床应充分考虑衰弱和知觉压力对MACE的重要作用,及早识别并予以预见性干预。Objective:To investigate the mediating role of perceived stress between frailty and major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease(CHD).Methods:A convenience sampling method was employed to select 270 elderly patients who were first diagnosed as CHD and underwent PCI in Department of Cardiology,Cangzhou People's Hospital between October 2021 and February 2022.A comprehensive investigation was carried out using general demographic questionnaires,the Fried frailty phenotype scale,the Chinese version of perceived stress scale(CPSS),and follow-up questionnaires.The association among frailty,CPSS score and MACE was analyzed using Logistic regression model.Bidirectional Spearman correlation analysis was used to explore the association of CPSS score with frailty and MACE.The R 4.2.2 software was employed to examine the mediating effects of perceived stress on frailty.Results:Within one year after PCI,the incidence rate of MACE was 13.70%.Multivariate Logistic regression analysis indicated that frailty(OR=3.554,95%CI 1.332~9.485,P=0.011)and CPSS score(OR=1.095,95%CI 1.038~1.154,P<0.001)were independent risk factors for MACE in elderly CHD patients after PCI.Spearman correlation analysis indicated that CPSS score was positively correlated with frailty and MACE(r=0.506,0.346,P<0.001 all).Perceived stress partially mediated the relationship between frailty and MACE after PCI,accounting for 38.03%of the total effect.Conclusion:Frailty may directly affect MACE in elderly CHD patients after PCI,and indirectly affect MACE through perceived stress.Clinically,the significant roles of both frailty and perceived stress in MACE should be fully considered,and early identification should be conducted for predictive interventions.

关 键 词：冠心病 血管成形术 气囊 冠状动脉 虚弱 

分 类 号：R541.4[医药卫生—心血管疾病]