急性冠状动脉综合征患者 PCI 术后生活质量及影响因素的纵向研究

Objective To investigate the quality of life of acute coronary syndrome patients (ACS) preoperatively to 6 months postoperatively percutaneous coronary intervention (PCI) and analyze its changing trend and influencing factors so as to provide reference for the improvement of ACS patients after PCI and direct for patient health management. Methods The patients with ACS were investigated for their sociodemographic characteristics, disease data, behavior and lifestyle and quality of life with the Seattle Angina Scale (SAQ) of PCI before PCI, 1 month, 3 months and 6 months after the surgery by means of medical records, face-to-face or telephone follow-up. Results A total of 235 ACS patients were surveyed before PCI, and 213 (90.6%) of them who were successfully followed up to 6 months after PCI were included in this study, with a mean age of (62.67±9.18) years, and 76.1% being male. The results of the generalized estimation equation analysis showed that all the scores of the five dimensions of SAQ before PCI to 6 months after surgery, i.e., physical limitation (Wald χ2=83.118, P<0.001), angina stabilizaton stability (Wald χ2=289.369, P<0.001), angina frequency (Wald χ2=219.458, P<0.001), treatment satisfaction (Wald χ2=159.055, P<0.001), and disease perception (Wald χ2=130.839, P<0.001) increased overall (all P<0.001). However, the scores of physical limitation, angina stability and disease perception were only moderate at 6 months after surgery. The results of generalized linear model analysis showed that the factors affecting the quality of life before PCI to 6 months after PCI were gender, educational level, type of ACS, time to diagnosis, in-stent restenosis (ISR), tobacco smoking, and alcohol drinking. Conclusion The quality of life of the ACS patients gradually improved at 6 months after PCI, but the improvement effect of physical activity, angina stability and cognitive level was not ideal. Being female, low-level education, unstable angina, onset to diagnosis time 6 months or longer, occurrence of ISR, and postoperative tobacco smoking and alcohol drinking made patients have relatively low quality of life; therefore, more attention and guidance should be given to this group of population.