| 刘盈盈,胡经文,刘美丽,肖 玲,赵彩艳.老年冠心病患者经皮冠状动脉介入治疗术后衰弱的影响因素及其对认知功能和预后的影响[J].,2023,(11):2089-2093 |
| 老年冠心病患者经皮冠状动脉介入治疗术后衰弱的影响因素及其对认知功能和预后的影响 |
| Influencing Factors of Postoperative Frailty after Percutaneous Coronary Intervention and its Effect on Cognitive Function and Prognosis in Elderly Patients with Coronary Heart Disease |
| 投稿时间：2022-09-28 修订日期：2022-10-23 |
| DOI：10.13241/j.cnki.pmb.2023.11.017 |
| 中文关键词: 老年 冠心病 经皮冠状动脉介入 衰弱 影响因素 认知功能 |
| 英文关键词: Elderly Coronary heart disease Percutaneous coronary intervention Frailty Influencing factors Cognitive function |
| 基金项目:陕西省重点研发计划项目（2022SF-122） |
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| 中文摘要: |
| 摘要 目的：探讨老年冠心病患者经皮冠状动脉介入治疗（PCI）术后衰弱的影响因素及其对认知功能和预后的影响。方法：选取2019年3月~2021年3月期间本院收治的行PCI的老年冠心病患者134例。查阅相关问卷制定调查表，收集、整理患者资料，统计术后衰弱发生情况，衰弱的影响因素采用多因素Logistic回归分析。根据患者是否合并衰弱纳为衰弱组和非衰弱组，对比两组认知功能和预后情况。结果：接受PCI治疗的134例老年冠心病患者中，术后合并衰弱者92例，占比68.66%。未合并衰弱者42例，占比31.34%。合并衰弱的患者纳为衰弱组（n=92），未合并衰弱的纳为非衰弱组（n=42）。单因素分析显示，老年冠心病患者PCI术后衰弱与婚姻状况、年龄、放入支架数量、家庭人均月收入、饮酒史、文化程度、吸烟史、心功能分级、合并症种类数、体质量指数、营养状况、近1年跌倒史、焦虑情况、抑郁情况有关（P<0.05）。多因素Logistic回归分析结果显示：有饮酒史、年龄偏大、合并症种类数≥3种、心功能分级III级、有焦虑情况、文化程度小学及其以下、有抑郁情况、有近1年跌倒史、家庭人均月收入≤3000元、营养状况不良是老年冠心病患者PCI术后衰弱的危险因素（P<0.05）。衰弱组的非常规就诊发生率、全因死亡率、主要不良心血管事件发生率均高于非衰弱组（P<0.05）。衰弱组的简易智力状态检查量表（MMSE）评分低于非衰弱组（P<0.05）。结论：老年冠心病患者PCI术后衰弱的发生率较高，且受到年龄、家庭人均月收入、文化程度、饮酒史、合并症种类数、心功能分级、焦虑情况、抑郁情况、有近1年跌倒史、营养状况等因素的影响。衰弱会导致患者的认知功能下降以及不良预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the influence factors of frailty after percutaneous coronary intervention (PCI) and its influence on cognitive function and prognosis in elderly patients with coronary heart disease. Methods: 134 elderly patients with coronary heart disease who underwent PCI in our hospital from March 2019 to March 2021 were selected. The relevant questionnaires were consulted to develop the questionnaire, and the patient data were collected and sorted out, the occurrence of frailty after surgery was counted. The influencing factors of frailty were analyzed by multiple factors Logistic regression. According to whether the patients are combined with frailty, they are divided into frailty group and non-frailty group, the cognitive function and prognosis were compared in the two groups. Results: Among 134 elderly patients with coronary heart disease receiving PCI, 92 cases were complicated with frailty after surgery, accounting for 68.66%. There were 42 cases without frailty, accounting for 31.34%. Patients complicated with frailty were classified as frailty group (n=92), and those without frailty were classified as non-frailty group(n=42). Univariate analysis showed that the frailty of elderly patients with coronary heart disease after PCI was related to marital status, age, the number of stents inserted, per capita family monthly income, history of drinking alcohol, education level, smoking history, cardiac function grade, the number of complications, body mass index, nutritional status, fall history in the past 1 year, anxiety and depression(P<0.05). The results of multivariate Logistic regression analysis showed that: history of drinking alcohol, older age, number of complications≥3, grade III cardiac function, anxiety, education level of primary school or below, depression, fall history in the past 1 year, per capita family monthly income≤3000 yuan, poor nutritional status were the risk factors for fattening elderly patients with coronary heart disease after PCI (P<0.05). The incidence of irregular visits, all-cause mortality and Major adverse cardiovascular events in the frailty group were higher than those in the non-frailty group (P<0.05). The score of Mini-Mental State Examination (MMSE) in the frailty group was lower than that in the non-frailty group(P<0.05). Conclusion: The incidence of frailty in elderly patients with coronary heart disease after PCI is higher, and it is affected by age, family per capita monthly income, education level, history of drinking alcohol,number of complications, cardiac function grade, anxiety, depression, fall history of nearly 1 year, nutritional status and other factors. Frailty can lead to cognitive decline and a poor prognosis. |
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