老年主动脉瓣重度狭窄患者行经导管主动脉瓣置换术后生活质量及其影响因素分析

Analysis of quality of life and its influencing factors in elderly patients with severe aortic stenosis after transcatheter aortic valve replacement

中文关键词: 老年  主动脉瓣狭窄  重度  经导管主动脉瓣置换术  生活质量  影响因素

英文关键词: elderly  aortic valve stenosis  severe  transcatheter aortic valve replacement  quality of life  influencing factor

中文摘要:

      目的 分析老年主动脉瓣重度狭窄患者行经导管主动脉瓣置换术(TAVR)术后生活质量水平及其影响因素.方法 回顾性选取2020 年2 月—2023 年2 月于新疆医科大学第一附属医院行TAVR术治疗的180 例主动脉瓣重度狭窄患者作为观察对象;收集患者人口学资料及围术期资料;采用中国心血管病人生活质量评定问卷(CQQC)对患者术后生活质量进行评估,同时应用多元线性回归方法分析影响患者生活质量的独立相关因素.结果 180 例主动脉瓣重度狭窄患者TAVR术后CQQC问卷总分平均得分明显低于全国常模[(77.74±14.93)分vs(93.93±26.53)分](t =8.012,P＜0.001).单因素分析结果显示,CQQC问卷评分与患者年龄、文化程度、有无配偶、家庭月收入、术前NYHA分级、术后并发症、术后时间及服药依从性有关(P＜0.05),而与患者的性别、医疗支付方式、体质量指数(BMI)无关(P＞0.05).多元线性回归分析结果提示,患者年龄≥70 岁、术前NYHA分级Ⅲ/Ⅳ级、术后有并发症、术后时间≥2 年是主动脉重度狭窄患者TAVR术后生活质量水平的独立相关因素(P＜0.05).结论 主动脉瓣重度狭窄患者TAVR术后生活质量水平不高,年龄≥70 岁、术前NYHA分级Ⅲ/Ⅳ级、术后有并发症且时间≥2 年可能是影响患者术后生活质量水平的独立相关因素,临床上应加以重视.

英文摘要:

      Objective To analyze the quality of life and its influencing factors in elderly patients with severe aortic ste-nosis after transcatheter aortic valve replacement(TAVR).Methods A total of 180 patients with severe aortic stenosis who underwent TAVR in First Affiliated Hospital of Xinjiang Medical University from February 2020 to February 2023 were retro-spectively selected as the observation subjects.Their demographic and perioperative data were collected.Their postoperative quality of life was evaluated by the Chinese Questionnaire of Quality of Life in Patients with Cardiovascular Diseases Question-naire(CQQC).Multiple linear regression method was used to analyze the independent related factors affecting patients'quality of life.Results The mean total CQQC score of 180 patients with severe aortic stenosis after TAVR was significantly lower than that of the national norm[(77.74±14.93)points vs(93.93±26.53)points](t =8.012,P＜0.001).The results of univariate analysis showed that CQQC score was related to patients'age,education level,spouse,family monthly income,pre-operative NYHA grade,postoperative complications,postoperative time and medication compliance(P＜0.05),but not relat-ed to patients'gender,medical payment modes and body mass index(BMI,P＞0.05).The results of multiple linear regres-sion analysis indicated that age of patients≥70 years old,preoperative NYHA gradeⅢ/Ⅳ,postoperative complications,and postoperative time≥2 years were independent related factors(P＜0.05)for the postoperative quality of life of patients with severeaorticstenosis(P＜0.05).Conclusion The quality of life is poor in patients with severe aortic valve stenosis after TAVR.Age≥70 years old,preoperative NYHA grade Ⅲ/Ⅳ,and postoperative complications and postoperative time≥2 years may be independent related factors affecting the postoperative quality of life of patients.More clinical attention should be paid to these factors in clinical practice.