心理因素在经皮冠状动脉介入术后老年患者运动耐量和睡眠质量的中介效应

Mediating effects of psychological factor on exercise tolerance and sleep quality in elderly patients after PCI surgery

中文关键词: 老年, 心理因素, 中介效应, 睡眠质量, 运动耐力, 经皮冠状动脉介入术

英文关键词: elderly  psychological factor  mediating effect  sleep quality  exercise tolerance  percutaneous coronary intervention

中文摘要:

      目的 探讨老年冠心病的患者在行经皮冠状动脉介入术后的运动耐量、睡眠质量和心理因素,进一步研究心理因素在运动耐量和睡眠质量之间的中介效应.方法 采取便利抽样的方法选取2022年6月-2023年6月在上海交通大学医学院附属新华医院心内科进行心肺运动试验(CPET)的老年冠心病行PCI术后的患者100例,采取心理量表评估患者的心理水平、采取一般资料问卷调查患者的一般状况、采取匹兹堡睡眠质量量表(PSQI)评估患者的睡眠质量、采取心肺运动试验的最大摄氧量(VO2max)评估运动耐力.结果 本研究中共纳入96例研究对象,PSQ1分值是8.00(6.25,9.00),患者可能有不同程度的睡眠问题,MAAS分值是65.00(60.25,70.25),中低水平,VO2max分值(1203.28±368.11)mL/min,水平较低.不同组别患者的VO2max、PSQI、MAAS、SDS及STAI分值比较差异无统计学意义(P＞0.05).96例研究对象的VO2max与MAAS正相关,PSQI与VO2max、MAAS、SDS及STAI与PSQI均为负相关,进一步研究患者的基础状态与心理因素、睡眠质量和运动耐量相关情况,发现心肌梗死病史和女性之间的相关性较强(P＜0.05).心理因素在PCI术后老年患者运动耐量和睡眠质量的中介效应进行分析,发现睡眠质量对运动耐量的预测效果明显(P＜0.05),纳入心理因素-正念注意觉知后,预测效果仍然明显差异均具有统计学意义(P＜0.05).结论 老年冠心病患者在行经皮冠状动脉介入术后睡眠质量对于运动耐力有积极作用,心理因素在运动耐力及睡眠质量之间具有中介作用.

英文摘要:

      Objective To investigate exercise tolerance,sleep quality and psychological factor in elderly patients with coronary heart disease after percutaneous coronary intervention(PCI),and further study the mediating effect of psychological factor on exercise tolerance and sleep quality.Methods A convenient sampling method was adopted to select 100 elderly pa-tients with coronary heart disease after PCI who underwent cardiopulmonary exercise test(CPET)in Department of Cardiolo-gy,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University from June 2022 to June 2023.A psychologi-cal scale was used to assess their psychological level,a general information questionnaire was used to investigate their general condition,the Pittsburgh Sleep Quality Inventory(PSQI)was used to assess their sleep quality,and the maximal oxygen up-take(VO2max)of CPET was used to assess their exercise tolerance.Results 96 subjects were included in this study.Their PSQI score was 8.00(6.25,9.00),indicating varying degrees of sleep problems.Their MAAS score was 65.00(60.25,70.25),which was medium to low.Their VO2max was(1203.28±368.11)mL/min,which was relatively low.There was no sta-tistically significant difference in VO2max,PSQI,MAAS,SDS and STAI among different groups of patients.VO2max was posi-tively correlated with MAAS,PSQI was negatively correlated with VO2max,MAAS,SDS and STAI was negatively correlated with PSQI.Further research on the correlation between patients'baseline status and psychological factor,sleep quality and exer-cise tolerance revealed a strong correlation between a history of myocardial infarction and females(P＜0.05).The mediating effects of psychological factor on exercise tolerance and sleep quality in elderly patients after PCI were analyzed,and it was found that sleep quality had a significant predictive effect on exercise tolerance(P＜0.05).After the inclusion of the psycho-logical factor-mindfulness of attention awareness,the prediction effect was still statistically significant(P＜0.05).Conclusion Sleep quality has a positive effect on exercise tolerance in elderly patients with coronary artery disease after PCI,and psycho-logical factor play a mediating role between exercise tolerance and sleep quality.