标题：急性心肌梗死患者的生活质量影响因素分析

      作者：苗婷，张新梅    (山东省立第三医院心内科，山东 济南 250031)

      卷次： 2018年29卷15期

      【摘要】 目的 探讨影响急性心肌梗死(AMI)患者生活质量的因素，为针对性护理干预提供科学依据。方法 收集 2015年 12月至 2017年 12月山东省立第三医院心内科收治的 100例AMI患者的临床资料，患者出院后 3~6个月内门诊复查时采用生活质量自评量表(WHOQOL-BREF)、焦虑自评量表(SAS)和家庭功能评估量表(APGAP)进行问卷调查，对调查结果分别进行单因素和多因素分析。结果 男性心理领域生活质量评分高于女性[(52.84±12.91)分 vs (47.11±11.02)分，P<0.05]，年龄小的患者生理领域生活质量得分高于年龄大的患者[(53.92±13.27)分 vs (48.07±12.76)分，P<0.05]，文化程度越高的患者心理和环境领域生活质量得分越高(P<0.05)，入院时心功能正常的患者生理和心理领域得分高于心功能差的患者(P<0.05)，入院次数少的患者心理和生理领域生活质量得分高于次数多的患者[(49.87±13.16)分 vs (44.01±12.73)分，P<0.05；(53.27±11.38)分 vs (48.49±11.01)分，P<0.05]，有医保的患者生活质量四个领域得分均高于自费患者(P<0.05)；家庭功能障碍和焦虑情绪越严重，生活质量得分越低(P<0.05)。Logistic回归分析结果显示，医疗费支付方式、入院时心功能、焦虑状态和家庭功能是AMI患者生活质量自我综合评分的影响因素(P<0.05)。结论 经济状况、支付方式、入院次数、入院时心功能等是AMI患者生活质量的影响因素，焦虑状况和家庭功能与AMI患者生活质量密切相关。
      【关键词】 急性心肌梗死；生活质量；影响因素
      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2018）15—2090—04

Study on factors affecting the quality of life in acute myocardial infarction patients.
MIAO Ting, ZHANG Xin-mei.Department of Cardiology, the Third Hospital of Shandong Province, Jinan 250031, Shandong, CHINA
【Abstract】 Objective To explore the factors affecting the quality of life in acute myocardial infarction(AMI) patients, and to provide a scientific basis for nursing intervention. Methods Clinical data of 100 AMI patientsfrom December 2015 to December 2017 were collected. WHOQOL-BREF, Self-rating Anxiety Scale (SAS) and Fami-ly Questionnaire Family on Function (APGAP) were evaluated during outpatient review 3~6 months after discharge.Investigation finding were statistically analyzed by univariate analysis and multivariate analysis. Results The psy-chological field score of males was significantly higher than that of females, (52.84±12.91) vs (47.11±11.02), P<0.05.The physiological field score of younger patients' was significantly higher than that of older patients, (53.92±13.27) vs(48.07±12.76), P<0.05. The psychological and environmental field scores were significantly higher in patients withhigher educational level than those in patients with lower educational level (P<0.05), and the psychological and physi-ological field scores were significantly higher in patients with normal cardiac function than patients with poor cardiacfunction (P<0.05). The psychological and physiological field scores were significantly higher in patients with fewertimes of admission than patients with more times of admission: (49.87 ± 13.16) vs (44.01 ± 12.73), P<0.05; (53.27 ±11.38) vs (48.49±11.01), P<0.05. The four field scores of quality of life were higher in patients with medical insurancethan the patients at their own expense (P<0.05). The more serious the family dysfunction and anxiety, the lower thescore of the quality of life (P<0.05). Logistic regression analysis showed that the way of payment for medical expens-es, cardiac function at admission, anxiety and family function were the influencing factors of self-comprehensivescore of AMI patients (P<0.05). Conclusion The economic status, the way of payment, the number of hospitaliza-tion and the cardiac function at admission are the influencing factors of the quality of life of AMI patients. Anxiety sta-tus and family function are closely related to the quality of life of AMI patients.
      【Key words】 Acute myocardial infarction; Quality of life; Influencing factors·论 著·doi:10.3969/j.issn.1003-6350.2018.15.006基金项目：山东省中医药科技发展计划项目(编号：2011-254)