浏览全部资源
扫码关注微信
心房颤动患者的生活质量及其影响因素分析
Quality of life and its influencing factors in patients with atrial fibrillation
- 陆军军医大学学报 2022年44卷第18期 页码：1835-1844
- 作者机构：
1.401120 重庆，重庆医科大学附属第三医院心血管内科
2.400038 重庆，陆军军医大学(第三军医大学)：军事预防医学系军队流行病学教研室
3.400038 重庆，陆军军医大学(第三军医大学)：第一附属医院心血管内科
- 作者简介：
[ 钟理，E-mail：zhongli28@163.com ZHONG Li, E-mail: zhongli28@163.com
- 基金信息：国家自然科学基金面上项目(82073649)
DOI：10.16016/j.2097-0927.202203248
中图分类号： R195.4;R492;R541.75收稿：2022-03-28，
修回：2022-05-09，
纸质出版：2022-09-30
- 稿件说明：
移动端阅览
马嘉雪, 张琴, 曾晓娟, 等. 心房颤动患者的生活质量及其影响因素分析[J]. 陆军军医大学学报, 2022,44(18):1835-1844.
Jiaxue MA, Qin ZHANG, Xiaojuan ZENG, et al. Quality of life and its influencing factors in patients with atrial fibrillation[J]. Journal of Army Medical University, 2022, 44(18): 1835-1844.
马嘉雪, 张琴, 曾晓娟, 等. 心房颤动患者的生活质量及其影响因素分析[J]. 陆军军医大学学报, 2022,44(18):1835-1844. DOI： 10.16016/j.2097-0927.202203248.
Jiaxue MA, Qin ZHANG, Xiaojuan ZENG, et al. Quality of life and its influencing factors in patients with atrial fibrillation[J]. Journal of Army Medical University, 2022, 44(18): 1835-1844. DOI： 10.16016/j.2097-0927.202203248.
摘要
目的
2
调查心房颤动(简称房颤)患者的生活质量，探讨影响房颤患者生活质量的相关因素。
方法
2
采用房颤患者特异性汉化版房颤生活质量量表(Atrial Fibrillation Effect on Quality-of-Life，AFEQT)，对2016年6月至2021年3月在两所三甲医院心血管内科就诊的非瓣膜性房颤患者进行生活质量调查，采用多因素logistic回归分析与房颤患者生活质量相关的因素。
结果
2
共调查321例房颤患者。房颤患者生活质量的总分中位数
M
(四分位数
P
25
，
P
75
)为79.86(70.25，89.81)。针对生活质量不同维度的多因素logistic回归分析发现，吸烟史、升高的凝血酶时间(thrombin time，TT)、总蛋白(total protein，TP)和D-二聚体(D-dimer)水平是症状维度的危险因素，而有甲状腺功能障碍史则是保护因素；日常活动维度的危险因素包括高龄(≥65岁)、高血压病史、脑卒中病史、华法林药物史以及升高的TT，而饮酒可能是保护因素；有高血压病史，华法林、他汀药物史以及单核细胞(monocytes，MONO)水平和凝血酶原时间(prothrombin time，PT)升高的房颤患者的治疗担心维度评分显著下降，而活化部分凝血活酶时间比值(activated partial thromboplastin time ratio，APTT-ratio)升高是治疗担心维度评分的保护因素；延长的TT是治疗满意维度评分下降的危险因素，而有新型口服抗凝(novel oral anticoagulants，NOACs)药物史以及APTT-ratio升高是治疗满意维度评分下降的保护因素；生活质量总分下降的危险因素包括高龄(≥75岁)、脑卒中史、华法林和他汀药物史以及D-dimer水平，而饮酒以及较高的中性粒细胞(neutrophil，NEU)水平则是其保护因素。
结论
2
高龄(≥65岁)、吸烟史、华法林和他汀类药物史、高血压和脑卒中病史、升高的MONO、TP、TT、PT以及D-dimer水平等多种因素影响房颤患者生活质量的不同维度。
Abstract
Objective
2
To explore the quality of life and its influencing factors in patients with atrial fibrillation (AF).
Methods
2
The Chinese Atrial Fibrillation Effect on Quality-of-Life(AFEQT) questionnaire was used to investigate the quality of life in AF patients who had been treated in the Department of Cardiovascular Diseases of 2 tertiary Class A hospitals from June 2016 to March 2021. Multivariate logistic regression model was used to analyze the factors related to the quality of life in the patients.
Results
2
A total of 321 AF patients were investigated. The median of total score for quality of life was 79.86 (interquartile range: 70.25
89.81) in the AF patients. Multivariate logistic regression analysis on different dimensions of quality of life found that smoking history
elevated thrombin time (TT)
total protein and D-dimer levels were risk factors in the symptom dimension
while a history of thyroid dysfunction was a protective factor; risk factors in the daily activity dimension included advanced age (≥65 years)
hypertension history
stroke history
history of warfarin use
and prolonged TT
while alcohol consumption may be protective factors; the patients with history of hypertension
warfarin and statin use
and elevated monocyte (MONO) count and prolonged prothrombin time (PT) had significantly lower scores in the dimension of treatment of worried
while an activated partial thromboplastin time ratio (APTT-ratio) was a protective factor in the treatment of the worry score; prolonged TT was a risk factor for decreased treatment satisfaction scores; a history of novel oral anticoagulants (NOACs) and elevated APTT-ratio were protective factors for decreased treatment satisfaction scores; risk factors for decreased overall quality of life scores included advanced age (≥75 years)
history of stroke
warfarin and statin use
and D-dimer level
while alcohol consumption and higher neutrophil count were protective factors.
Conclusion
2
Advanced age (≥65 years)
smoking history
warfarin and statin history
hypertension
stroke history
elevated MONO
TP
TT
PT
and D-dimer level affect quality of life in AF patients in different dimensions.
关键词
Keywords
references
DU X, GUO L Z, XIA S J, et al . Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China[J ] . Heart, 2021, 107(7): 535-541. DOI: 10.1136/heartjnl-2020-317915.
JOHN CAMM A, LIP G Y H, DE CATERINA R, et al . 2012 focused update of the ESC Guidelines for the management of atrial fibrillation[J ] . Eur Heart J (2012), 33(21): 2719-2747. DOI: 10.1093/eurheartj/ehs253.
SPERTUS J, DORIAN P, BUBIEN R, et al . Development and validation of the Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) Questionnaire in patients with atri al fibrillation[J ] . Circ Arrhythm Electrophysiol, 2011, 4(1): 15-25. DOI: 10.1161/CIRCEP.110.958033.
HÄRDÉN M, NYSTRÖM B, KULICH K, et al . Validity and reliability of a new, short symptom rating scale in patients with persistent atrial fibrillation[J ] . Health Qual Life Outcomes, 2009, 7: 65. DOI: 10.1186/1477-7525-7-65.
KOTECHA D, AHMED A, CALVERT M, et al . Patient-reported outcomes for quality of life assessment in atrial fibrillation: a systematic review of measurement properties[J ] . PLoS One, 2016, 11(11): e0165790. DOI: 10.1371/journal.pone.0165790.
张欢, 钟理, 陈兴华, 等. 房颤特异性生活质量量表的汉化和信效度评价[J]. 现代预防医学, 2020, 47(3): 471-473, 478.
ZHANG H, ZHONG L, CHEN X H, et al . The chinesization of atrial fibrillation effect on quality-of-life questionnaire and its reliability and validity[J ] . Mod Prev Med, 2020, 47(3): 471-473, 478.
HINDRICKS G, POTPARA T, DAGRES N, et al . 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC[J ] . Eur Heart J, 2021, 42(5): 373-498. DOI: 10.1093/eurheartj/ehaa612.
何权瀛, 高莹慧. 关于吸烟问题若干名词定义[J]. 中华结核和呼吸杂志, 2009, 32(1): 26. DOI: 10.3760/cma.j.issn.1001-0939.2009.01.008.
HE Q Y, GAO Y H. Definition of several terms on smoking[J]. Chin J Tuberc Respir Dis, 2009, 32(1): 26. DOI: 10.3760/cma.j.issn.1001-0939.2009.01.008.
朱丹红, 马冠生. 适量饮酒与健康[J]. 国外医学(卫生学分册), 2006, 33(4): 244-247. DOI: 10.13325/j.cnki.acta.nutr.sin.2005.05.003.
ZHU D H, MA G S. Drink in moderation with health[J]. Foreign Med Sci Sect Hyg, 2006, 33(4): 244-247. DOI: 10.13325/j.cnki.acta.nutr.sin.2005.05.003.
WANG Y J, CHEN H, LIU B, et al . A systematic review on the research progress and evolving trends of occupational health and safety management: a bibliometric analysis of mapping knowledge domains[J ] . Front Public Health, 2020, 8: 81. DOI: 10.3389/fpubh.2020.00081.
GUHL E, ALTHOUSE A, SHARBAUGH M, et al . Association of income and health-related quality of life in atrial fibrillation[J ] . Open Heart, 2019, 6(1): e000974. DOI: 10.1136/openhrt-2018-000974.
WANG J, WANG Q, BAO Z P, et al . The combined effects of patient activation and relational aspects on the quality of life in atrial fibrillation patients[J ] . Front Psychol, 2021, 12: 761149. DOI: 10.3389/fpsyg.2021.761149.
DORIAN P, JUNG W, NEWMAN D, et al . The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy[J ] . J Am Coll Cardiol, 2000, 36(4): 1303-1309. DOI: 10.1016/s0735-1097(00)00886-x.
汪京嘉, 杜昕, 李玲, 等. 心房颤动患者生活质量及影响因素分析[J]. 心肺血管病杂志, 2014, 33(6): 799-803. DOI: 10.3969/j.issn.1007-5062.2014.06.012.
WANG J J, DU X, LI L, et al . An analysis on quality of life in patients with atrial fibrillation and its influencing factors[J ] . J Cardiovasc Pulm Dis, 2014, 33(6): 799-803. DOI: 10.3969/j.issn.1007-5062.2014.06.012.
袁志权, 邬娜, 向颖, 等. 体力活动与房颤患者预后和生活质量的关联研究[J]. 中华疾病控制杂志, 2021, 25(7): 829-836. DOI: 10.16462/j.cnki.zhjbkz.2021.07.017.
YUAN Z Q, WU N, XIANG Y, et al . Association study about physical activity and prognosis and quality of life in patients with atrial fibrillation[J ] . Chin J Dis Control Prev, 2021, 25(7): 829-836. DOI: 10.16462/j.cnki.zhjbkz.2021.07.017.
CHENG W H, LO L W, LIN Y J, et al . Cigarette smoking causes a worse long-term outcome in persistent atrial fibrillation following catheter ablation[J ] . J Cardiovasc Electrophysiol, 2018, 29(5): 699-706. DOI: 10.1111/jce.13451.
GALLAGHER C, HENDRIKS J M L, ELLIOTT A D, et al . Alcohol and incident atrial fibrillation—A systematic review and meta-analysis[J ] . Int J Cardiol, 2017, 246: 46-52. DOI: 10.1016/j.ijcard.2017.05.133.
袁志权, 张欢, 邬娜, 等. 外周血炎症因子与房颤患者生活质量的关联研究[J]. 第三军医大学学报, 2021, 43(13): 1286-1292. DOI: 10.16016/j.1000-5404.202012222.
YUAN Z Q, ZHANG H, WU N, et al . Correlation between peripheral blood inflammatory factors and quality of life in patients with atrial fibrillation[J ] . J Third Mil Med Univ, 2021, 43(13): 1286-1292. DOI: 10.16016/j.1000-5404.202012222.
STAERK L, SHERER J A, KO D, et al . Atrial fibrillation: epidemiology, pathophysiology, and clinical outcomes[J ] . Circ Res, 2017, 120(9): 1501-1517. DOI: 10.1161/CIRCRESAHA.117.309732.
SCHNABEL R B, YIN X Y, GONA P, et al . 50 y ear trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study[J ] . Lancet, 2015, 386(9989): 154-162. DOI: 10.1016/S0140-6736(14)61774-8.
HAEUSLER K G, KIRCHHOF P, KUNZE C, et al . Systematic monitoring for detection of atrial fibrillation in patients with acute ischaemic stroke (MonDAFIS): a randomised, open-label, multicentre study[J ] . Lancet Neurol, 2021, 20(6): 426-436. DOI: 10.1016/S1474-4422(21)00067-3.
PISTOIA F, SACCO S, TISEO C, et al . The epidemiology of atrial fibrillation and stroke[J ] . Cardiol Clin, 2016, 34(2): 255-268. DOI: 10.1016/j.ccl.2015.12.002.
REDDY V, TAHA W, KUNDUMADAM S, et al . Atrial fibrillation and hyperthyroidism: a literature review[J ] . Indian Heart J, 2017, 69(4): 545-550. DOI: 10.1016/j.ihj.2017.07.004.
CONNOLLY S J, EZEKOWITZ M D, YUSUF S, et al . Dabigatran versus warfarin in patients with atrial fibrillation[J ] . N Engl J Med, 2009, 361(12): 1139-1151. DOI: 10.1056/NEJMoa0905561.
SADANAGA T, SADANAGA M, OGAWA S. Evidence that D-dimer levels predict subsequent thromboembolic and cardiovascular events in patients with atrial fibrillation during oral anticoagulant therapy[J]. J Am Coll Cardiol, 2010, 55(20): 2225-2231. DOI: 10.1016/j.jacc.2009.12.049.
SPRONK H M H, DE JONG A M, VERHEULE S, et al . Hypercoagulability causes atrial fibrosis and promotes atrial fibrillation[J ] . Eur Heart J, 2017, 38(1): 38-50. DOI: 10.1093/eurheartj/ehw119.
DUNOIS C. Laboratory monitoring of direct oral anticoagulants (DOACs)[J]. Biomedicines, 2021, 9(5): 445. DOI: 10.3390/biomedicines9050445.
0
浏览量
0
下载量
0
CSCD
- 网络PDF下载
- Meta-XML下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies
