摘要
目的对冠心病患者经皮冠状动脉介入术(PCI)治疗后的心脏康复依从性现状及影响因素进行分析,并进行模型预测。方法选取2022年3月—2024年3月在江苏省人民医院接受PCI治疗的255例冠心病患者,调查了解其术后心脏康复依从性,并依此分为两组,96例依从性较差者设为对照组,159例依从性良好者设为观察组,对两组相关资料进行对比分析,对相应的单因素进行筛选后,实施Logistic回归分析,总结心脏康复依从性的影响因素。结果255例冠心病PCI术后患者,心脏康复依从性问卷总分(38.53±3.21)分。两组年龄、文化程度、抑郁、自我效能、家庭支持、社会支持情况比较,差异有统计学意义(均P<0.05);多元Logistic回归分析发现,冠心病患者PCI术后心脏康复依从性影响因素包括年龄、文化程度、抑郁、自我效能、家庭支持程度、社会支持程度(P<0.05)。构建预测模型,内部验证显示,受试者操作特征(ROC)曲线下面积为0.824(95%CI:0.755~0.894),灵敏度、特异度分别为82.70%、74.80%,校准曲线的拟合度较好,Hosmer-Lemeshow拟合优度检验显示,χ^(2)=7.591,P=0.425。结论冠心病患者PCI术后心脏康复依从性不够理想,年龄≥60岁、文化水平低、抑郁、自我效能低、家庭支持与社会支持度低是主要影响因素。构建的列线图预警模型可对冠心病患者PCI术后心脏康复依从性进行较好的预测,临床上可从这些方面入手实施干预,以促进其心脏康复依从性及有效性进一步提升。
Objective To analyze the status quo and influencing factors of cardiac rehabilitation compliance in patients with coronary heart disease after percutaneous coronary intervention(PCI),and conduct model prediction.Methods 255 patients with coronary heart disease who received PCI treatment in Jiangsu Provincie Hospital from March 2022 to March 2024 were selected to investigate their postoperative cardiac rehabilitation compliance,based on this,they were divided into two groups:96 patients with poor compliance were set as the control group,and 159 patients with good compliance were set as the observation group.The relevant data of the two groups were compared and analyzed.After screening the corresponding single factors,Logistic regression analysis was conducted to summarize the influencing factors of cardiac rehabilitation compliance.Results In 255 patients with coronary heart disease after PCI,the total score of cardiac rehabilitation compliance questionnaire was(38.53±3.21)points.There were significant differences in age,education level,depression,self-efficacy,family support and social support between the two groups(all P<0.05).Multivariate Logistic analysis found that the influencing factors for compliance of patients with coronary heart disease after PCI included age,educational level,depression,self-efficacy,family support and social support(P<0.05).Construct predictive model,internal validation shows that,the(receiver operating characteristic)ROC of area under the curve was 0.824(95%CI:0.755-0.894),and the sensitivity and specificity were 82.70%and 74.80%,respectively.The calibration curve had a good fit,and the goodness of fit Hosmer-Lemeshow test shows,χ^(2)=7.591,P=0.425.Conclusion Patients with coronary heart disease after PCI have unsatisfactory compliance with cardiac rehabilitation.Age≥60 years old,low educational level,depression,low self-efficacy,and low degree of family and social support are the main influencing factors.The constructed line chart warning model can predict the compliance of cardiac rehabilitation after PCI in patients with coronary heart disease.Clinical interventions can be implemented from these aspects to further improve the compliance and effectiveness of cardiac rehabilitation.
作者
杜瑶
张敏
马玉娇
王骋
DU Yao;ZHANG Min;MA Yujiao;WANG Cheng(Department of Cardiology,Jiangsu Province Hospital/the First Affiliated Hospital of Nanjing Medical University,Nanjing Jiangsu 210000,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第6期710-714,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
2023年江苏省老年健康科研项目(LKM2023001)。
关键词
冠心病
经皮冠状动脉介入术
心脏康复
依从性
影响因素
Coronary heart disease
Percutaneous coronary intervention
Cardiac rehabilitation
Compliance
Influencing factor
