摘要
目的 探讨稳定性冠心病患者运动恐惧水平、心脏健康自我效能和自我管理量表(HH-SESM)评分与主要心血管不良事件(MACE)的关系,以期为降低患者MACE发生风险提供参考。方法 选取新疆医科大学第一附属医院2021年10月—2022年10月收治的437例稳定性冠心病患者,通过电话、门诊复诊等方式随访24个月,记录患者MACE发生情况。根据是否发生MACE分为MACE组(78例)与无MACE组(359例)。比较2组患者的一般资料及心脏病患者运动恐惧量表(TSK-SV Heart)评分和HH-SESM评分。采用Pearson相关分析TSK-SV Heart评分与HH-SESM评分的相关性。采用受试者工作特征(ROC)曲线分析TSK-SV Heart评分联合HH-SESM评分对稳定性冠心病患者MACE发生风险的预测价值。采用多因素logistic回归分析稳定性冠心病患者发生MACE的影响因素。结果 2组患者的性别构成和年龄比较,差异均无统计学意义(P>0.05);MACE组患者合并高血压、糖尿病、血脂异常比例及有吸烟史比例均高于无MACE组,差异均有统计学意义(P<0.05)。MACE组患者TSK-SV Heart评分高于无MACE组,而HH-SESM评分低于无MACE组,差异均有统计学意义(P <0.05)。Pearson相关分析结果显示,TSK-SV H eart评分与H H-SESM评分呈负相关(r=-0.192,P<0.05)。ROC曲线分析结果显示,TSK-SV Heart评分、HH-SESM评分以及二者联合预测MACE发生的曲线下面积(AUC)分别为0.892(0.851~0.933)、0.962(0.937~0.989)和0.986(0.965~0.997)。HH-SESM评分和二者联合预测稳定性冠心病患者发生MACE的效能高于TSK-SV Heart评分(Z=5.782、7.214,P=0.016、0.004)。多因素分析结果显示,TSK-SV Heart评分≥38.01分(OR=2.102,95%CI:1.504~2.939)和HH-SESM评分<49.98分(OR=0.556,95%CI:0.423~0.730)是稳定性冠心病患者发生MACE的影响因素(P<0.05)。结论 TSK-SV Heart评分和H H-SESM评分与稳定性冠心病患者MACE的发生密切相关,且二者联合评估对MACE发生风险的预测价值高于单一指标。临床应加强危险因素监测,动态评估患者的运动恐惧水平、自我效能及自我管理水平,以期早期识别MACE高风险患者,从而进行针对性干预。
Objective To investigate the relationship between kinesiophobia levels,Heart Health Self-Efficacy and Self-Man-agement Scale(HH-SESM)scores,and major adverse cardiovascular events(MACE)in patients with stable coronary arter-y disease(SCAD),providing references for reducing MACE risk.Methods A total of 437 SCAD patients admitted to the First Affiliated Hospital of Xinjiang Medical University from October 2021 to October 2022 were followed for 24 months via telephone and outpatient return visit to record MACE.Patients were assigned to MACE(n=78)and non-MACE(n=359)groups based on the presence or absence of MACE.General data,Tampa Scale for Kinesiophobia Swedish Version for the Heart(TSK-SV Heart)scores,and HH-SESM scores were compared.Pearson correlation was used to analyze TSK-SV Heart and HH-SESM score relationships.ROC curves were employed to evaluate their predictive value for MACE risk,and multivariate logistic regression was adopted to identify MACE influencing factors.Results No significant differences were noted in gender or age between groups(P>0.05).The MACE group had significantly higher proportions of hypertension,diabetes,dyslipidemia,and smoking history(P<0.05).TSK-SV Heart scores were significantly higher and HH-SESM scores were significantly lower in the MACE group as compared with the non-MACE group(P<0.05).Pearson correlation analysis showed a negative correlation between TSK-SV Heart and HH-SESM scores(r=-0.192,P<0.05).ROC analy-sis revealed area unoler the curve(AUC)values of 0.892(0.851-0.933)for TSK-SV Heart scores,0.962(0.937-0.989)for HH-SESM scores,and 0.986(0.965-0.997)for their combination.HH-SESM scores alone and combined demonstra-ted superior predictive efficacy versus TSK-SV Heart scores alone(Z=5.782,7.214;P=0.016,0.004).Multivariate a-nalysis identified TSK-SV Heart scores≥38.01(OR=2.102,95%CI:1.504-2.939)and HH-SESM scores<49.98(OR=0.556,95%CI:0.423-0.730)as influencing factors of MACE(P<0.05).Conclusion TSK-SV Heart and HH-SESM scores closely associate with MACE in SCAD patients.Combined assessment provides superior predictive value ver-sus either measure alone.Enhanced risk factor monitoring and dynamic evaluation of kinesiophobia,self-efficacy,and self-management are crucial for early identification and targeted intervention in high-risk patients of MACE.
作者
田晓苗
丁雪茹
王宝珠
梁敏
高敏雁
张吴琼
吴晶
姚娜
Tian Xiaomiao;Ding Xueru;Wang Baozhu;Liang Min;Gao Minyan;Zhang Wuqiong;Wu Jing;Yao Na(Cardiac Care Unit,Cardiovascular Disease Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《保健医学研究与实践》
2025年第8期8-13,共6页
Health Medicine Research and Practice
基金
新疆维吾尔自治区重点研发计划项目(2022B03022-5)。
关键词
运动恐惧
心脏健康自我效能和自我管理量表
稳定性冠心病
主要心血管不良事件
Kinesiophobia
Heart Health Self-Efficacy and Self-Management Scale
Stable coronary artery disease
Major adverse cardiovascular events
