心绞痛严重程度作为冠状动脉搭桥术后六个月生活质量变化的预测指标。

Severity of angina as a predictor of quality of life changes six months after coronary artery bypass surgery.

作者信息

Peric Vladan M, Borzanovic Milorad D, Stolic Radojica V, Jovanovic Aleksandar N, Sovtic Sasa R

机构信息

University of Pristina, School of Medicine, Internal Clinic, Kosova, Serbia and Montenegro.

出版信息

Ann Thorac Surg. 2006 Jun;81(6):2115-20. doi: 10.1016/j.athoracsur.2006.01.033.

DOI:10.1016/j.athoracsur.2006.01.033

PMID:16731139

Abstract

BACKGROUND

Although the fact that chest pain has a negative influence on the quality of life is well known, it is not completely clear whether the preoperative severity of angina can be a predictor of the quality of life change after coronary artery bypass grafting (CABG).

METHODS

We studied 243 consecutive patients who underwent elective CABG. The Nottingham Health Profile Questionnaire part 1 was used as the model for determination of quality of life. We distributed the questionnaire to all patients before and six months after coronary artery bypass surgery. Two hundred and twenty-six patients filled in the postoperative questionnaire. Severity of angina was estimated by Canadian Cardiovascular Society (CCS) classification of angina.

RESULTS

Quality of life (before and after CABG surgery) in all sections was significantly worse in patients with higher CCS angina class (p < 0.001). The CCS angina class was 1.89 +/- 0.97 at baseline and improved to 0.46 +/- 0.75 (p < 0.001) after CABG. Six months after the operation, quality of life significantly improved in patients with all classes of angina (p < 0.01). The improvement in quality of life was related to higher CCS angina class in sections of physical mobility (r = 0.4, p < 0.001), energy (r = 0.31, p < 0.001), and pain (r = 0.48, p < 0.001). High CCS angina class before CABG was an independent predictor of quality of life improvement after coronary artery bypass surgery in sections of physical mobility (p = 0.005; odds ratio [OR] = 2.11; confidence interval [CI] 1.25 to 3.55), energy (p = 0.021; OR = 1.77; CI 1.09 to 2.87), and pain (p < 0.001; OR = 3.99; CI 2.2 to 7.22).

CONCLUSIONS

Patients with higher CCS angina class had worse preoperative and postoperative quality of life. Patients with preoperative higher CCS angina class had greater improvement in sections of physical mobility, energy, and pain. High CCS angina class before CABG was the independent predictor of quality of life improvement six months after CABG.

摘要

背景

尽管胸痛对生活质量有负面影响这一事实众所周知，但术前心绞痛的严重程度是否可作为冠状动脉旁路移植术（CABG）后生活质量变化的预测指标尚不完全清楚。

方法

我们研究了243例连续接受择期CABG的患者。采用诺丁汉健康状况问卷第1部分作为生活质量测定模型。我们在冠状动脉旁路手术前和术后6个月向所有患者发放问卷。226例患者填写了术后问卷。通过加拿大心血管学会（CCS）心绞痛分级评估心绞痛的严重程度。

结果

CCS心绞痛分级较高的患者在所有方面的生活质量（CABG手术前后）均显著较差（p<0.001）。基线时CCS心绞痛分级为1.89±0.97，CABG术后改善至0.46±0.75（p<0.001）。术后6个月，所有心绞痛分级的患者生活质量均显著改善（p<0.01）。在身体活动能力（r=0.4，p<0.001）、精力（r=0.31，p<0.001）和疼痛（r=0.48，p<0.001）方面，生活质量的改善与较高的CCS心绞痛分级相关。CABG术前较高的CCS心绞痛分级是冠状动脉旁路手术后身体活动能力（p=0.005；优势比[OR]=2.11；置信区间[CI]1.25至3.55）、精力（p=0.021；OR=1.77；CI 1.09至2.87）和疼痛（p<0.001；OR=3.99；CI 2.2至7.22）方面生活质量改善的独立预测指标。