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Received:November 07, 2023 Published Online:October 20, 2024
Received:November 07, 2023 Published Online:October 20, 2024
中文摘要: 目的 调查风湿性心脏瓣膜病患者术后自我感受负担及心理脆弱程度，分析二者之间的关系及患者预后的影响因素。
方法 选取2019年6月至2022年6月于西京医院手术治疗的88例风湿性心脏瓣膜病患者作为研究对象。采用一般资料调查表以及自我感受负担量表（SPBS）、心理脆弱量表（MVQ）调查患者一般情况、自我感受负担与心理脆弱程度。采用门诊复诊或电话进行随访，了解患者术后全因死亡、因不良心血管事件住院或死亡情况，随访时间截至2023年6月。根据术后全因死亡、因不良心血管事件住院或死亡与否分为预后良好组（n=65）和预后不良组(n=23)。Pearson相关性分析风湿性心脏瓣膜病患者术后自我感受负担与心理脆弱程度的关系，对比两组相关临床资料、SPBS评分和MVQ评分，logistic多因素回归分析风湿性心脏瓣膜病患者术后预后不良的影响因素。
结果 两组年龄、术前心功能分级、SPBS评分、MVQ评分对比，差异均有统计学意义（P＜0.05）。Logistic多因素回归分析显示，年龄≥60岁（OR=1.487,P=0.002）、术前心功能分级为Ⅲ～Ⅳ级（OR=1.709, P=0.039）、SPBS评分（OR=1.180, P=0.016）和MVQ评分升高（OR=1.110, P=0.043）均是风湿性心脏瓣膜病患者术后预后不良的独立影响因素。Pearson相关性分析显示，风湿性心脏瓣膜病患者SPBS评分与MVQ评分呈正相关（r=0.589， P＜0.01）。
结论 风湿性心脏瓣膜病患者术后SPBS评分与MVQ评分具有相关性，年龄大、术前心功能分级高、SPBS评分及MVQ评分高均是其预后不良的独立危险因素。
Abstract:ObjectiveTo investigate the self-perceived burden and psychological vulnerability of patients with rheumatic valvular heart disease after operation, and analyze the relationship between them and their influence on the prognosis of patients.
Methods A total of 88 patients with rheumatic valvular heart disease treated by surgery in Xijing Hospital from June 2019 to June 2022 were selected as the study subjects. The general situation questionnaire, self-perceived burden scale (SPBS) and mental vulnerability questionnaire (MVQ) were used to investigate the general situation, self-perceived burden and psychological vulnerability. Follow-up was conducted by outpatient visit or telephone to obtain all-cause death, hospitalization or death due to adverse cardiovascular events after surgery. The follow-up time was up to June 2023. According to postoperative all-cause death, hospitalization or death due to adverse cardiovascular events, the subjects were divided into good prognosis group (n=65) and poor prognosis group (n=23). Pearson correlation analysis was used to analyze the relationship between postoperative self-perceived burden and psychological vulnerability in patients with rheumatic valvular heart disease. The clinical data, SPBS score and MVQ score were compared between two groups. Multivariate logistic regression analysis was used to analyze the influencing factors of poor prognosis in patients with rheumatic valvular heart disease.
Results There were significant differences in age, preoperative cardiac function classification, SPBS score and MVQ score between the two groups (P＜0.05). Multivariate logistic regression analysis showed that age ≥60 years old (OR=1.487, P=0.002), preoperative cardiac function grade Ⅲ-Ⅳ (OR=1.709, P=0.039), high SPBS score (OR=1.180, P=0.016) and high MVQ score (OR=1.110, P= 0.043) were independent influencing factors of poor prognosis in patients with rheumatic valvular heart disease. Pearson correlation analysis showed that SPBS score was positively correlated with MVQ score in patients with rheumatic valvular heart disease (r=0.589, P＜0.01).
Conclusion Postoperative SPBS score is correlated with MVQ score in patients with rheumatic valvular heart disease. Older age, higher preoperative cardiac function classification, higher SPBS score and MVQ score are independent risk factors for their poor prognosis.
keywords: Rheumatic heart valvular disease Cardiac valve replacement Self-perceived burden Psychological vulnerability Prognosis
文章编号： 中图分类号：R654.2 R395 文献标志码：B
基金项目:国家自然科学基金项目（82270526）
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