| Objective:To investigate the quality of life (QOL) before and after drug-eluting stent (DES) implantation in patients with coronary heart disease (CHD); And to learn if there was a difference in QOL among patients in different ages, gender, educational level, payment method, place of residence, comorbidities, clinical diagnosis, left ventricular ejection fraction (LVEF), severity of coronary stenosis. And look for the factors affect the QOL, which would provide more targeted guidance for future treatment and rehabilitation of these patients.Methods:140patients with CHD treated in First Affiliated Hospital of Kunming Medical University were selected as object of the study. The patients were voluntary to accept coronary DES implantation for treatment. A questionnaire survey was conducted before and after DES implantation6months later with36-Item Short-Form (SF-36), Settle Angina Questionnaire (SAQ) and self-designed basic information questionnaire of patients. The patients were firstly divided into two groups according to the operative time, then within the group to compare that the QOL in patients of different age, gender, educational level, payment method, place of residence, comorbidities, clinical diagnosis, LVEF and severity of coronary stenosis, and these factors which affect the QOL were analyzed with physical component summary and mental component summary as dependent variable. All data were analyzed by the SPSS17.0software package and P<0.05was considered statistically significant.Results:140patients were enrolled in this study, a total of132patients completed the questionnaire after DES implantation for6months with a response rate of94.29%. Statistics show that:1. All dimensions of SF-36and SAQ in after6months group were better than the preoprative group.2. Considered age, gender, educational level, payment method, place of residence, comorbidities, clinical diagnosis, left ventricular ejection fraction, severity of coronary stenosis as the independent grouping criterion for comparison. the results showed that:(1) Preoperative:the patients whose age<60years had higher scores in physical functioning (PF) and vitality (VT) than those whose age≥60years; however, the scores of disease perception (DP) was lower. Postoperative:the patients whose age<60years had higher scores in PF, role-physical (RP), general health (GH), VT, mental health (MH), physical limited (PL), angina stability (AS), angina frequency (AF), treatment satisfaction (TS) and DP of than those whose age≥60years (P<0.05).(2) Preoperative:the male patients had lower scores in bodily pain (BP) and social function (SF) than female patients (P<0.05). Postoperative:the male patients had higher scores in PF, RP, MH and VT than female patients (P<0.05).(3) Preoperative:it was significantly different (P<0.05) in dimension of PF, GH, VT, MH for without and with complications or with more than one. Postoperative:complications were significantly different (P<0.05) in dimension of BP, GH. Then LSD-t test was used for pairwise comparison and found that QOL of without complication was higher than this with one complication, which was higher than more than one.(4) Preoperative:the patients diagnosed with chronic coronary artery disease had higher scores in BP, social functioning (SF), PL, AS and AF than acute coronary syndrome, and the difference disappeared after operation.(5) Preoperative:the patients of LVEF>50%had higher scores in PF,RP, VT,RE,AF and AS than patients of LVEF<50%. Postoperative:the patients of LVEF>50%had higher scores in RP,RE and AS than patients of LVEF≤50%.(6) Preoperative:coronary stenosis patients with low-risk group had higher scores in two dimensions of PF and PL than the middle-risk and high-risk group (P>0.05). and postoperative these difference were disappeared.(7) Preoperative:the patients of different education level, place of residence and payment methods had no difference in all dimensions of SF-36and SAQ. For postoperative, the same is true.(P>0.05).3. Comorbidities, body mass index (BMI), age were factors to the quality of life before drug-eluting stent implantation. Age, comorbidities, LVEF, gender and BMI were factors to the QOL after DES implantation for6months. The patients who had higher age, more comorbidities, lower LVEF, higher BMI would have lower QOL. Conclusion:1Coronary DES implatation can significantly improve the QOL in patients with CHD;2The QOL of patients with different age, gender, comorbidities, clinical classification, LVEF and coronary artery disease is different before and after operation for6months.3. The main factors affecting the QOL in patients with CHD before DES implantation are comorbidities, BMI and age, and that after operation for6months are age, comorbidities, LVEF, gender and BMI. |
