稳定性冠心病患者疲劳现状及认知状况调查分析
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摘要
目的分析稳定性冠心病患者疲劳现状及认知状况。方法选取2016年7月至2018年5月于本院住院的稳定性冠心病患者600例为研究对象。采用多维疲劳量表(multidimensional fatigue inventory 20,MFI-20)评价患者疲劳情况,采用匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)评价患者睡眠质量,采用医院焦虑抑郁量表(hosipital anxiety and depression scale,HADS)评价患者焦虑和抑郁发生情况。统计稳定性冠心病患者疲劳发生情况及其影响因素,分析疲劳患者PSQI评分、HADS焦虑和抑郁评分变化及疲劳与睡眠质量、焦虑、抑郁的相关性。结果 600例稳定性冠心病患者中出现疲劳320例(53.33%)。疲劳组和无疲劳组中独居、有吸烟史、有高脂血症病史有心肌梗死病史患者占比均无显著差异(P_均> 0.05);疲劳组中女性、年龄≥60岁、有高血压病史、有糖尿病病史、有心肌梗死病史患者占比均显著高于无疲劳组(P_均<0.05)。疲劳组患者平均PSQI评分、HADS焦虑和抑郁评分均显著高于无疲劳组(P_均<0.001)。稳定性冠心病患者疲劳与睡眠质量、焦虑及抑郁均呈线性正相关(P_均<0.001)。结论稳定性冠心病患者疲劳发生率较高,疲劳与睡眠质量、焦虑及抑郁均呈正相关。
Objective To investigate the fatigue status and cognition of patients with stable coronary heart disease. Method The 600 patients with stable coronary heart disease from July 2016 to May 2018 were selected as the study subjects. The multidimensional fatigue inventory 20(MFI-20) was used to evaluate the patient's fatigue, and the Pittsburgh sleep quality index(PSQI) was used to evaluate the quality of the patients' sleep quality, and the anxiety and depression were evaluated by the hosipital anxiety and depression scale(HADS). The incidence of fatigue in patients with stable coronary heart disease, the analysis of the influencing factors of fatigue, the changes of PSQI scores, anxiety and depression scores of HADS in fatigue patients, and the correlation between fatigue and sleep quality, anxiety and depression were analyzed. Result Among 600 patients with stable coronary heart disease, 320 cases(53.33%) suffered from fatigue. There were no significant differences between the fatigue group and the non-fatigue group in the proportion of solitary living, smoking and hyperlipidemia(P_(all)> 0.05); the proportion of women, age ≥ 60 years old, with the history of hypertension, diabetes and myocardial infarction in fatigue group were significantly higher than that in non-fatigue group(P_(all)< 0.05). The average PSQI score, anxiety and depression scores of HADS in fatigue group were significantly higher than those in non-fatigue group(P_(all)< 0.001). There was a linear positive correlation between fatigue and sleep quality, anxiety and depression in patients with stable coronary heart disease(P_(all)< 0.001). Conclusion There is a high incidence of fatigue in patients with stable coronary heart disease, and fatigue is positively correlated with sleep quality, anxiety and depression.
Objective To investigate the fatigue status and cognition of patients with stable coronary heart disease. Method The 600 patients with stable coronary heart disease from July 2016 to May 2018 were selected as the study subjects. The multidimensional fatigue inventory 20(MFI-20) was used to evaluate the patient's fatigue, and the Pittsburgh sleep quality index(PSQI) was used to evaluate the quality of the patients' sleep quality, and the anxiety and depression were evaluated by the hosipital anxiety and depression scale(HADS). The incidence of fatigue in patients with stable coronary heart disease, the analysis of the influencing factors of fatigue, the changes of PSQI scores, anxiety and depression scores of HADS in fatigue patients, and the correlation between fatigue and sleep quality, anxiety and depression were analyzed. Result Among 600 patients with stable coronary heart disease, 320 cases(53.33%) suffered from fatigue. There were no significant differences between the fatigue group and the non-fatigue group in the proportion of solitary living, smoking and hyperlipidemia(P_(all)> 0.05); the proportion of women, age ≥ 60 years old, with the history of hypertension, diabetes and myocardial infarction in fatigue group were significantly higher than that in non-fatigue group(P_(all)< 0.05). The average PSQI score, anxiety and depression scores of HADS in fatigue group were significantly higher than those in non-fatigue group(P_(all)< 0.001). There was a linear positive correlation between fatigue and sleep quality, anxiety and depression in patients with stable coronary heart disease(P_(all)< 0.001). Conclusion There is a high incidence of fatigue in patients with stable coronary heart disease, and fatigue is positively correlated with sleep quality, anxiety and depression.
引文
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[11]欧薇,孙月吉,孙玉兰,等.D型人格不稳定心绞痛患者治疗前后抑郁情绪躯体疲劳状况及生活质量的变化[J].中华行为医学与脑科学杂志,2008,17(10):889-890.
[12]Nunes EJ,Randall PA,Hart EE,et al.Effort-related motivational effects of the VMAT-2 inhibitor tetrabenazine:implications for animal models of the motivational symptoms of depre ssion[J].J Neurosci,2013,33(49):19120-19130.
[13]Nakagawa S,Sugiura M,Akitsuki Y,et al.Compensatory effort parallels midbrain deactivation during mental fatigue:an fMRIstudy[J].PLoS One,2013,8(2):e56606.
[14]Fennessy MM,Fink AM,Eckhardt AL,et al.Gender differences in fatigue associated with acute myocardial infarction[J].JCard iopulm Rehabil Prev,2010,30(4):224-230.
[15]Pragodpol P,Ryan C.Critical review of factors predicting health-related quality of life in newly diagnosed coronary artery disease patients[J].J Cardiovasc Nurs,2013,28(3):277-284.
[16]Ekmann A,Osler M,Avlund K.The predictive value of fatigue for nonfatal ischemic heart disease and all-cause mortality[J].Psychosom Med,2012,74(5):464-470.
[17]Staniute M,Bunevicius A,Brozaitiene J,et al.Relationship of health-related quality of life with fatigue and exercise capacity in patients with coronary artery disease[J].Eur J Cardiovasc Nurs,2014,13(4):338-344.
[18]严家嫦,罗英,李群笑,等.急性心肌梗死患者疲劳症状性别差异的观察[J].国际医药卫生导报,2013,19(5):620-622.
[19]包扬,刘晓飞.冠心病患者疲乏状况及其与睡眠质量、焦虑及抑郁的关系[J].中国保健营养,2016,26(1):170.
[2]Task Force Members,Montalescot G,Sechtem U,et al.2013ESC guidelines on the management of stable coronary artery disease:the Task Force on the management of stable coronary artery disease of the European Society of Cardiology[J].Eur Heart J,2013,34(38):2949-3003.
[3]张永珍,高炜.稳定性冠心病诊治策略的选择:欧美指南给我们的提示[J].北京大学学报(医学版),2014,46(6):832-835.
[4]GBD 2013 Mortality and Causes of Death Collaborators.Global,regional,and national age-sex specific all-cause and cause-specific mortality for 240 causes of death,1990-2013:a systematic analysis for the Global Burden of Disease Study2013[J].Lancet,2015,385(9963):117-171.
[5]Finsterer J,Mahjoub SZ.Fatigue in healthy and diseased individuals[J].Am J HospPalliat Care,2014,31(5):562-575.
[6]Smets EM,Garssen B,Bonke B,et al.The Multidimensional Fatigue Inventoy(MFI)psychometric qualities of an instrument to assess fatigue[J].J Psychosom Res,1995,39(3):315-325.
[7]Buysse DJ,Reynolds CF 3rd,Monk TH,et al.The Pittsburgh Sleep Quality Index:a new instrument for psychiatric practice and research[J].Psychiatry Res,1989,28(2):193-213.
[8]Zigmond AS,Snaith RP.The hospital anxiety and depression scale[J].Acta Psychiatr Scand,1983,67(6):361-370.
[9]王波,王临池,赵翼洪,等.2009-2013年苏州20岁及以上居民冠心病发病率变化趋势及类型分析[J].中国全科医学,2015,18(24):2952-2956.
[10]包扬,刘晓飞.冠心病患者疲乏状况及其与睡眠质量、焦虑及抑郁的关系[J].中国保健营养,2016,26(1):170.
[11]欧薇,孙月吉,孙玉兰,等.D型人格不稳定心绞痛患者治疗前后抑郁情绪躯体疲劳状况及生活质量的变化[J].中华行为医学与脑科学杂志,2008,17(10):889-890.
[12]Nunes EJ,Randall PA,Hart EE,et al.Effort-related motivational effects of the VMAT-2 inhibitor tetrabenazine:implications for animal models of the motivational symptoms of depre ssion[J].J Neurosci,2013,33(49):19120-19130.
[13]Nakagawa S,Sugiura M,Akitsuki Y,et al.Compensatory effort parallels midbrain deactivation during mental fatigue:an fMRIstudy[J].PLoS One,2013,8(2):e56606.
[14]Fennessy MM,Fink AM,Eckhardt AL,et al.Gender differences in fatigue associated with acute myocardial infarction[J].JCard iopulm Rehabil Prev,2010,30(4):224-230.
[15]Pragodpol P,Ryan C.Critical review of factors predicting health-related quality of life in newly diagnosed coronary artery disease patients[J].J Cardiovasc Nurs,2013,28(3):277-284.
[16]Ekmann A,Osler M,Avlund K.The predictive value of fatigue for nonfatal ischemic heart disease and all-cause mortality[J].Psychosom Med,2012,74(5):464-470.
[17]Staniute M,Bunevicius A,Brozaitiene J,et al.Relationship of health-related quality of life with fatigue and exercise capacity in patients with coronary artery disease[J].Eur J Cardiovasc Nurs,2014,13(4):338-344.
[18]严家嫦,罗英,李群笑,等.急性心肌梗死患者疲劳症状性别差异的观察[J].国际医药卫生导报,2013,19(5):620-622.
[19]包扬,刘晓飞.冠心病患者疲乏状况及其与睡眠质量、焦虑及抑郁的关系[J].中国保健营养,2016,26(1):170.