D型人格对成人先天性心脏病患者死亡率影响的队列研究

目的 研究成人先天性心脏病患者中D型人格对死亡率的影响。方法 纳入中国科学技术大学附属第一医院2016年4月-2020年4月心血管内科门诊及病房就诊的成人先天性心脏病患者287例,采用D型人格量表评估是否具有D型人格,随访至2021年4月结束。进一步比较D型人格与非D型人格先天性心脏病患者的一般资料及死亡率有无差异。结果 最终入组263例患者,其中124例为男性,平均(49.4±7.1)岁。D型人格者62例。D型人格患者更容易出现NYHA分级II级以上的心功能,罹患慢性肾脏病(12.9% vs 4.5%,P=0.039),无业(32.3% vs 20.0%,P=0.043)及单身(35.5% vs 20.1%,P=0.019)的比例均更高。随访结束发现,D型人格的先天性心脏病患者较无D型人格者的生存率明显变差(82% vs 87%,P=0.014),在Cox比例风险回归模型分析中,D型人格是死亡的明显预测因子(风险比1.85,95%置信区间1.12-3.04,P=0.015)。结论 成人先天性心脏病患者中D型人格可以预测死亡率,护理工作中需注意评估。

Cohort study on effects of type D personality on mortality of adults with congenital heart disease

Objective To study the effects of type D personality on mortality of adults with congenital heart disease (CHD).Methods Two hundred and eighty seven adult patients with CHD admitted to the Department of Cardiovascular Medicine, the First Affiliated Hospital of University of Science and Technology of China from April 2016 to April 2020 were included in the study. Type D personality scale was applied to evaluate if the patients had Type D personality, the follow-up was ended in April 2021. The differences in general data and mortality of patients with type D personality and those without type D personality were further compared. Results A total of 263 patients were enrolled, 124 were male with average age of (49.4±7.1) years, 62 patients were found to have type D personality. Patients with type D personality were more likely to have NYHA II or higher cardiac function, and were more likely to have higher percentage for chronic kidney disease (12.9% vs 4.5%, P=0.039), unemployed status (32.3% vs 20.0%, P=0.043), and single (35.5% vs 20.1%, P=0.019). The patients with type D personality were found to have significantly worse survival than those without type D personality (82% vs 87%, P=0.014) at the end of the follow-up. Type D personality was noted to be significant predictor of death (hazard ratio of 1.85, 95% confidence interval 1.12-3.04, P=0.015) in Cox proportional hazard regression model analysis. Conclusion Type D personality is eligible to predict the mortality rate in adults with CHD, and need to pay attention to assessment in nursing work.