对比堪萨斯心肌病问卷对慢性心力衰竭患者生活质量的评估

目的 采用堪萨斯心肌病问卷(KCCQ)及其他生活质量问卷对有心衰症状的患者的生活质量进行评估.方法 以2007年12月至2008年12月北京协和医院心内科住院并有心衰症状的271例患者为研究对象,采用KCCQ及其他生活质量量表对生活质量情况进行测量.收集患者的一般人口学资料、临床资料和冠脉造影资料.分析不同心功能状态患者的生活质量及其影响因素.结果 50例左心室射血分数(LVEF)值<50%和221例t≥50%患者KCCQ体力受限分别为(66±22)分和(73±22)分(P<0.05).NYHA心功能分级I、Ⅱ级227例和Ⅲ、Ⅳ级44例患者,KCCQ体力受限、症状和生活质量3项分别为(74±20)分比(60±27)分、(62±22)分比(49±25)分、(61±16)分比(53±18)分,(均P<0.05).197例心衰分级A、B级和74例C、D级患者生活质量比较,KCCQ体力受限、症状和生活质量3项分别为(75±19)分比(61±26)分、(63±22)分比(52±24)分、(61±16)分比(56±18)分(均P<0.05).多元逐步回归分析研究生活质量KCCQ影响因素:年龄、NYHA心功能分级、性别、Judkins评分分级对患者体力受限有影响;性别和心衰分期对患者心衰症状有影响;性别对患者社会功能有影响.结论 KCCQ的部分指标对患者心功能的评估更为敏感.年龄、NYHA心功能分级、性别、Judkins评分分级、心衰分期是心衰患者生活质量的影响因素.

Assessment of life quality in patients with chronic heart failure

Objective Using Kansas city cardiomyopathy questionnaire (KCCQ) to evaluate the quality of life (QOL) of the patients with chronic heart failure.Methods A total of 271 hospitalized patients with heart failure symptoms in cardiology department,Peking Union Medical College Hospital,who undergone coroluLry angiography from December 2007 to December 2008,were included in this study.QOL of the subjects was measured,and their demographic and clinical data were collected.Patients were divided into 2 groups according to heart function and they were compared by QOL Multiple linear regression analysis was conducted to identify the variables associated with the quality of life.Results KCCQ physical limitation scores of the patients of left ventricular ejective fraction(LVEF) <50% (n=50) and LVEF≥50%(n=221) were (66±22) points and (73±22) points (P<0.05).In the patients of NYHA I/Ⅱ(n=227) vs NYHA Ⅲ/Ⅳ(n=44),KCCQ scores of physical limitation,symptoms and QOL were (74±20) vs (60±27) points,(62±22) vs (49±25) points and (61±16) vs (53±18) points (all P<0.05).In the patients of heart failure grade A/B (n:197) vs grade C/D (n=74),KCCQ scores of physical limitation.symptoms and QOL were (75±19) vs (61±26) points,(63±22) vs (52±24) points,(61±16) vs (56±18) points (all P<0.05).Multiple linear regression analysis of QOL KCCQ showed that,age,NYHA cardiac function classification,gender and Judkins score were the risk factors of patients' physical limitation (P<0.01);gender and stages of heart failure were the risk factors of patients'symptoms (P<0.01);gender was the risk factors of patients'social function (P<0.01).Conclusion The patients with poor cardiac function have a poor QOL.KCCQ is more sensitive for the evaluation of heart function. Age,NYHA,gender,Judkins score and stages of heart failure Call change QOL for the patients with chronic heart failure.