摘要
目的 探究因冠心病(CHD)行经皮冠状动脉介入治疗(PCI)术后并发睡眠障碍患者的氧化应激水平的变化及其危险因素.方法 回顾性分析2018年6月至2023年6月期间于攀枝花市第三人民医院心内科就诊并行PCI术的128例CHD患者临床资料,采用匹兹堡睡眠质量指数量表(PSQI)评估PCI术后是否并发睡眠障碍,并依据评分结果将患者分为并发组(n=35)和未并发组(n=93).对比分析两组血清中超氧化物歧化酶和丙二醛的表达水平,采用单因素分析对患者基本资料(性别、年龄、体重指数、腰臀比、文化程度、是否吸烟或饮酒等)和生理病理情况[合并疾病、焦虑、术后疼痛、术后用药情况、每周运动时间、纽约心脏病协会(NYHA)心功能分级、植入支架数)]进行分析,采用多因素Logistic回归分析对影响CHD患者行PCI术后并发睡眠障碍的因素进行分析.结果 并发组患者血清超氧化物歧化酶水平为(61.68±10.32)U/mL,低于未并发组[(78.11±15.38)U/mL],并发组丙二醛水平为(2.72±0.44)µmol/L,高于未并发组[(2.02±0.38)μmol/L],差异均有统计学意义(P＜0.05).单因素分析结果显示,年龄、腰臀比、合并高脂血症、焦虑、术后疼痛和每周运动时间是CHD患者行PCI术后并发睡眠障碍的影响因素.多因素Logistic回归分析结果显示,超氧化物歧化酶(OR=1.290,95％CI:1.145～1.454)、丙二醛(OR=1.667,95％CI:1.362～2.040)、年龄(OR=1.672,95％CI:1.348～2.074)、腰臀比(OR=1.368,95％CI:0.901～2.076)、焦虑(OR=1.470,95％CI:1.021～2.116)、术后疼痛(OR=1.844,95％CI:1.175～2.894)和每周运动时间(OR=1.261,95％CI:0.911～1.746)为影响CHD患者行PCI术后并发睡眠障碍的独立危险因素.结论 CHD行PCI术后并发睡眠障碍的患者氧化应激水平显著高于未并发睡眠障碍患者;超氧化物歧化酶、丙二醛、年龄、腰臀比、焦虑、术后疼痛和每周运动时间为影响CHD患者行PCI术后并发睡眠障碍的独立危险因素..
Abstract
Objective To investigate the changes in oxidative stress levels and risk factors of concurrence of dyssomnia postoperative per-cutaneous coronary intervention(PCI)of coronary artery heart disease(CHD)patients.Methods The clinical deta which included 128 CHD pa-tients who received concurrent PCI surgery in the Department of Cardiology,The Third People's Hospital of Panzhihua from June 2018 to June 2023 as the study subjects.The pittsburgh sleep quality index(PSQI)was used to evaluation whetherthe patients were complicated with sleep disorders after PCI and they were divided into the concurrent group(n=35)and the non concurrent group(n=93)according to the result of PSQI scores.The expression levels of superoxide dismutase and malondialdehyde in the serum of two groups of molecules were compared,basic informa-tion(gender,age,body mass index,waist to hip ratio,education level,whether smoking or drinking,etc.)and pathological conditions(comor-bidities,anxiety,postoperative pain,postoperative medication,weekly exercise time,New York Heart Association(NYHA)heart function grad-ing,number of stents implanted)]were collected and analyzed by univariate analysis,and the factors affecting postoperative sleep disorders in CHD patients undergoing PCI were analyzed using multivariate Logistic regression analysis.Results The level of serum superoxide dismutase in the concurrent group was(61.68±10.32)U/mL,which was lower than that in the non concurrent group[(78.11±15.38)U/mL],and the malondialdehyde level in the concurrent group was(2.72±0.44)μmol/L,which was higher than that in the non concurrent group[(2.02± 0.38)μmol/L],the differences were statistically significant(P＜0.05).The results of univariate analysis showed that age,waist to hip ratio,concurrent hyperlipidemia,anxiety,postoperative pain,and weekly exercise time were the influencing factors for postoperative sleep disorders in CHD patients undergoing PCI.Univariate and multiple Logistic regression analysis showed that Superoxide dismutase(OR=1.290,95％CI:1.145-1.454),malondialdehyde(OR=1.667,95％CI:1.362-2.040),age(OR=1.672,95％CI:1.348-2.074),waist to hip ratio(OR=1.368,95％CI:0.901-2.076),anxiousness(OR=1.470,95％CI:1.021-2.116),postoperative pain(OR=1.844,95％CI:1.175-2.894)and exercise time(OR=1.261,95％CI:0.911-1.746)were the independent risk factors of concurrence of dys-somnia postoperative PCI of CHD patients.Conclusion The levels of oxidative stress in patients with sleep disorders after PCI in CHD were sig-nificantly higher than those without.Superoxide dismutase,malondialdehyde,age,WHR,anxiety,postoperative pain,and weekly exercise time were independent risk factors for sleep disorders in CHD patients after PCI.
NETL
NSTL
维普
万方数据