急性冠脉综合征患者经皮冠状动脉介入术后症状负担的潜在剖面分析

doi:10.3761/j.issn.2096-7446.2026.04.003

摘要/Abstract

摘要：

目的识别急性冠脉综合征（acute coronary syndrome，ACS）患者经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）术后症状负担的潜在剖面，分析不同剖面的影响因素，为实施分层护理管理提供依据。方法采用便利抽样法，选取2024年11月—2025年8月重庆市某三级甲等医院接受PCI治疗的261例ACS患者作为研究对象。采用一般资料调查表、心脏症状调查量表、西雅图心绞痛量表进行调查，采用潜在剖面分析识别症状负担的潜在类别，采用无序多分类Logistic回归分析探讨不同潜在剖面的影响因素。结果 ACS患者PCI术后症状负担可分为3个潜在剖面：低症状负担型（62.8%）、缺血症状主导型（18.4%）和心肺症状主导型（18.8%）。Logistic回归分析显示，年龄（≥65岁）和多支架植入（≥2个）是心肺症状主导型的影响因素（P<0.05），女性是缺血症状主导型的独立影响因素（OR=2.453，P<0.05）。结论 ACS患者PCI术后症状负担存在明显异质性，临床护理实践中应基于症状剖面特征识别高风险人群，实施分层管理与精准干预。

关键词: 急性冠脉综合征, 经皮冠脉介入, 症状负担, 潜在剖面分析, 护理

Abstract:

Objective To identify latent profiles of symptom burden in patients with acute coronary syndrome （ACS） after percutaneous coronary intervention（PCI） and to explore factors associated with different profiles，so as to provide evidence for stratified nursing management. Methods A convenience sampling method was used to recruit 261 patients with ACS who underwent PCI at a tertiary hospital in Chongqing，China，between November 2024 and August 2025. Data were collected using a general information questionnaire，the Cardiac Symptom Survey，and the Seattle Angina Questionnaire. Latent profile analysis was conducted to identify latent classes of symptom burden，and multinomial logistic regression analysis was performed to examine factors associated with different profiles. Results Three latent profiles of symptom burden after PCI were identified，including low symptom burden（62.8%），ischemic symptom dominant type（18.4%），and cardiopulmonary symptom dominant type（18.8%）. Multinomial logistic regression analysis indicated that age（≥65 years） and multiple stent implantation（≥2） were significantly associated with the cardiopulmonary symptom-dominant profile（P<0.05），whereas female was independently associated with the ischemic symptom dominant profile（OR=2.453，P<0.05）. Conclusion Symptom burden after PCI in patients with ACS shows marked heterogeneity. In clinical nursing practice，high-risk patients should be identified based on symptom profile characteristics，and stratified management and targeted interventions should be implemented.

Key words: Acute Coronary Syndrome, Percutaneous Coronary Intervention, Symptom Burden, Latent Profile Analysis, Nursing

洪淑琴, 甘秀妮, 周雯, 刘利, 高燕. 急性冠脉综合征患者经皮冠状动脉介入术后症状负担的潜在剖面分析[J]. 中华急危重症护理杂志, 2026, 7(4): 404-411.

HONG Shuqin, GAN Xiuni, ZHOU Wen, LIU Li, GAO Yan. Latent profile analysis of symptom burden in patients with acute coronary syndrome after percutaneous coronary intervention[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 404-411.

图/表 6

表1

表2

图1

表3

表4

表5

参考文献 24

[1]	《中国心血管健康与疾病报告》编写组, 王增武. 《中国心血管健康与疾病报告2024》:心血管疾病及其危险因素流行状况[J]. 中国心血管病研究, 2025, 23(9):771-793.
	The Compilation Team of “China Cardiovascular Health and Disease Report”, Wang ZW. Report on cardiovascular health and diseases in China 2024:Epidemiological status of cardiovascular diseases and their risk factors[J]. Chin J Cardiovasc Res, 2025, 23(9):771-793.
[2]	Fukuoka Y, Lindgren TG, Rankin SH, et al. Cluster analysis:a useful technique to identify elderly cardiac patients at risk for poor quality of life[J]. Qual Life Res, 2007, 16(10):1655-1663. doi: 10.1007/s11136-007-9272-7
[3]	Du CS, Hao BC, Mao S, et al. Post-percutaneous coronary intervention psychological disorders predict poor adherence and cardiovascular events in elderly heart failure patients[J]. World J Psychiatry, 2025, 15(10):111039.
[4]	Davis MP, Kirkova J. Lifting symptom burden:how far off the ground are we?[J]. Support Care Cancer, 2008, 16(7):757-761.
[5]	李东枝. 基于症状管理概念修正模型对急性冠脉综合征症状群及其影响因素研究[D]. 太原: 山西中医药大学, 2021.
	Li DZ. Study on the symptom group of acute coronary syndrome and its influencing factors based on the modified model of symptom management concept[D]. Taiyuan: Shanxi University of Traditional Chinese Medicine, 2021.
[6]	陈小艳, 黄丽华. 急性冠脉综合征患者症状群的研究进展[J]. 中华护理杂志, 2024, 59(1):117-123. doi: 10.3761/j.issn.0254-1769.2024.01.016
	Chen XY, Huang LH. Research progress of symptom cluster in patients with acute coronary syndrome[J]. Chin J Nurs, 2024, 59(1):117-123. doi: 10.3761/j.issn.0254-1769.2024.01.016
[7]	Wang Y, Kim E, Yi ZY. Robustness of latent profile analysis to measurement noninvariance between profiles[J]. Educ Psychol Meas, 2022, 82(1):5-28. doi: 10.1177/0013164421997896 pmid: 34992305
[8]	中国医师协会急诊医师分会, 国家卫健委能力建设与继续教育中心急诊学专家委员会, 中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中国急救医学, 2019, 39(4):301-308.
	Chinese Medical Doctor Association Emergency Medical Branch; Expert Committee on Emergency Medicine,National Health Commission Capacity Building and Continuing Education Center; Chinese Medical Promotion Association Emergency and Critical Care Branch. Guidelines for emergency rapid diagnosis and treatment of acute coronary syndrome(2019)[J]. Chin J Crit Care Med, 2019, 39(4):301-308.
[9]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
	Ni P, Chen JL, Liu N. The sample size estimation hi quantitative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380.
[10]	Nieveen JL, Zimmerman LM, Barnason SA, et al. Development and content validity testing of the Cardiac Symptom Survey in patients after coronary artery bypass grafting[J]. Heart Lung, 2008, 37(1):17-27. doi: 10.1016/j.hrtlng.2006.12.002 pmid: 18206523
[11]	陈小康, 刘建平, 张永恒, 等. 中文版心脏症状调查量表在心脏瓣膜置换术后患者症状调查中的信度与效度分析[J]. 中国实用护理杂志, 2021, 37(2):115-120.
	Chen XK, Liu JP, Zhang YH, et al. Analysis of the reliability and validity of the Cardiac Symptom Survey applied to the patients after cardiac valve replacement[J]. Chin J Pract Nurs, 2021, 37(2):115-120.
[12]	Spertus JA, Winder JA, Dewhurst TA, et al. Monitoring the quality of life in patients with coronary artery disease[J]. Am J Cardiol, 1994, 74(12):1240-1244. doi: 10.1016/0002-9149(94)90555-x pmid: 7977097
[13]	刘淑红. 西雅图心绞痛量表(SAQ)中文译本的信度、效度、反应度[D]. 天津: 天津医科大学, 2003.
	Liu SH. The evaluation of the reliability and validity of SAQ applied in a group of Chinese patients with CHD[D]. Tianjin: Tianjin Medical University, 2003.
[14]	Collison D, Copt S, Mizukami T, et al. Angina after percutaneous coronary intervention:patient and procedural predictors[J]. Circ Cardiovasc Interv, 2023, 16(4):e012511.
[15]	朱晓婧, 陶贵周. 经皮冠状动脉介入治疗术后合并焦虑抑郁的临床研究进展[J]. 解放军医学杂志, 2021, 46(3):280-285.
	Zhu XJ, Tao GZ. Progress of clinical research on complicated anxiety and depression after percutaneous coronary intervention[J]. Med J Chin PLA, 2021, 46(3):280-285.
[16]	孙婷婷, 徐候艳, 张红岩. 不同性别老年冠心病患者经皮冠状动脉介入治疗术后心理状态及相关因素分析[J]. 中华老年心脑血管病杂志, 2025, 27(11):1517-1521.
	Sun TT, Xu HY, Zhang HY. Psychological status and related factor analysis of elderly patients with coronary heart disease after PCI surgery of different genders[J]. Chin J Geriatr Heart Brain Vessel Dis, 2025, 27(11):1517-1521.
[17]	刘畅, 王忠霞, 瞿江月, 等. 中青年患者经皮冠状动脉介入术后恐惧疾病进展应对策略的研究进展[J]. 中华急危重症护理杂志, 2025, 6(8):1021-1024. doi: 10.3761/j.issn.2096-7446.2025.08.022
	Liu C, Wang ZX, Qu JY, et al. Research progress on coping strategies for fear of disease progression in young and middle-aged post-PCI patients[J]. Chin J Emerg Crit Care Nurs, 2025, 6(8):1021-1024.
[18]	洪莹莹. 理性情绪行为疗法对急性心肌梗死患者血管造影治疗前负性情绪的影响[J]. 心血管病防治知识, 2024, 14(10):100-103.
	Hong YY. Effect of rational emotional behavior therapy on negative emotions of patients with acute myocardial infarction before angiography treatment[J]. Prev Treat Cardiovasc Dis, 2024, 14(10):100-103.
[19]	沈翌卉, 王慧虹, 邵芳, 等. 静默疗法对急性心肌梗死患者疾病进展恐惧和心理健康的影响[J]. 中国实用护理杂志, 2021, 37(30):2340-2345.
	Shen YH, Wang HH, Shao F, et al. Effects of meditation therapy on fear of disease progress and mental health among acute myocardial infarction patients[J]. Chin J Pract Nurs, 2021, 37(30):2340-2345.
[20]	Zhao S, Wang JY, Chen Y, et al. Improvement of symptoms and quality of life after successful percutaneous coronary intervention for chronic total occlusion in elderly patients[J]. J Am Heart Assoc, 2023, 12(8):e029034. doi: 10.1161/JAHA.123.029034
[21]	李月, 陈务贤, 李高叶, 等. 经皮冠状动脉介入术后病人多维症状网络分析[J]. 护理研究, 2024, 38(7):1129-1138.
	Li Y, Chen WX, Li GY, et al. Multidimensional symptom network analysis of patients after percutaneous coronary intervention[J]. Chin Nurs Res, 2024, 38(7):1129-1138.
[22]	Sun BB, Han J, Tian BB, et al. Associations between depression,resilience,and fatigue in patients with multivessel coronary disease:a cross-lag study[J]. Int J Nurs Sci, 2025, 12(2):144-151.
[23]	瞿佳弘, 王琳, 廖俪雯. 经皮冠状动脉介入术后病人运动恐惧分型及其影响因素[J]. 护理研究, 2024, 38(23):4145-4151.
	Qu JH, Wang L, Liao LW. Study on the classification of kinesiophobia and its influencing factors in PCI patients[J]. Chin Nurs Res, 2024, 38(23):4145-4151.
[24]	周剑英, 许晖, 张芳, 等. 心脏康复分级诊疗模式在经皮冠状动脉介入术后患者中的应用[J]. 中华急危重症护理杂志, 2020, 1(6):495-499.
	Zhou JY, Xu H, Zhang F, et al. The application of hierarchical medical mode in cardiac rehabilitation of patients after percutaneous coronary intervention[J]. Chin J Emerg Crit Care Nurs, 2020, 1(6):495-499.