Abstract: Background　Unhealthy lifestyle is closely associated with the increasing prevalence and mortality of cardiovascular diseases in China.For coronary heart disease treated with coronary stent implantation，an important treatment，the maintenance of therapeutic result requires both medication and changing unhealthy lifestyle.So attention should be paid to post-discharge lifestyle and associated factors in coronary stent implantation patients，to promote the establishment and maintenance of healthy lifestyle.Objective　To investigate the influencing factors of appropriate post-discharge lifestyle in coronary stent implantation patients.Methods　From July to November 2017，we conducted a questionnaire-based telephone survey in a random sample of 798 coronary stent implantation patients who had been discharged for at least one year from the cardiovascular department of 3 grade A tertiary hospitals from Tangshan，Shijiazhuang and Zhangjiakou，Hebei Province（one from each city） selected by stratified multistage random sampling.The survey covered demographic data，clinical data，and appropriate lifestyle.Appropriate post-discharge lifestyle was assessed by whether following the 5 instructions（regularly monitoring blood lipid，eating heart healthy diet，controlling weight，quitting smoking，and having physical exercise），and was classified into 3 levels（following at least 4 instructions，following 2-3 instructions and following 0-1 instruction）.Multinomial Logistic regression analysis was used to explore the associated factors of appropriate post-discharge lifestyle.Results　798 questionnaires were distributed，798 valid questionnaires were collected，and the effective recovery rate was 100.0%.The prevalence rates of regularly monitoring blood lipids，eating heart healthy diet，losing weight，successful smoking cessation，and having physical exercise were 67.2%（536/798），62.2%（496/798），44.0%（351/798），56.8%（220/387），and 45.5%（363/798），respectively.And smokers still accounted for 20.9%（167/798）of the total.The prevalence rates of following at least 4 instructions，2-3 instructions，and 0-1 instruction were 48.6%（388/798），28.7%（229/798），and 22.7%（181/798），respectively.Gender〔male：OR=1.600，95%CI（1.149，2.228），P=0.005〕，age〔≤40 years old：OR=23.927，95%CI（7.980，71.664），P<0.001；41-50 years old：OR=3.307，95%CI（1.870，5.847），P<0.001〕，returning to work after coronary stent implantation〔no：OR=1.747，95%CI（1.280，2.385），P<0.001〕，number of coronary artery lesions〔single lesion：OR=1.654，95%CI（1.132，2.416），P=0.009；double branch lesions：OR=1.483，95%CI（1.033，2.132），P=0.033〕，disease-related knowledge〔lack：OR=2.340，95%CI（1.701，3.219），P<0.001〕，knowledge of cardiac rehabilitation〔knowing nothing：OR=2.691，95%CI（11.545，4.688），P<0.001；knowing a little：OR=1.745，95%CI（1.083，2.815），P=0.022〕were associated with the level of appropriate post-discharge lifestyle.Conclusion　The level of appropriate pos-discharge lifestyle differs significantly across the patients，which is associated with gender，age，returning to work after coronary stent implantation，number of coronary artery lesions，disease-related knowledge，and knowledge of cardiac rehabilitation.Therefore，clinical health education of coronary heart disease，and cardiac rehabilitation for these patients，especially males，the young and middle-aged，and those with mild coronary artery disease，should be strengthened，and patients should be encouraged to return to work after discharge，and to develop and maintain a healthy lifestyle.

Key words: Coronary disease, Coronary artery stent implantation, Life style, Patient discharge, Root cause analysis

摘要： 背景　我国心血管疾病患病率及死亡率不断上升，与居民不健康生活方式密切相关，冠状动脉支架植入术作为治疗冠心病的重要手段，治疗效果的维持除药物治疗外也需要患者改变生活方式，因此有必要重视冠状动脉支架植入患者出院后的生活方式及其影响因素，以促进其健康生活方式的建立与维持。目的　了解河北省冠状动脉支架植入患者出院后合理生活方式遵循情况的影响因素。方法　采用多阶段分层随机抽样方法，选取2017年7—11月在河北省唐山市、石家庄市、张家口市分别随机抽取一家三级甲等医院心内科出院1年及以上的798例冠状动脉支架植入患者为研究对象，通过电话进行问卷调查。问卷内容包括：患者一般资料、临床医学资料、合理生活方式。患者出院后合理生活方式评定包括5个方面：（1）定期血脂评估、（2）冠心病饮食、（3）控制体质量、（4）戒烟、（5）运动，分为遵循4~5条、2~3条、0~1条3个等级。采用多分类Logistic回归分析探究冠状动脉支架植入患者出院后遵循合理生活方式的影响因素。结果　共发放问卷798份，回收有效问卷798份，有效回收率为100.0%。67.2%（536/798）的患者定期血脂评估；62.2%（496/798）的患者执行冠心病饮食；44.0%（351/798）患者减重；56.8%（220/387）吸烟者戒烟成功，占总体20.9%（167/798）的患者仍吸烟；45.5%（363/798）的患者运动。合理生活方式遵循4~5条388例（48.6%）、2~3条229例（28.7%）、0~1条181例（22.7%）。性别〔男性：OR=1.600，95%CI（1.149，2.228），P=0.005〕、年龄〔≤40岁：OR=23.927，95%CI（7.980，71.664），P<0.001；41~50岁：OR=3.307，95%CI（1.870，5.847），P<0.001〕、冠状动脉支架植入术后回归工作〔否：OR=1.747，95%CI（1.280，2.385），P<0.001〕、冠状动脉血管病变数目〔单支病变：OR=1.654，95%CI（1.132，2.416），P=0.009；双支病变：OR=1.483，95%CI（1.033，2.132），P=0.033〕、疾病相关知识了解程度〔不了解：OR=2.340，95%CI（1.701，3.219），P<0.001〕、心脏康复知识了解程度〔完全不了解：OR=2.691，95%CI（11.545，4.688），P<0.001；有点了解：OR=1.745，95%CI（1.083，2.815），P=0.022〕是冠状动脉支架植入患者合理生活方式遵循情况的影响因素。结论　冠状动脉支架植入患者出院后合理生活方式遵循情况偏差，且性别、年龄、冠状动脉支架植入术后回归工作情况、冠状动脉血管病变数目、疾病相关知识了解程度、心脏康复知识了解程度是其出院后合理生活方式遵循情况的影响因素，因此，临床应加强心脏康复、疾病相关知识的健康宣教，尤其应加强对男性、中青年和冠状动脉病变较轻患者的健康宣教，鼓励患者回归工作，促进冠状动脉支架植入患者健康生活方式的建立与维持。

关键词: 冠心病, 冠状动脉支架植入术, 生活方式, 病人出院, 影响因素分析