目的 评价基于成果导向教育（OBE）理念的“赛教一体化”教学模式在健康教育课程实验教学中的应用效果。方法 选取我校2021级预防医学专业的81名学生为研究对象。采用整群随机分组的方法，将其分为观察组（n=29）和对照组（n=52），观察组采用基于OBE理念的“赛教一体化”教学模式，对照组采用传统教学模式。通过对实验教学质量的模糊综合评判以及期末考试成绩进行效果评价。结果 观察组和对照组实验教学质量的模糊综合评判结果均为“优秀”，最大隶属度分别为0.727和0.534，观察组优于对照组。在一级指标层面，观察组所有指标得分均高于对照组，5个一级指标的两组得分差值从大到小依次为潜能激发（0.80）、教师素养（0.77）、学习成效（0.74）、内容设计（0.70）和教学方法（0.59）。观察组和对照组的期末考试成绩差异无统计学意义（P＞0.05）。结论 基于OBE理念的“赛教一体化”教学模式应用于健康教育课程实验教学能够有效改善教学质量，在潜能激发和教师素养方面提升较为明显。

       Objective To evaluate the application effect of the “integration of competition and education” teaching model based on the（outcomes-based education，OBE） concept in the experimental teaching of health education courses．Methods A total of 81 students majoring in preventive medicine from the 2021 grade at our university were selected as the research objects．They were divided into an observation group（n=29）and a control group（n=52）using cluster randomization．The observation group adopted the “integration of competition and education” teaching model based on the OBE concept，while the control group adopted the traditional teaching model．The effectiveness was evaluated using the fuzzy comprehensive evaluation of experimental teaching quality and the final exam scores．Results The fuzzy comprehensive evaluation results of the experimental teaching quality in both the observation group and the control group were “excellent”，with the maximum membership degrees of 0.727 and 0.534，respectively，indicating that the observation group was superior to the control group．At the level of first-level indicators，all indicators of the observation group scored higher than those of the control group．The score differences between the two groups for the five first-level indicators，from largest to smallest，were：potential excitation（0.80），teacher literacy（0.77），learning effectiveness（0.74），content design（0.70），and teaching method（0.59）．No statistically significant difference was found in the final exam scores between the observation group and the control group（P＞0.05）．Conclusions The application of the “integration of competition and education” teaching model based on the OBE concept in the experimental teaching of health education courses can effectively improve teaching quality，with more obvious improvements in potential excitation and teacher literacy．

       目的 探讨自回归求和时间序列模型（ARIMA）在耐碳青霉烯类肺炎克雷伯菌（CRKP）医院感染预测中的应用，为CRKP感染的科学防控提供策略。方法 选取贾汪区人民医院住院患者2018年1月—2024年12月共7年每月CRKP医院感染率，应用SPSS 19.0建立ARIMA模型，利用该模型对2024年1—12月每月CRKP医院感染数据进行验证，以评价模型的预测性能。结果 用2018—2024年住院患者每月CRKP医院感染率建模、拟合，建立最优模型ARIMA（1，1，1），模型拟合值与实际值较吻合，模型对CRKP医院感染率实际值与预测值吻合度较高，平均相对误差为5.40%。结论 用ARIMA模型可有效拟合、预测CRKP医院感染情况，为CRKP防控提供科学指导。

     Objective To explore the value of auto regressive integrated moving average（ARIMA）model in predicting theinfection rate of carbapenem-resistant Klebsiella pneumoniae（CRKP）．Methods The monthly incidence of nosocomial infection of CRKP in Jiawang District People’s Hospital from 2018 to 2024 was selected，and the ARIMA model was established by19.0 SPSS to analyze the fitting and prediction value of the model．Results The ARIMA was established based on the monthly CRKP infection rate from January 2018 to December 2024．The fitted value of the ARIMA（1，1，1）model was in good agreement with the actual value．The incidence of CRKP infection were in good agreement with the predicted value．The average relative errors were 5.40%．Conclusions The ARIMA model can effectively fit and predict the CRKP infection rate，providing scientific guidance for the prevention and control of CRKP infection．

       目的 探究1990—2023年中国人群下背痛（LBP）疾病负担，并预测2024—2040年LBP疾病负担发展趋势，为公共卫生政策制定提供数据支撑。方法 基于GBD2023数据库，采用Joinpoint模型、分解分析（decomposition analysis）量化我国LBP负担变化趋势，最后通过ARIMA（autoregressive integrated moving average model）模型预测未来趋势。结果 2023年我国LBP患病人数达9 532.40万人，发病人数为4 138.36万人，伤残调整生命年（DALYs），虽然患病人数、发病人数及DALYs绝对数较1990年显著增长，但年龄标准化率（ASR）均呈显著下降趋势（AAPC依次为-0.90%、-0.84%、-0.89%）。分解分析表明，人口年龄结构是我国LBP疾病负担增长的主要正向驱动因素，流行病学趋势变化对患病率和DALYs起关键抑制作用，且存在明显性别差异。ARIMA模型预测显示，2024—2040年男性和女性LBP相关ASR将持续下降，但我国女性LBP负担仍高于男性。结论 我国LBP负担沉重，受人口结构、性别差异、行为与职业等多方面因素影响，未来需通过分人群、分职业精准干预及多部门协同，持续降低疾病负担。

     Objective To explore the characteristics of disease burden of low back pain（LBP） in the Chinese population from 1990 to 2023，and predict its development trend from 2024 to 2040，so as to provide data support for the formulation of public health policies．Methods Based on the Global Burden of Disease Study 2023（GBD 2023） database，the Joinpoint model and decomposition analysis were adopted to quantify the changing trend of LBP burden in China．The autoregressive integrated moving average（ARIMA） model was used to predict the future trend，with the data for prediction stratified by gender and age group．Results In 2023，the number of LBP patients in China reached 95.3240 million，the number of incident cases was 41.3836 million，and the disability-adjusted life years（DALYs） were 10.6359 million person-years．Although the absolute numbers of prevalent cases，incident cases，and DALYs increased significantly compared with 1990，the age-standardized rates（ASRs） all showed a significant downward trend（average annual percentage changes were -0.90%，-0.84%，and -0.89%，respectively）．Decomposition analysis revealed that population age structure was the primary positive driving factor for the growth of LBP disease burden in China，while changes in epidemiological trends played a key inhibitory role in prevalence and DALYs，with significant gender differences．ARIMA model prediction indicated that the LBP-related ASRs would continue to decrease in both males and females from 2024 to 2040，but the LBP burden in females would remain higher than that in males in China．Conclusions The baseline burden of LBP in China is heavy，affected by multiple factors such as population structure，gender differences，behavioral and occupational factors．In the future，targeted interventions for specific populations and occupations，as well as multi-sectoral collaboration，are needed to continuously reduce the disease burden．

      目的 对川南地区重症专科联盟认知与需求进行调查，为该地区重症专科联盟建设提供参考。方法 采用分层随机抽样，在川南地区（乐山、宜宾、泸州、自贡）31个区县的二级医院内随机抽取213名医务人员作为调查对象。采用自制问卷收集调查对象基本情况，并评估其对重症医学专科联盟概念的认知情况，通过开放式问卷收集调查对象对重症医学专科联盟的需求。根据认知评估结果将研究对象分为了解充分组与了解不充分组，比较两组基本情况，并用多因素Logisitic回归筛选出独立性影响因素。结果 在纳入的213名医护人员中有68名（31.92%）对重症专科联盟了解不充分，单因素分析显示：两组在性别、年龄、工作岗位、职务及职称差异均具有统计学意义（P＜0.05）。多因素Logistic回归分析显示：性别、学历为本科 、学历为博/硕士研究生、工作岗位、职务为中层干部、院领导职务及职称为川南地区重症专科联盟认知的独立性影响因素（P＜0.05）。川南地区重症专科联盟需求排名前9位依次：派出专家技术指导、派出管理干部开展业务管理、接收联盟单位人员培训、协助开展新技术、为联盟单位成员开展培训与讲座、业务资源共享、接收联盟单位转诊、开展远程医疗、科研项目申报指导。结论 川南地区重症专科联盟认知情况主要与性别、学历、工作岗位、职务、职称及基层对于专家技术指导、管理干部业务指导及技能培训的需求较大。

      Objective To investigate the awareness and demand for the Critical Care Specialty Alliance in Southern Sichuan，providing a reference for the development of the alliance in this region．Methods Using stratified random sampling，213 medical staff were randomly selected from secondary hospitals in 31 districts/counties of the Southern Sichuan region（Leshan，Yibin，Luzhou，Zigong）as survey subjects．A self-designed questionnaire was used to collect basic information from the respondents，assess their understanding of the concept of the Critical Care Specialty Alliance，and gather their demands for the alliance through open-ended questions．Based on the assessment results，respondents were divided into a well-informed group and a poorly informed group．The basic characteristics of the two groups were compared，and multivariate logistic regression was used to identify independent influencing factors．Results Among the 213 medical staff included in the study，68（31.92%）had insufficient understanding of the Critical Care Specialty Alliance．Univariate analysis revealed statistically significant differences（P＜0.05）in gender，age，job position，administrative role，and professional title between the group with sufficient understanding and the group with insufficient understanding．Multivariate Logistic regression analysis showed that gender，undergraduate education，master’s/doctoral education，job position，middle management role，hospital leadership role，and professional title were independent influencing factors for the awareness of the Critical Care Specialty Alliance in the Southern Sichuan region（P＜0.05）．The top nine demands for the alliance in Southern Sichuan were dispatching experts for technical guidance，sending management cadres for operational management，providing training for personnel from alliance units，assisting in the development of new technologies，organizing training and lectures for alliance unit members，sharing business resources，accepting referrals from alliance units，implementing telemedicine，and providing guidance on research project applications．Conclusions Awareness of the Critical Care Specialty Alliance in Southern Sichuan is primarily associated with gender，educational background，job position，and professional title．There is significant demand at the primary level for expert technical guidance，operational management guidance from cadres，and skills training．

       目的 探讨不同附着体类型对上颌种植覆盖义齿修复患者种植体周围软硬组织健康状况的影响。方法 选取2020年1月—2023年12月于南京医科大学附属口腔医院就诊并接受上颌种植覆盖义齿修复的90例患者，根据所用附着体类型分为杆卡组（n=30）、球帽组（n=30）和Locator组（n=30）。戴用后随访12个月，比较三组种植体周围探诊深度（PD）、探诊出血（BOP）、菌斑指数（PLI）、牙龈指数（GI）、边缘骨吸收（MBL）等指标，并记录机械并发症发生情况。结果 佩戴12个月后，杆卡组在PD［（3.25±0.41） mm vs （3.58±0.50） mm，校正后P＜0.016 7］、PLI（1.25±0.38 vs 1.55±0.44，校正后P＜0.016 7）、GI（1.15±0.35 vs 1.37±0.42，校正后P＜0.016 7）及MBL［（0.38±0.11） mm vs （0.63±0.14） mm，校正后P＜0.016 7］方面的表现均优于Locator组；球帽组PLI（1.42±0.41 vs 1.55±0.44，校正后P＜0.016 7）、GI（1.28±0.39 vs 1.37±0.42，校正后P＜0.016 7）低于Locator组；三组间BOP阳性率两两比较差异均无统计学意义（校正后P＞0.016 7）。三组机械并发症总发生率的总体差异具有统计学意义（P＜0.05），进一步两两比较显示，杆卡组并发症发生率最低（16.67%），Locator组最高（50.00%）（校正后P＜0.016 7）。结论 对于上颌种植覆盖义齿修复，杆卡式附着体在维持种植体周围软硬组织健康、减少边缘骨吸收及降低机械并发症方面表现出相对优势，临床适用性较高。

       Objective To investigate the effects of different attachment types on the health of peri-implant soft and hard tissues in patients rehabilitated with maxillary implant-supported overdentures．Methods A total of 90 patients who received maxillary implant-supported overdentures at the Affiliated Stomatological Hospital of Nanjing Medical University between January 2020 and December 2023 were selected and divided into three groups based on the attachment type：bar-clip group（n=30），ball attachment group（n=30），and Locator group（n=30）．After prosthesis delivery，patients were followed up for 12 months．Parameters including probing depth（PD），bleeding on probing（BOP），plaque index（PLI），gingival index（GI），and marginal bone loss（MBL）were compared among the groups，and mechanical complications were recorded．Results At 12 months after delivery，the bar-clip group demonstrated significantly better performance in PD（［3.25±0.41］mm vs ［3.58±0.50］mm，adjusted P＜0.016 7），PLI（［1.25±0.38］ vs ［1.55±0.44］，adjusted P＜0.016 7），GI（［1.15±0.35］ vs ［1.37±0.42］，adjusted P＜0.016 7），and MBL（［0.38±0.11］mm vs ［0.63±0.14］mm，adjusted P＜0.016 7）compared to the Locator group．The ball attachment group showed significantly lower PLI（［1.42±0.41］ vs ［1.55±0.44］，adjusted P＜0.016 7）and GI（［1.28±0.39］ vs ［1.37±0.42］，adjusted P＜0.016 7）values than the Locator group．No statistically significant difference was observed in BOP positive rates among the three groups in pairwise comparisons（adjusted P＞0.016 7）．The overall difference in the total incidence of mechanical complications among the three groups was statistically significant（P＜0.05），and further pairwise comparisons showed that the bar-clip group had the lowest incidence（16.67%），while the Locator group had the highest（50.00%）（adjusted P＜0.016 7）．Conclusions For maxillary implant-supported overdentures，bar-clip attachments demonstrate relative advantages in maintaining peri-implant soft and hard tissue health，reducing marginal bone loss，and minimizing mechanical complications，suggesting good clinical applicability．

       目的 探究体成分变化对肥胖患者肾小球高滤过的影响。方法 根据纳入排除标准，连续收集在中南大学湘雅二医院营养科及代谢内分泌科就诊的肥胖患者（体质指数≥28 kg/m²），对其随访3个月以上，纳入体质量减轻≥5%的患者，记录一般人口学、人体测量学、体脂率（BFP）、体脂肪量（BFM）、内脏脂肪面积（VFA）和骨骼肌量（SMM）等体成分和实验室检验数据，计算估计肾小球滤过率（eGFR）。肾小球高滤过被定义为eGFR大于普通人群第95个百分位数，根据此标准分为肾小球高滤过组和正常滤过组，比较组间一般人口学资料、生化指标及体成分的差异，绘制限制性立方样条图分析体成分的变化与eGFR变化之间的非线性关联。结果 （1）共收集85例肥胖患者初复诊资料，其中肾小球正常滤过患者43例，肾小球高滤过患者42例，男性35例，女性50例；（2）单因素分析提示肾小球高滤过患者减重前后eGFR差异有统计学意义［143.34 mL/（min·1.73 m²） vs 125.68 mL/（min·1.73 m²）；（3）非线性相关分析结果显示肥胖肾小球高滤过患者eGFR的变化与VFA的变化相关（P=0.015 1），与BFP的变化相关（P=0.022 6）。结论 肥胖患者减重后，随着VFA和BFP的下降可能改善肾小球高滤过。

    Objective This study aimed to investigate the impact of alterations in body composition on glomerular hyperfiltration in obese patients．Methods According to predefined inclusion and exclusion criteria，obese patients（body mass index ≥28 kg/m2）from the department of clinical nutrition and the department of metabolism and endocrinology at Second Xiangya Hospital of Central South University were consecutively enrolled．Patients who achieved a weight loss of ≥5% after more than three months of follow-up were included．Data on general demographics，anthropometric measurements，body composition parameters-including body fat percent（BFP），body fat mass（BFM），visceral fat area（VFA），and skeletal muscle mass（SMM）-and laboratory test results were collected．The estimated glomerular filtration rate（eGFR）was calculated．Glomerular hyperfiltration was defined as an eGFR greater than the 95th percentile for the general population．Based on this criterion，patients were categorized into a hyperfiltration group and a normofiltration group．Differences in demographic characteristics，biochemical indices，and body composition parameters between the two groups were compared．Restricted cubic spline curves were plotted to analyze the non-linear relationship between changes in body composition and changes in eGFR．Results （1）A total of 85 obese patients（35 males and 50 females） with initial and follow-up data were included，comprising 43 patients with normofiltration and 42 with hyperfiltration；（2）Univariate analysis indicated a statistically significant difference in eGFR before and after weight loss in the hyperfiltration group（143.34 mL/min/1.73m² vs 125.68 mL/min/1.73m²，P＜0.001）；（3）Non-linear correlation analysis revealed that changes in eGFR among obese patients with hyperfiltration were significantly associated with changes in VFA（P=0.015 1）and changes in BFP（P=0.022 6）．Conclusions Weight loss in obese patients may ameliorate glomerular hyperfiltration，potentially mediated through reductions in VFA and BFP．

       目的 了解《医疗保障基金使用监督管理条例》（以下简称《条例》）在广东省实施的情况,分析其存在的问题与挑战, 提出改进建议。方法 依据《条例》设计调查问卷,采用便利抽样方法 , 针对广东省医保基金相关监管人员和医院工作人员展开问卷调查, 并进一步围绕相关主题展开深度访谈, 以便更全面地了解《条例》的实施情况。结果 回收有效问卷1 473份, 数据分析显示《条例》的实施有效遏制了违规行为、提高了监管效率、落实了信用管理制度、促进了服务规范性与费用合理化, 但同时也存在着部分违规行为仍难以监管、政策培训效果欠佳、技术支撑能力薄弱等问题。结论 在持续推进现有各项监管举措的基础上, 需进一步细化《条例》的具体内容, 加大政策培训与宣传力度, 持续完善技术支撑手段, 以提升基金监管效能。

        Objective To understand the specific implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds”（hereinafter referred to as the “Regulations”）in Guangdong Province, analyze its existing problems and challenges, and propose improvement suggestions．Methods A questionnaire was designed based on the “Regulations”, and a convenience survey method was adopted to conduct questionnaire surveys among regulatory personnel related to medical insurance funds and hospital staff．Further in-depth interviews were conducted around relevant themes to gain a more comprehensive understanding of the implementation of the “Regulations．” Results The implementation of the “Regulations” has effectively curbed violations, improved regulatory efficiency, implemented a credit management system, and promoted service standardization and cost rationalization．However, challenges remain,such as difficulties in regulating certain violations, suboptimal policy training outcomes, and weak technical support capabilities．Conclusions On the basis of continuously advancing existing regulatory measures, it is necessary to further refine the specific content of the “Regulations” strengthen policy training and publicity efforts, and continuously improve information technology support methods to better enhance the effectiveness of fund supervision．

       目的   了解育龄期乳腺癌患者对子代健康和遗传风险担忧现状及其对癌症诊断前后生育意愿改变的影响。方法   于2019年11月—2020年9月，采用中文版癌症后生育忧虑量表（RCAC）-子女健康亚量表对广州市某三甲医院的230例育龄期乳腺癌患者进行调查，应用SPSS 26.0及PSM插件对结果进行统计分析。在进行子女健康亚量表得分低分组和中高分组患者的生育意愿改变率的比较时，应用倾向性评分匹配法控制混杂因素。结果   育龄期乳腺癌患者对子代健康和遗传风险担忧得分为（11.40±2.99）分；匹配前后不同子女健康亚量表得分分组的患者在癌症诊断前后生育意愿改变率的差异均不具有统计学意义（P＞0.05）。结论   育龄期乳腺癌患者对子代健康和遗传风险的担忧虽然没有显著影响其生育意愿的改变，但其对子代健康和遗传风险担忧处于较高水平，临床医护人员应提高对这一现象的重视，可通过多渠道科普相关知识，开展遗传咨询服务以减轻患者的担忧。

      Objective  To explore the current status of childbearing age breast cancer patients’  concerns  about their children’s health and genetic risk and its influence on the change of fertility intention before and after cancer diagnosis．Methods  From November 2019 to September 2020，the Chinese version of the Reproductive Concern After Cancer Scale（RCAC）- Children’s Health Sub-scale was used to interview 230 patients with breast cancer of childbearing age in a tertiary hospital in Guangzhou，and SPSS 26.0 and PSM plug-in were used to analyze the results statistically．The  propensity  score matching method was used to control confounding factors when comparing the change  rate of fertility intention of patients with low scores and those with medium and high scores in the children health subscale．Results  The score of concern for the health and genetic risk of children in breast cancer patients of childbearing age was（11.40±2.99）．There was no statistically significant difference in the change  rate of fertility intention before and after cancer diagnosis among patients with different subscale scores of children’s health．Conclusions   Despite not significantly impacting fertility intentions，the notably high level of concern regarding children’s health and genetic risks among childbearing-age breast cancer patients necessitates increased clinical awareness．It is recommended that healthcare professionals address this through multi-channel education and genetically focused counseling within a collaborative model to mitigate patient distress．

       目的   探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离（ESD）术患者心理及治疗依从性的效果。方法   前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象，采用随机数字表法将患者分为A、B组，B组56例患者采取治疗性沟通干预，A组66例患者采用认知行为疗法联合治疗性沟通干预，两组均连续干预2个月。比较两组患者干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、心理弹性量表（CD-RISC）评分、Herth希望指数量表（HHI）评分差异，对比两组干预依从性。结果   干预后，两组SAS、SDS评分均下降且A组低于B组（t分别为12.096、10.326，P＜0.05）；干预后，两组CD-RISC量表各项评分均提高且A组高于B组（t分别为18.483、12.060、13.622，P＜0.05）；干预后，两组HHI量表各项评分均上升且A组高于B组（t分别为1.289、11.568、12.527、13.794，P＜0.05）；A组患者总依从率96.97%（64/66）高于B组80.36%（45/56）（χ ² =8.782，P＜0.05）。结论   认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想，能够明显改善患者负性情绪，提高心理弹性及对疾病康复的希望水平，有效提升依从性。

       Objective  To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological  health and therapy compliance of patients undergoing endoscopic submucosal dissection（ESD）．Methods  Prospectively，122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects．These patients were randomly divided into Group A and Group B using the random number table method，and 56 patients in group B were treated with therapeutic communication，66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication，and both groups were continuously intervened for 2 months．The  scores of Self-Rating Anxiety Scale（SAS），Self-Rating Depression Scale（SDS），Connor-Davidson Resilience Scale（CD-RISC）and Herth Hope Index（HHI）were compared between the two groups before and after treatment．Therapy compliance between the two groups was compared．Results  After treatment，the SAS and SDS scores of the two groups were decreased，and the scores of group A was lower than that of group B（t=12.096，10.326，P＜0.05）after the intervention，the scores of the CD-RISC scale of the two groups were improved，and the score of group A was higher than that of group B（t=18.483，12.060，13.622，P＜0.05）．After intervention，the scores of HHI scale in both groups increased and score of group A was higher than that ofgroup B（t=11.289，11.568，12.527，13.794，P＜0.05）．The total compliance rate of patients in group A was 96.97%（64/66），which was significantly higher than 80.36%（45/56）in group B（χ ² =8.782，P＜0.05）．Conclusions  Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients，which can significantly improve patients’ negative emotions，psychological resilience and hope for disease recovery，and also therapy compliance．

       目的   识别经皮冠状动脉介入治疗（PCI）后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究，纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能，并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素，应用中介分析探索潜在的中介机制。结果  271例（34.7%）、304例（39.0%）和153例（19.6%）恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明，较高的家庭月收入与较高的抑郁水平相关（线性回归：β为0.908和1.937；Logistic：OR为2.05和5.47），社会支持程度与抑郁水平呈负相关（线性回归：β=-0.079；Logistic：OR=0.93）。单身/离异/寡居患者的焦虑水平显著高于已婚患者（线性回归：β=1.613；Logistic：OR=2.28）。与家庭月收入低于5 000元者相比，家庭月收入为5 000~10 000元之间的患者的压力水平较高（线性回归：β=1.065；Logistic：OR=3.14）。此外，自我感受负担较重的患者具有更高的压力水平（线性回归：β=0.077；Logistic：OR=1.05）。中介分析结果表明，焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题，其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素，制定综合管理策略以改善其预后。

       Objective  To identify the risk factors associated with depression，anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention（PCI）．Methods  In this cross-sectional study，780 patients who developed kinesiophobia after undergoing PCI were enrolled．A series of scales were used to assess the psychological health status，quality of life，self-perceived burden，social support，and exercise self-efficacy of patients with kinesiophobia，and socio-demographic data of the patients were collected through a questionnaire．Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes，including depression，anxiety，and stress．Furthermore，mediation analysis was employed to explore the potential mediating mechanisms．Results  Among the 780 patients with kinesiophobia，271（34.7%），304（39.0%）and 153（19.6%）were found to have varying degrees of depression，anxiety，and stress，respectively．The levels of depression，anxiety and stress in patients with kinesiophobia were positively correlated with each other．The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression（linear：β=0.908 and 1.937；Logistic：OR=2.05 and 5.47），while the degree of social support was negatively correlated with depression levels（linear：β=-0.079；Logistic：OR=0.93）．For patients who were single，divorced or widowed，their levels of anxiety were significantly higher than those of married patients（linear：β=1.613；Logistic：OR=2.28）．Compared to patients with a monthly household income of less than 5 000 yuan，those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress（linear：β=1.065；Logistic：OR=3.14）．Additionally，patients who perceived a higher personal burden also experienced greater stress（linear：β=0.077；Logistic：OR=1.05）．Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression．Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues．Factors such as monthly household income，age，marital status，lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes．Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis．