健康管理模式对老年冠心病患者不良生活习惯及相关并发症的影响

摘要

Objective :To study influence of health management mode on poor living habits and incidence rate of relat—ed complications in aged patients with coronary heart disease (CHD).Methods : Medical data of 259 aged CHD pa—tients in our hospital from Jan 2013 to Dec 2016 were collected .Health management mode was performed in our hospital since Jan 2015 ,therefore ,according to treatment time ,patients were divided into CHD control group (n＝114) and health management group (n＝ 140 ) ,both groups were intervened for continuous six months .Scores of self—rated abilities for health practices scale (SRAHP ) and Seattle angina questionnaire (SAQ ) ,levels of fasting blood glucose (FBG) ,blood pressure and blood lipids before and after intervention ,incidence of complications and mortality during follow—up were measured and assessed between two groups .Results :Compared with before interven—tion ,after six—month intervention , there were significant rise in each item score and total scores of SRAHP and SAQ ,and significant reductions in levels of FBG ,SBP ,DBP ,TC and TG in two groups , P＝0. 001 all.Compared with CHD control group after six—month intervention ,there were significant rise in each item score and total score of SRAHP [(82. 95 ± 18.24) scores vs .(91.91 ± 20.23) scores] ,each item score and total score of SAQ [(64. 90 ± 14. 29) scores vs .(72. 15 ± 15.87) scores] ,and significant reductions in levels of FBG [(5.51 ± 1.21) mmol／L vs. (5. 14 ± 1. 13)mmol／L] ,SBP[(121.07 ± 14.52) mmHg vs.(116. 72 ± 14. 01) mmHg] ,DBP [(80. 23 ± 9.63) mmHg vs.(77. 62 ± 9.31)mmHg] ,TC[(4. 31 ± 0.65)mmol／L vs.(4. 11 ± 0. 61) mmol／L] and TG[(1.45 ± 0. 21) mmol／L vs.(1. 39 ± 0.21)mmol／L] in health management group , P＜0. 05 or ＜0. 01. During follow—up ,incidence rates of recurrent angina pectoris (21.4% vs.35.3%) ,heart failure (2. 1% vs.7.6%) and myocardial infarction (3. 6%vs.10. 1%) in health management group were significantly lower than those of CHD control group , P＜0.05 all. Conclusion :Health management mode can enhance health behavior ,correct poor living habits ,stabilize blood glu—cose ,blood lipid and blood pressure ,and reduce incidence rate of related complications in aged CHD patients .%目的:研究健康管理模式对老年冠心病患者不良生活习惯及相关并发症发生率的影响.方法:我院2013年1月至2016年12月259例老年冠心病患者自2015年1月起开始实施健康管理模式,根据治疗时间,患者被分为冠心病对照组(114例)和健康管理组(140例) ,两组均连续干预6个月.测量、评估并比较两组干预前后健康行为能力量表(SRAHP)评分、空腹血糖(FBG) 、血压、血脂水平、西雅图心绞痛调查量表(SAQ)评分以及随访期间并发症和死亡率情况.结果:与干预前比较,干预6个月后两组SRAHP各分项得分及总分、 SAQ各分项得分及总分均显著升高, FBG 、收缩压(SBP) 、舒张压(DBP) 、总胆固醇(TC)和甘油三酯(TG)水平均显著降低, P均＝0.001 .与冠心病对照组比较,健康管理组干预6个月后SRAHP各分项得分及总分[ (82.95 ± 18. 24)分比(91.91 ± 20.23)分] 、 SAQ各分项得分及总分[ (64.90 ± 14.29)分比(72. 15 ± 15.87)分]升高更显著, FBG [ (5.51 ± 1.21) mmol／L比(5. 14 ± 1. 13) mmol／L] 、 SBP [ (121.07 ± 14. 52) mmHg比(116.72 ± 14.01) mm—Hg] 、 DBP [ (80. 23 ± 9. 63) mmHg比(77.62 ± 9.31) mmHg] 、 TC [ (4.31 ± 0.65) mmol／L比(4.11 ± 0.61) mmol／L]和TG [ (1. 45 ± 0.21) mmol／L比(1. 39 ± 0.21) mmol／L]水平降低更显著, P＜0. 05或＜0. 01 .随访期间,健康管理组再次心绞痛(21.4% 比35. 3%) 、心力衰竭(2.1% 比7.6%)和心肌梗死(3. 6% 比10. 1%)发生率显著低于冠心病对照组, P均＜0.05 .结论:健康管理模式可以增强老年冠心病患者健康行为能力,纠正不良生活习惯,稳定血糖、血脂及血压,降低相关并发症发生率.