冠心病社区综合干预的效果评价  

Effect of Comprehensive Community Intervention on Coronary Heart Disease

作　　者：尉晓霞[1] 朱静芬[1] 施榕[1] 

机构地区：[1]上海交通大学公共卫生学院,上海市200025

出　　处：《中国全科医学》2010年第4期415-418,共4页Chinese General Practice

基　　金：上海市公共卫生重点学科建设项目(08GWZX1002)

摘　　要：目的初步探讨社区综合干预措施对冠心病患者发作症状、药物服用率及消耗量、血糖和血脂等指标及生活方式的影响。方法选取社区冠心病患者8075例,随机分为干预组4077例、对照组3998例。干预组给予3个月的社区综合干预,包括健康教育、饮食、运动及药物干预,对照组维持原有的治疗方案及常规的冠心病相关知识教育。结果干预3个月后,两组发作症状的发作次数较干预前均有所减少(P<0.05),但干预组发作次数的减少幅度大于对照组,差异有统计学意义(P<0.05)。干预组干预后消心痛或硝酸甘油服用率降低、一周消耗量减少,且消耗量降低幅度大于对照组,差异有统计学意义(P<0.05);干预后两组麝香保心丸一周消耗量均有所减少,干预组消耗量的降低幅度大于对照组,差异有统计学意义(P<0.05)。干预组干预后三酰甘油水平较干预前降低,也低于干预后对照组,差异有统计学意义(P<0.05);干预组干预后高密度脂蛋白水平高于对照组,差异有统计学意义(P<0.05);干预组空腹血糖、总胆固醇及三酰甘油水平均降低(P<0.05),而对照组空腹血糖及三酰甘油水平无明显变化,差异无统计学意义(P>0.05)。干预组不饮酒和不吸烟的比例均上升,差异有统计学意义(P<0.05)。结论社区综合干预可以降低冠心病患者的药物服用率和消耗量,改善症状、代谢指标和生活方式。Objective To explore the effects of comprehensive community intervention on symptoms,drug-use rate and drug consumption,blood glucose,blood lipid and lifestyle of patients with coronary heart disease（CHD）.Methods Totally 8 075 CHD patients were randomized into two groups：trial group（n=4 077）and control group（n=3 988）.The patients in the trial group were given 3-month intervention on health education,diet,exercise and drug;while those in the control group were given conventional treatment and education on relative knowledge of CHD.Results After 3-month intervention,the attack times in the two groups decreased（P0.05）,and the decreased magnitude was higher in the trial group than that in the control group（P0.05）.The usage rate and the dosage in one week of isosorbide dinitrate or nitroglycerin were decreased in the trial group,and the magnitude of latter was higher than that in the control group（P0.05）.The dosage of Baoxin Pills in one week was decreased more in the trial group than in the control group（P0.05）.In the trial group the levels of triglyceride,total cholesterol and fasting blood glucose decreased,the level of high density lipoprotein-cholesterol increased（P0.05）,which showed significant differences as compared with those in the control group（P0.05）;while in the control group the levels of fasting blood glucose and triglyceride changed insignificantly（P0.05）.Also the ratios of quitting smoking and alcohol in the trial group increased（P0.05）.Conclusion Comprehensive community intervention can decrease the drug-use rate and drug consumption,improve symptoms,metabolic indexes and lifestyle in patients with coronary heart disease.

关 键 词：冠心病 综合干预 社区 效果 

分 类 号：R541.4[医药卫生—心血管疾病] R197[医药卫生—内科学]