门诊规范化管理对老年冠心病患者预后的影响  

Effects of Normalization Management on Prognosis in Elderly Patients with Coronary Artery Disease

作　　者：吴锦晖[1] 孙春丽[1] 张绍敏[1] 任晓晖[2] 杨玲[3] 李君[1] 张俊[1] 

机构地区：[1]四川大学华西医院老年病科,成都610041 [2]四川大学华西公共卫生学院社会医学教研室,成都610041 [3]四川大学华西医院老年门诊,成都610041

出　　处：《中国循证医学杂志》2012年第5期520-523,共4页Chinese Journal of Evidence-based Medicine

摘　　要：目的评估规范化门诊随访对老年冠心病患者服药依从性、心血管事件再入院率和生活质量的影响。方法选择2010年8月～2011年2月在四川大学华西医院老年心血管门诊就诊的110例65岁以上冠心病患者,分为强化管理组(n=55)和一般管理组(n=55)。强化管理组给予定期随访、定期检测、疾病讲座等措施,观察两组患者服药依从性、心血管事件再入院率和生活质量。结果随访1年后发现,强化随访组阿斯匹林/氯吡格雷(98.18% vs. 67.27%,P<0.05)、硝酸甘油制剂(85.45% vs. 40.00%,P<0.05)、ACEI/ARB(56.36% vs. 18.18%,P<0.05)、β受体阻滞剂(58.18% vs. 29.09%,P<0.05)和他汀类药物(94.55% vs. 32.73%,P<0.05)的服药率均好于一般管理组;因心血管事件再入院率也较低(12.73% vs. 41.42%,P<0.05);生活质量评分也好于一般管理组(P<0.05)。结论以循证医学为指导加强老年冠心病患者的门诊规范化管理,有助于提高患者服药依从性,减少患者心血管事件再入院率,并能提高患者生活质量。Objective To evaluate the efficacy of normalization management on prognosis in elderly patients with coronary artery disease,in aspects of drug compliance,readmission rate and quality of life.Methods A total of 110 patients above 65 years old with coronary artery disease visiting West China Hospital from August 2010 to February 2011 were investigated.The patients were divided into two groups： the intensive management group（n=55） and the general management group（n=55）.The measures such as regular follow-up,regular examination and medical education were conducted in the intensive management group,and the two groups were observed in aspects of drug compliance,readmission rate and quality of life.Results After 1-year follow-up,the percentages of patients taking aspirin/clopidogrel（98.18% vs.67.27%,P〈0.05）,nitrate（85.45% vs.40.00%,P〈0.05）,ACEI/ARB（56.36% vs.18.18%,P〈0.05）,β receptor blocker（58.18% vs.29.09%,P〈0.05） and statin（94.55% vs.32.73%,P〈0.05） were higher in the intensive management group than those in the general management group.Also,the readmission rate was lower（12.73% vs.41.42%,P〈0.05） and the score of quality of life was higher in the intensive management group than that in the general management group.Conclusion The normalization management guided by evidence-based medicine for the elderly patients with coronary artery disease is helpful to improve the drug compliance,reduce the readmission rate,and improve the quality of life.

关 键 词：老年 冠心病 疾病管理 预后 

分 类 号：R541.4[医药卫生—心血管疾病]