冠心病规范化二级预防的临床结果分析  

Clinical Outcomes of Standardized Secondary Prevention in Patients with Coronary Heart Disease

作　　者：赵桂琴[1] 狄文娟[2] 郭振峰[1] ZHAO Guiqin;DI Wenjuan;GUO Zhenfeng(Department of Cardiology,BenQ Medical Center Affiliated to Nanjing Medical University,Nanjing 210019,China;Department of Gerotology,the People′s Hospital of Jiangsu Province,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院心血管内科,南京210019 [2]江苏省人民医院老年科,南京210019

出　　处：《医学综述》2018年第21期4350-4354,共5页Medical Recapitulate

摘　　要：目的观察冠心病患者规范化二级预防的临床效果。方法选取2014年4月至2016年4月南京医科大学附属明基医院收治的440例冠心病患者为研究对象,按随机数字法分为对照组和研究组,各220例。对照组给予常规冠心病治疗干预;观察组给予冠心病规范化二级预防干预,主要包括合理的二级预防药物治疗、控制冠心病危险因素、帮助患者建立健康的生活方式、心理干预、健康宣教、定期随访。全部患者随访2年后,比较两组患者的血压、血脂、血糖和体质指数、患者对冠心病危险因素的知晓情况、患者出院后二级预防用药的依从性、2年内心血管事件发生率。结果研究组患者干预后的收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、体质指数显著低于对照组[(120. 3±7. 4) mm Hg(1 mm Hg=0. 133 k Pa)比(134. 0±7. 9) mm Hg,(73. 6±6. 1) mm Hg比(81. 8±7. 6) mm Hg,(4. 0±0. 8) mmol/L比(5. 7±1. 3) mmol/L,(2. 4±0. 7) mmol/L比(4. 1±1. 0) mmol/L,(5. 9±0. 5)%比(6. 6±0. 6)%,(23. 1±2. 1)比(24. 0±1. 8)](P <0. 05)。研究组对高血压、高血脂、高血糖、体重超标、吸烟冠心病危险因素的知晓率显著高于对照组[92. 7%(204/220)比67. 3%(148/220),95. 9%(211/220)比68. 6%(151/220),90%(198/220)比46. 3%(102/220),90. 4%(199/220)比69. 1%(152/220),88. 2%(194/220)比75. 0%(165/220)](P <0. 05)。研究组服药依从性高于对照组[90. 0%(198/220)比56. 8%(125/220)],心脑血管不良事件总体发生率显著低于对照组[7. 7%(17/220)比28. 2(62/220)](P <0. 05),但两组病死率比较差异无统计学意义(P> 0. 05)。结论冠心病患者给予规范化二级预防干预,效果明显,有利于改善冠心病患者预后。Objective To analyze the efficacy of standardized secondary prevention patients with coronary heart disease（CHD）. Methods A total of 440 patients with CHD admitted to BenQ Medical Center Affiliated to Nanjing Medical University from Apr. 2014 to Apr. 2016 were included in the study and divided into a control group and an observation group according to the random number method,220 cases each.The control group was given conventional therapy;the observation group was given standardized secondary prevention,including pharmacologic treatment,risk factor control,establishment of healthy life style,psychological intervention,health education and regular follow-up.Blood pressure,glycosylated hemoglobin,blood lipids,knowledge about CHD risk factors,medicine-taking compliance after discharge and cardiovascular events were compared between groups. Results Compared with the control group, the observation group had much lower systolic pressure[（120.3±7.4） mmHg vs （134.0±7.9） mmHg],diastolic pressure[（73.6±6.1） mmHg vs （81.8±7.6） mmHg] , total cholesterol[（4.0±0.8） mmol/L vs （5.7±1.3） mmol/L],low density lipoprotein cholesterol[（2.4± 0.7 ） mmol/L vs （4.1±1.0） mmol/L],glycosylated hemoglobin[（5.9±0.5）% vs （6.6±0.6）%], body mass index[（23.1±2.1） vs （24.0±1.8）]（all P 〈0.05）, and much better awareness of CHD risk factors of hypertension, hyperlipidemia, hyperglycemia, overweight, smoking coronary heart disease[92.7%（204/220） vs 67.3%（148/220）,95.9%（211/220） vs 68.6% （151/220）,90%（198/220） vs 46.3%（102/220）,90.4%（199/220） vs 69.1%（152/220）,88.2%（194/220） vs 75.0% （165/220）]（ P 〈0.05）. Moreover, medicine-taking compliance in the observation was much higher group than in the control group[90.0%（198/220） vs 56.8%（125/220）]（ P 〈0.05）,and the overall incidences of cardiocerebral vascular events in the observation group were much less than in the control group[7.7%（17/220） vs 28.2%（62/220）]（ P

关 键 词：冠心病 二级预防 危险因素 预后 

分 类 号：R543.3[医药卫生—心血管疾病]