基于心血管专科护士为主导的综合性运动方案对冠心病合并2型糖尿病患者康复的影响  

Effect of comprehensive exercise program led by cardiovascular nurses on rehabilitation of patients with coronary heart disease and type 2 diabetes mellitus

作　　者：郑艳 缪星 孙洁 ZHENG Yan;MIAO Xing;SUN Jie(Department of Cardiology,Provincial Hospital Affiliated to Fuzhou University,Fuzhou,Fujian,350001,China)

机构地区：[1]福州大学附属省立医院心内科,福建福州350001 [2]福建医科大学省立临床医学院

出　　处：《心血管康复医学杂志》2025年第2期271-275,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨以专科护士为主导的综合性运动方案在冠心病合并2型糖尿病患者中的应用效果。方法:纳入福州大学附属省立医院2022年4月-12月收治的冠心病合并2型糖尿病患者386例,按入区时间的先后顺序,将患者分为对照组和干预组,每组193例,对照组采用常规治疗和随访,干预组在对照组的基础上制定以专科护士为主导的个体化运动康复方案,干预24周。比较两组患者出院时、6个月后血糖(空腹血糖,糖化血红蛋白)、血脂(低密度脂蛋白胆固醇,总胆固醇)水平,左室射血分数及6min步距(6MWD)。结果:经过6个月的干预,与对照组相比,干预组患者的空腹血糖[(5.30±0.97)mmol/L比(5.52±1.04)mmol/L],糖化血红蛋白[(5.60±0.65)%比(5.78±0.95)%]、低密度脂蛋白胆固醇[(1.88±0.52)mmol/L比(2.01±0.48)mmol/L]、总胆固醇[(3.85±0.82)mmol/L比(4.04±0.75)mmol/L]水平均显著降低,左室射血分数[(59.67±4.84)%比(57.22±6.45)%]、6MWD[(504.66±75.21)m比(487.75±56.16)m]显著增加(P<0.05或<0.01)。结论:以专科护士为主导的运动康复方案可以有效控制冠心病合并2型糖尿病患者的血糖、血脂,提高心功能及运动耐力,改善预后。Objective:To explore the application effect of comprehensive exercise program led by specialized nurses in patients with coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).Methods:We enrolled 386 CHD+T2DM patients admitted in Provincial Hospital Affiliated to Fuzhou University between April and December 2022.The patients were divided into control group(n=193)and intervention group(n=193)according to the order of their admission.The patients in control group received routine treatment and follow-up,while those in the intervention group received additional individualized exercise rehabilitation program led by specialized nurses.Both groups were intervened for 24 weeks.Levels of blood glucose[fasting blood glucose(FBG),glycosylated hemoglobin A1c(HbA1c)],blood lipids[low density lipoprotein cholesterol(LDL-C),total cholesterol(TC)],left ventricular ejection fraction(LVEF)and 6min walking distance(6MWD)were compared between two groups at discharge and six months after discharge.Results:Compared with patients in control group after 6-month intervention,those in intervention group had significant lower FBG[(5.30±0.97)mmol/L vs.(5.52±1.04)mmol/L],HbA1c[(5.60±0.65)%vs.(5.78±0.95)%],LDL-C[(1.88±0.52)mmol/L vs.(2.01±0.48)mmol/L],TC[(3.85±0.82)mmol/L vs.(4.04±0.75)mmol/L],and significant higher LVEF[(59.67±4.84)%vs.(57.22±6.45)%]and 6MWD[(504.66±75.21)m vs.(487.75±56.16)m](P<0.05 or<0.01).Conclusion:Specialized nurse-led exercise rehabilitation program could effectively control blood glucose and lipid levels,improve heart function,exercise endurance and prognosis in patients with type 2 diabetes mellitus and coronary heart disease.

关 键 词：冠心病 糖尿病 2型 康复 

分 类 号：R541.4[医药卫生—心血管疾病]