上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (3): 302-.doi: 10.3969/j.issn.1674-8115.2011.03.012

• 论著（临床研究） • 上一篇    下一篇

强化规范化二级预防对急性冠脉综合征患者生活方式的影响

韩文正1, 张 敏1, 王 骏2, 孙育民2, 方唯一1   

  1. 1.上海交通大学附属胸科医院心内科, 上海 200030；2.上海市静安区中心医院心内科, 上海 200040
  • 出版日期:2011-03-28 发布日期:2011-03-29
  • 通讯作者: 方唯一, 电子信箱: fwychest@163.com。
  • 作者简介:韩文正(1984—), 男, 住院医师, 硕士；电子信箱: jiaohu_x@hotmail.com。
  • 基金资助:

    上海市科委课题(074119635)

Effects of standardized secondary prevention on lifestyle of patients with acute coronary syndrome

HAN Wen-zheng1, ZHANG Min1, WANG Jun2, SUN Yu-min2, FANG Wei-yi1   

  1. 1.Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China；2.Department of Cardiology, Shanghai Jing'an District Centre Hospital, Shanghai 200040, China
  • Online:2011-03-28 Published:2011-03-29
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 074119635

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摘要：

目的 探讨规范化二级预防措施对急性冠脉综合征患者生活方式的影响。方法 249例急性冠脉综合征患者随机分为强化规范化随访组(n=116)和常规随访组(n=133)。强化规范化随访组每3个月随访一次，随访过程中进行二级预防生活方式的教育，包括戒烟、运动、体质量控制、规范药物服用及压力调节等；常规随访组每6个月随访一次。于随访6个月和1年时点，比较两组患者在戒烟、运动、体质量控制及终点事件（包括心源性死亡、非致死性心肌梗死、靶血管的再次血运重建等）发生方面的差异。结果 218例患者完成6个月随访，103例患者完成1年随访。6个月和1年随访时，强化规范化随访组的戒烟未成功者比例均显著低于常规随访组(P<0.01)，运动达标率均显著高于常规随访组(P<0.05或 P<0.01)。1年随访时，强化规范化随访组超重者比例显著低于常规随访组（P<0.05）；两组均无主要终点事件发生。结论 强化规范化随访能够有效改善急性冠脉综合征患者的生活方式。

关键词: 二级预防, 急性冠脉综合征, 生活方式

Abstract:

Objective To investigate the effects of standardized secondary prevention on lifestyle of patients with acute coronary syndrome. Methods Two hundred and forty-nine patients with acute coronary syndrome were randomly divided into standardized follow-up group (n=116) and routine follow-up group (n=133). Patients in standardized follow-up group were followed up every 3 months, and lifestyle education of secondary prevention was carried out during the follow-up, including smoking quitting, exercise, body weight control, drug use standardization and pressure regulation. Patients in routine follow-up group were followed up every 6 months. At the time points of 6 months of follow-up and 1 year of follow-up, the conditions of smoking quitting, exercise, body weight control and ultimate events (cardiac death, non-lethal myocardial infarction and revascularization of targeted vessels) were compared between groups. Results Two hundred and eighteen patients completed the 6-month follow-up, and 103 patients finished the 1-year follow-up. After follow-up for 6 months or 1 year, the percents of unsuccessful smoking quitting in standardized follow-up group were significantly lower than those in routine follow-up group (P<0.01), and the percents of successful exercise in standardized follow-up group were significantly higher than those in routine follow-up group (P<0.05 or P<0.01). One year after follow-up, the percent of overweight in standardized follow-up group was significantly lower than that in routine follow-up group (P<0.05), and there was no ultimate event in both groups. Conclusion Standardized follow-up can effectively improve the lifestyle of patients with acute coronary syndrome.

Key words: secondary prevention, acute coronary syndrome, lifestyle