急性冠脉综合征疾病管理模式对冠心病二级预防水平的影响

摘要

目的 探讨急性冠脉综合症患者疾病管理模式对冠心病二级预防水平的影响.方法 将72例急性冠脉综合征患者随机分为干预组36例和对照组36例.干预组干预包括2次针对生活方式和用药依从性的健康教育,电话或门诊随访;对照组仅包括2次健康教育.观察出院6个月后两组患者各项指标的差异情况.结果 共70例患者完成6个月的随访.随访6个月后,干预组总胆固醇达标率高于对照组(100.00％vs.77.14％,P＜ 0.01),干预组糖化血红蛋白(HbA1c)达标率显著高于对照组(71.43％vs.27.78％,P＜0.01);干预组用药依从性(阿司匹林、β-受体阻滞剂、他汀类药物)显著优于对照组(P＜0.05);干预组吸烟率明显低于对照组(2.86％ vs.17.14％,P＜0.05).结论 本研究应用的疾病管理模式可显著提高急性冠脉综合征患者二级预防达标率.%Objective To investigate the effect of disease management model on secondary prevention in patients with acute coronary syndrome (ACS).Methods 72 patients with ACS were randomly divided into intervention group (n=36) and control group (n=36).Intervention measures of intervention group included 2 times of health education focusing on healthy lifestyle and medication adherence,telephone or outpatient follow-up,while control group only had 2 times of healthy education.The conditions of two groups 6 months later were observed.Results 70 patients completed 6-month follow-up.After follow-up 6 months,the standard reaching rate of total cholesterol in intervention group was significantly higher than that in control group (100％ vs.77.14％,P＜0.01),the standard reaching rate of hemoglobin (HbAlc) in intervention group was significantly higher than that in control group (71.43％ vs.27.78％,P＜0.01);the medication compliance (aspirin,β-blocker,statins) in intervention group were higher than those in control group (P＜0.05);the rate of unsuccessful smoking quitting in intervention group was significantly lower than that in control group (2.86％ vs.17.14％,P＜0.05).Conclusion The disease management model can effectively improve the standard reaching rate of secondary prevention in patients with acute coronary syndrome.