| 张国明,陈家进,留志贤,欧尾妹,黄承敏,王斌,戴翠莲,王焱.冠心病介入术后患者随访依从性对危险因素影响的研究[J].实用中西医结合临床,2024,24(18): |
| 冠心病介入术后患者随访依从性对危险因素影响的研究 |
| Study on the influence of follow-up compliance on risk factors of patients with coronary heart disease after interventional treatment |
| 投稿时间：2024-06-10 修订日期：2024-07-23 |
| DOI： |
| 中文关键词: 冠心病 随访模式 随访依从性 |
| 英文关键词: |
| 基金项目:科技部政府间国际科技创新合作项目(2019YFE0113900),厦门市卫生健康委员会和厦门市科学技术局联合项目(3502Z20209007),福建省自然科学基金(2023J011676) |
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| 中文摘要: |
| 目的 评价随访依从性对冠心病介入术后患者危险因素的影响。方法 回顾性分析2021年6月至2022年1月在厦门大学附属心血管病医院住院行冠脉介入治疗并顺利出院的1 383例冠心病患者临床资料，根据有效随访次数分为高依从性组（随访次数≥3次）和低依从性组（随访次数≤2次）。收集患者住院时的基线资料与术后随访资料，采用统计学方法对两组患者资料进行对比分析。结果 两组性别、年龄、出院诊断、合并疾病及术前冠脉病变等基线资料对比，差异无统计学意义（P＞0.05）。两组冠脉手术血管处理支数、支架总长度、支架最大内径、药物球囊例数、单纯PTCA球囊内径、当次住院计划内二次手术及出院带药中各类药物比例对比，差异无统计学意义（P＞0.05）。两组出院后随访12个月时的危险因素达标率对比，高依从性组均显著优于低依从性组（P＜0.05）。两组抗凝、护胃、降压、他汀类药物服用情况对比，差异无统计学意义（P＞0.05）；但高依从性组抗血小板、降糖药物使用比例高于低依从性组，而降压、降糖药物种类高于低依从性组（P＜0.05）；高依从性组使用两种或以上降脂药物比例高于低依从性组（P＜0.05）。两组出院后建议择期再次手术的比例对比，差异无统计学意义（P＞0.05）；但高依从性组计划二次冠脉手术、无症状复查再次手术的比例高于低依从性组，而症状驱使再次手术的比例低于低依从性组（P＜0.05）。结论 冠心病介入治疗术后，随访高依从性可有效提升危险因素的达标率，有效降低症状驱使性手术。 |
| 英文摘要: |
| Objective To evaluate the effect of follow-up compliance on risk factors of patients with coronary heart disease after interventional treatment. Methods This study was a retrospective study. 1383 patients with coronary heart disease who were admitted to the affiliated cardiovascular hospital of Xiamen University from June 2021 to January 2022 and successfully discharged from the hospital were included. Patients were divided into high compliance group (more than 3 follow-up visits) and low compliance group (less than 2 follow-up visits) according to the number of effective follow-up visits. Baseline data and postoperative follow-up data were collected. Statistical methods were used to compare and analyze the data of the two groups. Results
There was no significant difference between the two groups in gender, age, discharge diagnosis, combined diseases and preoperative coronary lesions (P > 0.05). There was no significant difference in the number of vascular treatment, total length of stent, maximum internal diameter of stent, number of drug balloon cases, internal diameter of PTCA balloon alone, planned second operation and the proportion of different drugs at discharge (P > 0.05). The rate of achieving targets for risk factors was significantly higher in the high compliance group than in the low compliance group (P < 0.05) at 12 months after discharge. There was no significant difference in the use of anticoagulation, stomach protection, blood pressure and statins between the two groups (P > 0.05). However, the proportion of antiplatelet and hypoglycemic drugs used in high compliance group was higher than that in low compliance group, and the types of antihypertensive and hypoglycemic drugs were higher than those in low compliance group (P < 0.05). The proportion of high compliance group using two or more lipid-lowering drugs was higher than that of low compliance group (P < 0.05). There was no significant difference between the two groups in the ratio of recommended re-operation after discharge (P > 0.05). However, the proportion of planning second operation, asymptomatic re-operation in the high compliance group was higher than that of the low compliance group, while the proportion of symptom-driven re-operation was lower than that of the low compliance group (P < 0.05). Conclusion After interventional treatment for coronary heart disease, high follow-up compliance can effectively improve the standard rate of achieving targets for risk factors and reduce symptom-driven re-operation. |
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