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

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

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。

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.