健康教育与预防性治疗干预老年缺血性心脑血管病血栓前状态:10年随访(英文)

Ten-year follow-up in healthy education and prophylactic treatment of pre-thrombosis phase of ischemic cardiovascular and cerebrovascular diseases in senium

背景:健康教育与预防性治疗能减少老年人缺血性心脑血管病的发生,但少见将两者结合使之成为新预防模式,用于干预血栓前状态。目的:探讨新预防模式对老年人缺血性心脑血管病的实际预防效果。设计:采用组群干预试验。地点和对象:研究对象来自于1993-02/2002-03杭州铁路分局305名离退休干部,年龄61～75岁。高血压平均患病率18%,心脑血管梗死率平均7.2%。干预:干预组给予心血管健康教育,每半年一次预防性检测(预检)血液流变学,对发现的高血压综合征者给予以改良型血液稀释综合疗法为主的预防性治疗(预治),直至复检正常。对照组不给予上述干预措施。主要观察指标:两组跟踪监测血液流动特性指标和心血管复合事件发生率和病死率。结果:干预组145例,对照组148例,完成10年随访。持续干预后干预组的血液流变学和凝血谱各项指标较对照组有明显改善犤低切粘度(10.29±1.66)mPa·s,(12.39±1.54)mPa·s,P<0.05犦;血液稀释疗法干预后的血细胞比溶较前有明显降低(P<0.05);干预组心血管复合事件发生率和病死率较对照组分别下降44%,37%。结论:相结合的新预防模式能有效改善血栓前状态的血液异常流动性,明显降低老年人心血管复合事件的发生率和病死率,具有临床实用价值。

BACKGROUND:Although the occurrence of cardiac and cerebral vessels ischemic diseases in senium can be reduced through either healthy education or prophylactic treatment,a new prophylactic pattern consisting of healthy education and prophylactic treatment,which is applied to the pre-thrombosis phage,is barely seen.OBJECTIVE:To discuss the practical effect of a new prophylactic pattern in cardiac and cerebral vessels ischemic diseases in senium.DESIGN:Group-designed intervention experiment.SETTING and PARTICIPANTS:A total of 305 objects aged 61 to 75 years old,who retired from Hangzhou Railway Branch Bureau from February 1993 to March 2002,were selected with a 18%average prevalence rate of hypertension and a 7.2%average infarction rate of cardiac and cerebral vessels.INTERVENTION:In intervention group,healthy education of cardiac vessels and a prophylactic detection in hemorheology twice a year were applied and when a hyperviscosity blood syndrome was discovered,a prophylactic treatment mainly including the improved-pattern complex therapy of hemodilution was carried out till the normal examination of the case was detected.No intervention mentioned above was administered in the control group.MAIN OUTCOME MEASURES:The incidence and fatality rate in cardiac vessels compound events and the blood flow characteristics marker was tracking monitored in both two groups.RESULTS:Ten-year follow-up was accomplished in both the intervention team including 145 cases and the control group including 148 cases.Various markers of blood coagulation spectrum and hemorheology in the intervention group were strikingly ameliorated after continuous interventions,compared with that in the control group.Ten-year follow-up in healthy education and prophylactic treatment of pre-thrombosis phase of ischemic cardiovascular and cerebrovascular diseases in senium$$$$ Yue Chen, Ping Lai,Yuan-Chao Zhou,Xiao-Zhi Qiao,Xiao-Hong Zheng,Hong Yue Yue Chen,Ping Lai,Yuan-Chao Zhou,Xiao-Zhi Qiao,Xiao-Hong Zheng,Hong Yue ,Department of Cadre Ward,Hangzhou Railway Central Hospital,Hangzhou 310009,Zhejiang Province,ChinaAbstractBACKGROUND:Although the occurrence of cardiac and cerebral vessels ischemic diseases in senium can be reduced through either healthy education or prophylactic treatment,a new prophylactic pattern consisting of healthy education and prophylactic treatment,which is applied to the pre-thrombosis phage,is barely seen.OBJECTIVE:To discuss the practical effect of a new prophylactic pattern in cardiac and cerebral vessels ischemic diseases in senium.DESIGN:Group-designed intervention experiment.SETTING and PARTICIPANTS:A total of 305 objects aged 61 to 75 years old,who retired from Hangzhou Railway Branch Bureau from February 1993 to March 2002,were selected with a 18%average prevalence rate of hypertension and a 7.2%average infarction rate of cardiac and cerebral vessels.INTERVENTION:In intervention group,healthy education of cardiac vessels and a prophylactic detection in hemorheology twice a year were applied and when a hyperviscosity blood syndrome was discovered,a prophylactic treatment mainly including the improved-pattern complex therapy of hemodilution was carried out till the normal examination of the case was detected.No intervention mentioned above was administered in the control group.MAIN OUTCOME MEASURES:The incidence and fatality rate in cardiac vessels compound events and the blood flow characteristics marker was tracking monitored in both two groups.RESULTS:Ten-year follow-up was accomplished in both the intervention team including 145 cases and the control group including 148 cases.Various markers of blood coagulation spectrum and hemorheology in the intervention group were strikingly ameliorated after continuous interventions,compared with that in the control group.[the whole blood low-cut viscosity(10.29±1.66) mPa·s,(12.39±1.54)mPa·s,P< 0.05).Hematocrit(HCT)of those objects were obviously declined after the complex therapy of hemodilution(P< 0.05).The incidence and fatality rate in cardiac vessels compound events in the inter