住院期间生活方式强化干预对冠心病并糖耐量减低患者远期依从性的影响

The Long-Term Efficacy of Lifestyle Intervention during Hospitalization on the Compliance of Coronary Heart Disease Patients Complicated with Impaired Glucose Tolerance

目的探讨住院期间生活方式强化干预对冠心病合并糖耐量减低(impaired glucose tolerance,IGT)患者的远期效果。方法 将138例符合入组标准的冠心病合并IGT分为强化组(76例)和常规组(62例)。强化组患者住院全程进行生活方式强化干预;常规组仅住院前3 d进行生活方式干预。测评两组出院时及出院后0.5、1.0、1.5和2.0年时"糖尿病患者依从性测量问卷"得分,并统计两组血糖恢复正常、符合冠心病介入治疗或搭桥手术指征情况。结果 135例完成所有随访,强化组75例,常规组60例。出院时及出院后的4次随访中,强化组依从性均显著高于常规组(P<0.05),但随着随访时间延长依从性得分逐步降低,出院后2.0年时显著低于出院时(P<0.05);常规组出院后4次随访得分均显著低于出院时。4次随访中,强化组血糖恢复正常例数35例,常规组17例,两组比较差异有统计学意义(P<0.05);冠心病转归例数两组差异无统计学意义。结论对冠心病合并IGT患者住院期间的生活方式进行强化干预,有助于提高患者出院后的依从性,以改善疾病预后。

Objective To evaluate the long-term efficacy of lifestyle intervention during hospitalization on the compliance of coronary heart disease（CHD）patients complicated with impaired glucose tolerance（IGT）. MethodsA total of 138 CHD patients complicated with IGT were divided into intensive group（n=76） and control group（n=62）.Intensive lifestyle supervision was provided for the patients in the intensive group all the time,while provided for patients in control group only 3 days before hospitalization.Patients＇ compliance score,blood glucose and indicators of interventional treatment or coronary artery bypass graft were compared between the two groups before discharge from hospital and 0.5,1.0,1.5 and 2.0 years after discharge from hospital. Results135 were followed up,75 cases in intensive group,and 60 cases in control group.When compared with that in the control group,the patients＇ compliance scores was higher in intensive group at the 4 times of following up（P0.05）,but it decreased along with the time,and lower 2 years after following up when compared with that before discharged from hospital（P0.05）;the patients＇ compliance scores in control group was lower at the 4 times of following up when compared with that before discharged from the hospital,and the difference showed significant difference at the top 3 times（P0.05）.The blood glucose was recovery to normal in 35 cases in intensive group,but 17 cases in the control group,there was significant difference between the two groups（P0.05）.There was no significant difference of CHD recovery between the two groups（P0.05）. ConclusionIntensive lifestyle intervention during hospitalization has positive efficacy on the compliance and prognosis in CHD patients complicated with IGT.