老年冠心病患者低盐低脂饮食现状及其影响因素分析

Status and influencing factors of low-salt and low-fat diet in elderly patients with coronary heart disease

目的分析出院1年的老年冠心病患者的低盐低脂饮食现状,并分析影响其低盐低脂饮食的因素,为科学有效指导老年冠心病患者健康饮食提供理论依据。方法调查2017年7月至11月河北省3地区出院1年的714例老年冠心病患者,通过调查问卷、冠心病自我管理量表等方法收集患者信息,分析其饮食状况,并通过logistics回归分析影响老年冠心病患者饮食的因素。结果714例患者中男性522例(73.1%),女性192例(26.9%);年龄范围60~95岁。225人(31.5%)出院1年后仍坚持低盐低脂饮食,且老年冠心病患者低脂低盐饮食状况在病变血管数量、抑郁、吸烟、饮酒等方面分布存在差异(P<0.05)。logistics回归分析结果显示,病变血管数量(OR_(双支病变)=0.567,95%CI:0.353~0.911;OR_(多支病变)=2.418,95%CI:1.351~4.328)、抑郁(OR_(轻度)=5.367,95%CI:2.594~11.107;OR_(中重度)=3.782,95%CI:1.826~7.835)、吸烟(OR_(偶尔)=4.105,95%CI:2.261~7.456;OR_(经常)=1.985,95%CI:0.973~4.051)是老年冠心病患者坚持低盐低脂饮食的影响因素。结论老年冠心病患者坚持低盐低脂饮食现状不理想,多支病变、伴有抑郁、吸烟的老年冠心病患者低盐低脂饮食长期执行率差。

Objective To analyze the status and explore its main influencing factors of low-salt and low-fat diet in elderly patients with coronary heart disease discharged from hospitals for 1 year,in order to provide theoretical basis for scientific and effective guidance to conduct healthy diet.Methods From July 2017 to November 2017,714 elderly patients with coronary heart disease in three regions of Hebei Province who have been discharged for one year were investigated,and patients′information was collected through self-designed questionnaires and the coronary heart disease self-management scale.The diet status and the affecting factors were analyzed by logistics regression.Results Among the 714 patients,522(73.1%)were male and 192(26.9%)were female.The age ranged from 60 to 95 years old.And 225 patients(31.5%)with CHD adhered to a low-salt and low-fat diet discharged from hospital after one year.There were differences in the number of diseased vessels,depression,smoking and drinking in elderly patients with coronary heart disease(P<0.05).Logistics regression analysis showed that the diseased vessels(double branch lesions:OR=0.567,95%CI:0.353-0.911;multi branch lesions:OR=2.418,95%CI:1.351-4.328),depression(mild:OR=5.367,95%CI:2.594-11.107;moderate and severe:OR=3.782,95%CI:1.826-7.835),smoking(once a while:OR=4.105,95%CI:2.261-7.456;often:OR=1.985,95%CI:0.973-4.051)were the main influencing factors for the low-salt and low-fat diet of elderly patients with CHD.Conclusion The situation of low-salt and low-fat diet in elderly patients with CHD was unsatisfactory,and low salt and low fat diet has poor long-term performance for elderly patients with coronary heart disease with multiple vessel disease,depression and smoking.