线下线上混合式慢病管理对系统性红斑狼疮患者病情转归的影响

Effects of online and offline mixing chronic disease management on outcome of systemic lupus erythematosus

目的研究线上线下混合式慢病管理干预对系统性红斑狼疮(SLE)患者病情转归的影响。方法将72例SLE患者随机分为对照组和慢病管理组,每组36例。对照组给予标准药物治疗和护理,慢病管理组在标准药物治疗基础上给予持续性线上线下混合式慢病管理。出院后第1、3、6个月测定患者SLE疾病活动指数(SLEDAI)、血清IgA、IgM、IgG和补体C3、C4水平及抑郁[采用患者健康问卷-9(PHQ-9)进行评估]和焦虑[采用广泛性焦虑障碍量表(GAD-7)进行评估]状况,第6个月评估患者临床症状、不良反应和生活质量[采用健康调查量表(SF-36)进行评估]。结果慢病管理组出院后第1、3、6个月SLEDAI评分低于对照组(P<0.05),第3、6个月血清IgA、IgM、IgG水平低于对照组(P<0.05),补体C3、C4水平高于对照组(P<0.05),且第3、6个月GAD-7和PHQ-9评分低于对照组(P<0.05)。慢病管理组第6个月临床症状和SF-36评分优于对照组(P<0.05),不良反应发生率低于对照组(P<0.05)。结论线下线上混合式慢病管理可改善SLE患者预后,控制病情进展,减少不良反应,提高生活质量,消除负面情绪。

Objective To explore the effects of online and offline mixing chronic disease management intervention on the outcome of systemic lupus erythematosus(SLE).Methods Seventy-two SLE patients were randomly divided into the control group and chroni disease management groups,36 cases in each group.The control group was given the standard medication treatment and nursing.The management group was given the continued online and offline mixed chronic disease management under the basis of standard medication treatment.The SLE disease activity index(SLEDAI),depression(PHQ-9)and anxiety status(GAD-7),and serum IgA,IgG,IgM and complement C3,C4 levels were observed in 1,3,6 months after discharge,and the clinical symptom,adverse reactions,living quality(SF-36)in 6 months after discharge were evaluated.Results The SLEDAI scores in 1,3,6 months after discharge in the chronic disease management group were lower than those in the control group(P<0.05),the serum IgA,IgM and IgG levels in 3,6 months after discharge were lower than those in the control group(P<0.05),the complement C3,C4 levels were higher than those in the control group(P<0.05),moreover the and GAD-7 and PHQ-9 scores in 3,6 months were lower than those in the control group(P<0.05).The clinical symptom and SF-36 scores in 6 months after discharge in the chronic disease management group were better than those in the control group(P<0.05)and the incidence rate of adverse reactions was lower than that in the control group(P<0.05).Conclusion The online and offline mixing chronic disease management can improve the prognosis of the patients with SLE,control the disease progress,reduce the adverse reactions,improve the living quality and eliminate the negative emotions.