新冠疫情期间“互联网+健康管理”模式应用于慢性心血管疾病的价值

The intervention effect of chronic cardiovascular diseases by"Internet+Health Management"mode during COVID-19 epidemic

目的慢性心血管疾病患者易感染新型冠状病毒(COVID-19),因此构建一种新型降低动脉粥样硬化性心血管疾病(ASCVD)发病率的健康管理模式在COVID-19流行期间具有重要意义。方法选择2020年10月至2022年12月期间北方城市共1290例受试者接受干预。利用可穿戴设备和互联网构建区域性医疗平台,采用China-PAR模型评价心血管疾病风险水平,根据风险水平进行生活方式干预(合理饮食、充分休息、戒烟、限制饮酒、定期运动、心理干预)和药物治疗。比较干预前和干预后1年China-PAR评分的变化。将ASCVD发病率与China-PAR队列研究的发病率进行比较。结果①China-PAR评分变化:低风险组无显著变化(1.39±1.28 vs.1.37±1.27;P>0.05),中风险组显著降低(6.92±1.42 vs.5.86±1.97;P<0.05),高风险组也显著降低(15.60±6.01 vs.14.00±4.94;P<0.05);②ASCVD事件发病率:ASCVD事件发病率显著低于China-PAR队列研究(低危组为0.76%vs.1.63%,中危组为1.75%vs.4.61%,高危组为3.57%vs.8.74%)。结论新型健康管理模式能有效降低新型冠状病毒肺炎疫情期间ASCVD的发病率。

Objective Patients with chronic cardiovascular diseases are susceptible to novel coronavirus(COVID-19),so constructing a new health management model to reduce the incidence of atherosclerotic cardiovascular disease(ASCVD)is important during the COVID-19 epidemic.Methods The regional medical platform was constructed by wearable devices and the internet.1290 north city subjects were intervened from October 2020 to December 2022.The risk level of cardiovascular disease was assessed by the China-PAR model.Changes of lifestyle(reasonable diet,adequate rest,quit smoking,alcohol restriction,regular exercise,psychological intervention)and medication were carried out according to risk levels.The changes of China-PAR were observed before and 1 year after the intervention.The incidence of ASCVD was compared with the China-PAR cohort study.Results①Changes of China-PAR score:There was no significant change(1.39±1.28 vs.1.37±1.27;P>0.05)in low risk group while there were significant decreases in the middle-risk group(6.92±1.42 vs.5.86±1.97;P<0.05)and high-risk group(15.60±6.01 vs.14.00±4.94;P<0.05)after intervention;②ASCVD event rates:ASCVD event rates were lower significantly than China-PAR cohort’s(0.76%vs.1.63%in the low-risk group,1.75%vs.4.61%in the middle-risk group and 3.57%vs.8.74%in the high-risk group).Conclusion The new health management model can reduce the incidence of ASCVD effectively during the nCoV epidemic.