健康教育宣传对围绝经期心衰患者外周灌注指数自护能力及主要不良心血管事件发作风险的影响

Effects of health education on peripheral perfusion index self-care ability and risk of major adverse cardiovascular events in patients with perimenopausal heart failure

目的探讨健康教育宣传对围绝经期心衰患者外周灌注指数、自护能力及主要不良心血管事件(MACE)发作风险的影响。方法选取2021年1月—2023年5月在湖州市第一人民医院就诊的120例围绝经期心衰患者为研究对象,随机将其分常规干预组(A组)和健康教育宣传组(B组),每组各60例,观察两组患者外周灌注指数、自护能力及MACE发作风险等情况。结果与A组对比,B组显效、有效人数明显增加,B组总有效率(93.33%)明显高于A组(78.33%),差异有统计学意义(χ2=5.551,P<0.05)。干预前,两组患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及左室射血分数(LVEF)水平比较,差异均无统计学意义(均P>0.05);干预后,B组患者LVEDD、LVESD水平[(47.66±5.38)mm、(40.33±4.12)mm]显著低于A组[(52.34±5.11)mm、(44.26±4.20)mm],LVEF水平[(56.64±5.86)%]显著高于B组[(48.87±4.72)%],差异均有统计学意义(t=4.886、5.174及7.999,均P<0.05)。干预前,A组与B组外周灌注指数分别为(2.08±0.24)、(2.11±0.25),组间比较差异无统计学意义(t=0.671,P>0.05);干预后,A组与B组外周灌注指数分别为(2.63±0.33)、(3.15±0.39),B组患者外周灌注指数显著高于A组,差异有统计学意义(t=7.884,P<0.05)。干预前,A组与B组心力衰竭自我护理量表(EHFSCB-9)评分分别为(30.59±5.38)分、(30.24±5.35)分,组间比较差异无统计学意义(t=0.357,P>0.05);干预后,A组与B组EHFSCB-9评分分别为(20.33±3.67)分、(15.94±2.43)分,且B组患者EHFSCB-9评分低于A组,差异有统计学意义(t=7.726,P<0.05)。与A组对比,B组冠心病、心肌梗死、心衰加重及心源性再住院人数明显降低,B组MACE总发生率(5.00%)明显低于A组(16.67%),差异有统计学意义(χ2=4.227,P<0.05)。结论采用健康教育宣传对围绝经期心衰患者进行干预,比常规干预效果更佳,可显著改善患者外周灌注指数,提高自护能力,降低MACE发作风险。

Objective To investigate the effects of health education on peripheral perfusion index,self-care ability and risk of major adverse cardiovascular events(MACE)in patients with perimenopausal heart failure.Methods A total of 120 patients with perimenopausal heart failure who were treated in Huzhou First People's Hospital from January 2021 to May 2023 were selected as the study objects,and randomly divided into routine intervention group(group A)and health education and publicity group(group B),with 60 cases in each group.Peripheral perfusion index,self-care ability and risk of MACE attack were observed in the two groups.Results Compared with group A,the number of effective patients in group B was significantly increased,and the total effective rate in group B(93.33%)was significantly higher than that in group A(78.33%),the difference had statistical significance(χ2=5.551,P<0.05).Before intervention,there were no significant differences in left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)between two groups(all P>0.05).After intervention,the levels of LVEDD and LVESD in group B[(47.66±5.38)mm,(40.33±4.12)mm]were significantly lower than those in group A[(52.34±5.11)mm,(44.26±4.20)mm].LVEF level[(56.64±5.86)%]was significantly higher than group B[(48.87±4.72)%],the difference had statistical significance(t=4.886,5.174 and 7.999,P<0.05).Before intervention,the peripheral perfusion index of group A and group B was(2.08±0.24)and(2.11±0.25),respectively,and there was no statistical significance between groups(t=0.671,P>0.05).After intervention,the peripheral perfusion index of group A and group B was(2.63±0.33)and(3.15±0.39),respectively,and the peripheral perfusion index of group B was significantly higher than that of group A,with statistical significance(t=7.884,P<0.05).Before intervention,the scores of heart failure Self-care Scale(EHFSCB-9)in group A and group B were(30.59±5.38)scores and(30.24±5.35)scores,respectively,and there was no statistical significance between groups(t=0.357,P>0.05).The EHFSCB-9 scores of group A and group B were(20.33±3.67)scores and(15.94±2.43)scores,respectively,and the EHF-SCB-9 scores of group B were lower than those of group A,with statistical significance(t=7.726,P<0.05).Compared with group A,the number of coronary heart disease,myocardial infarction,heart failure aggravation and cardiogenic re-hospitalization in group B was significantly reduced,and the total incidence of MACE in group B(5.00%)was significantly lower than that in group A(16.67%),with statistical significance(χ2=4.227,P<0.05).Conclusion Health education was more effective than conventional intervention in patients with perimenopausal heart failure,which can significantly improve peripheral perfusion index,improve self-care ability and reduce the risk of MACE attack.