氨氯地平阿托伐他汀联合循证-情志干预模式对老年高血压合并冠心病患者的应用价值

Application value of amlodipine/atorvastatin combined with evidence-based emotional nursing mode in elderly patients with hypertension complicated by coronary heart disease

目的探讨氨氯地平阿托伐他汀钙片(AACT)联合循证-情志干预模式(EENM)对老年高血压合并冠心病(HTN-CHD)患者的应用价值。方法回顾性选取2021年6月至2023年6月温州医科大学附属第二医院心内科收治的HTN-CHD患者为研究对象。根据干预方式不同,分为AACT组和EENM组。AACT组患者给予AACT联合常规护理干预,EENM组则在AACT组基础上实施EENM。比较两组患者干预前后心理状态[抑郁自评量表(SDS)评分、焦虑自评量表(SAS)和自我感受负担量表(SPBS)]、依从性(遵医服药行为、日常锻炼行为、不良管理行为和饮食管理行为)和血压(收缩压和舒张压)变化情况。观察比较两组患者在6个月心血管事件发生率。结果研究共纳入HTN-CHD患者118例,其中AACT组55例、EENM组63例。干预前,AACT组和EENM组患者SDS评分、SAS评分、SPBS评分、遵医服药行为评分、日常锻炼行为评分、不良管理行为评分、饮食管理行为评分、收缩压和舒张压差异均无统计学意义(P>0.05)。干预后,AACT组和EENM组HTN-CHD患者SDS评分、SAS评分、SPBS评分、收缩压和舒张压较前显著下降(P<0.05),而遵医服药行为评分、日常锻炼行为评分、不良管理行为评分和饮食管理行为评分较前显著上升(P<0.05);EENM组患者SDS评分、SAS评分、SPBS评分、收缩压和舒张压低于AACT组(P<0.05),而遵医服药行为评分、日常锻炼行为评分、不良管理行为评分和饮食管理行为评分高于AACT组(P<0.05)。EENM组心血管事件发生率低于AACT组(P<0.05)。结论EENM联合AACT干预有利于提高HTN-CHD患者依从性,改善心理状态及血压值,降低心血管事件发生率。

Objective To investigate the application value of amlodipine atorvastatin calcium tablet(AACT)combined with evidence-based emotional nursing mode(EENM)in elderly patients with hypertension complicated by coronary heart disease(HTN-CHD).Methods HTN-CHD patients admitted to the department of cardiology of The Second Affiliated Hospital of Wenzhou Medical University from June 2021 to June 2023 were selected retrospectively as study subjects.According to the intervention methods,the HTN-CHD patients were divided into the AACT group and the EENM group.Patients in the AACT group were given AACT combined with the usual care intervention,and the EENM group was given EENM on the basis of the AACT group.The changes of psychological status(SDS,SAS,and SPBS),adherence(medication compliance,daily exercise behavior,poor management behavior,and dietary management behavior)and blood pressure[(systolic blood pressure,SBP)and diastolic blood pressure(DBP)]were compared between two groups.The incidence of cardiovascular events in the two groups at 6 months was observed and compared.Results A total of 118 HTNCHD patients(55 in AACT group and 63 in EENM group)were included in this study.Before the intervention,there was no significant statistical difference in the SDS,SAS,SPBS,medication compliance,daily exercise,poor management,diet management scores,SBP and DBP between AACT and EENM groups(P>0.05).After the intervention,SDS,SAS,SPBP scores,SBP and DBP of the HTN-CHD patients significantly decreased in both AACT and EENM groups compared with before(P<0.05).However,the medication compliance behavior score,daily exercise behavior score,bad management behavior score and diet management behavior score increased significantly compared with before(P<0.05);SDS,SAS,SPBS scores,SBP and DBP of the patients in EENM group decreased more than those in the AACT group(P<0.05),however,the increase of medication compliance,daily exercise,poor management and diet management behavior scores of the EENM group was higher than that in the AACT group(P<0.05).Furthermore,the incidence of cardiovascular events was lower in the EENM group than in the AACT group(P<0.05).Conclusion EENM combined with AACT intervention is beneficial to improve the compliance with HTN-CHD patients,improve the psychological status and blood pressure values,and reduce the incidence of cardiovascular events.