基于物联网平台的智能管理模式对冠心病患者血运重建术后预后的影响

Effect of intelligent management model based on internet of things platform on the prognosis of patients with coronary heart disease after coronary artery revascularization

目的:探讨基于物联网平台的智能管理模式对已行冠状动脉(冠脉)血运重建术患者预后的影响。方法:选择行冠脉血运重建术1个月内的患者200例,按就医顺序编号,通过随机数字表法将其分为干预组和对照组,每组各100例。对每例患者定期随访12个月。所有患者均由我院专科医生制定治疗方案并定期复诊,每月复诊1次。此外,干预组患者每例发放脉搏波血压计1台,安装心脏APP,关联医生帐号,自测血压及心率,通过蓝牙上传至心脏APP云端,由关联医生每日线上监测血压、心率并处理APP智能预警,解答线上提问,定期开展针对性、个体化的卫生宣教,进行心理疏导、行为干预及药物调整。所有患者每3个月按试验设计体检1次,检测指标包括血脂、空腹血浆葡萄糖(FBG)、身高、体重、肝肾功能以及糖化血红蛋白(HbA1c);记录所有患者的药物不良反应、再住院次数、平均住院天数和主要心脏不良事件(MACE)。结果:①干预组患者治疗后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和BMI均较治疗前下降(均P<0.05);对照组患者治疗后TC与LDL-C较治疗前下降(均P<0.05),TG与BMI无明显差异;干预组患者治疗后的TG与BMI低于对照组(均P<0.05)。②干预组及对照组患者血压控制达标率均较治疗前升高(均P<0.05),干预组血压控制达标率优于对照组(P<0.05)。③干预组及对照组2型糖尿病患者治疗后的FBG与HbA1c控制达标率均较治疗前提高(均P<0.05),干预组控制达标率较对照组高(均P<0.05)。④随访1年,干预组再住院率和平均住院天数较对照组降低(均P<0.05),干预组总的MACE发生率较对照组降低(P<0.05)。结论:基于物联网平台的智能管理模式可进一步改善行冠脉血运重建术患者的预后。

Objective:To explore the effect of intelligent management mode based on internet of things platform on the prognosis of patients undergoing coronary artery revascularization.Method:A total of 200 patients who underwent coronary revascularization within one month were selected and numbered according to the order of medical treatment.They were divided into intervention group and control group by random number table method,with 100 cases in each group.Each patient was followed up regularly for 12 months.All patients were treated by specialist,and regularly consulted,once a month.In addition,each patient in intervention group received a pulse wave sphygmomanometer,a heart APP and an account with associated doctor.Blood pressure and heart rate were self-measured and uploaded to the APP.The associated doctor monitored blood pressure and heart rate,handled the intelligent warning of APP,answered online questions,carried out targeted and individualized health education,psychological counseling,behavioral intervention and drug adjustment.All patients were checked up once every 3 months according to the design of the experiment.The detection indexes included blood lipid,fasting plasma glucose(FBG),height,weight,liver and kidney function and glycosylated hemoglobin(HbA1 c).Adverse drug reactions,number of readmission,average length of stay and major adverse cardiac events(MACEs)were recorded.Result:①Total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)and BMI in the intervention group decreased after treatment(all P<0.05);while TC and LDL-C in the control group decreased after treatment(both P<0.05),and there was no significant difference between TG and BMI.TG and BMI in the intervention group were lower than those in the control group(both P<0.05).(2)After treatment,the compliance rate of blood pressure increased in both group(both P<0.05),and it was better in intervention group than that in control group(P<0.05).(3)After treatment,the control rate of FBG and HbA1 cincreased in both group(both P<0.05),and it was better in intervention group than that in control group(P<0.05).(4)After 1 year followedup,the re-hospitalization rate and the average length of stay in the intervention group were lower than those in the control group(both P<0.05),and the overall incidence of MACEs in the intervention group was lower than that in the control group(P<0.05).Conclusion:Intelligent management mode based on internet of things platform can further improve the prognosis of patients undergoing revascularization of coronary artery.