健康管理网络平台对心肌梗死后心力衰竭患者的干预研究
Intervention Study of Health Management Network Platform in Patients with Heart Failure after Myocardial Infarction
摘要: 目的：探究健康管理网络平台对心肌梗死后心力衰竭患者预后的干预研究，旨在改善心力衰竭患者的生存质量。方法：纳入青岛大学附属医院急诊内科2018年12月至2019年12月份收治的急性心肌梗死并发心力衰竭的214名患者作为研究对象，按照随机数表法，将其分为对照组(n = 107)和研究组(n = 107)；对照组为常规治疗后门诊随访，研究组为在常规治疗基础上通过健康管理网络平台加强患者用药指导及健康教育指导。比较2组患者在干预前后血浆中NT-pro BNP、6分钟步行距离(6MWD)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及患者再住院率。结果：对比两组患者干预前的血浆NT-pro BNP、6分钟步行距离(6MWD)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)，差异无统计学意义(P > 0.05)。干预治疗后研究组各项指标均显著优于对照组，差异具有统计学意义(P < 0.05)。研究组再住院率低于对照组，但无显著性差异(P > 0.05)。结论：通过健康管理网络平台对出院患者的干预指导，能够改善患者的心功能，提高患者生活质量，改善预后，降低患者再住院率。
Abstract: Objective: To explore the intervention of health management network platform on the prognosis of patients with heart failure after myocardial infarction in order to improve the quality of life of patients with heart failure. Methods: 214 patients with acute myocardial infarction complicated with heart failure admitted to the Emergency Department of The Affiliated Hospital of Qingdao University from December 2018 to December 2019 were enrolled as study subjects, and were divided into control group (n = 107) and study group (n = 107) according to the random number table method. The control group received outpatient follow-up after routine treatment, and the study group strengthened medication guidance and health education guidance for patients through the health management network platform on the basis of routine treatment. Plasma NT-proBNP, 6-minute walking distance (6MWD), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and patient rehospitalization rates were compared between the two groups before and after intervention. Results: after 12 months of intervention, plasma NT-proBNP, 6-minute walking distance (6MWD), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) were compared between the two groups before intervention, showing no statistically significant differences (P > 0.05). After intervention treatment, all indexes of the study group were significantly better than those of the control group, and the difference was statistically significant (P < 0.05). The rehospitalization rate of the study group was lower than that of the control group, but there was no significant difference (P > 0.05). Conclusion: The intervention and guidance of the health management network platform for discharged patients can improve the cardiac function, improve the quality of life, improve the prognosis and reduce the rehospitalization rate of patients.
文章引用：臧守亚, 刘艳伟, 张驰, 徐宝丽, 苏哲, 管甲亮, 李喆, 周长勇. 健康管理网络平台对心肌梗死后心力衰竭患者的干预研究[J]. 临床医学进展, 2020, 10(9): 2102-2107. https://doi.org/10.12677/ACM.2020.109315

参考文献

[1] 肖秋玉. 心肌梗死后心力衰竭的防治进展[J]. 心血管病防治知识(学术版), 2020, 10(3): 94-96.
[2] 李路路, 张希玲, 王岩, 等. 不同性别急性心肌梗死合并心衰患者院内治疗及一年随访情况的比较[J]. 现代生物医学展, 2019(12): 2295-2298.
[3] 玉泽伟, 张华朝. 心肌梗死后心力衰竭防治现状及进展[J]. 中西医结合心血管病电子杂志, 2020, 8(10): 10-11
[4] 周平启, 吴 琼. 老年慢性心力衰竭的病因及临床治疗方式研究[J]. 临床医药文献电子杂志, 2016, 3(49): 9731.
[5] Kulchitskaya, D.B., Shovkun, T.V., Yarnykh, E.V., et al. (2019) Impact of External Counterpulsation on Microcirculation in Patients with Coronary Heart Disease Complicated by Chronic Heart Failure after Surgical and Endovascular Myocardial Revascularization. Voprosy Kurortologii, Fizioterapii, Ilechebnoi Fizicheskoi Kultury, 96, 5-10. [Google Scholar] [CrossRef] [PubMed]
[6] Tian, J., Yan, J.J., Zhang, Q., Yang, H., Chen, X., Han, Q., Han, R., Ren, J., Zhang, Y. and Han, Q. (2019) Analysis of re—Hospitalizations for Patients with Heart Failure Caused by Coronary Heart Disease: Data of First Event and Recur-Rent Event. Therapeutics and Clinical Risk Management, 15, 1333-1341. [Google Scholar] [CrossRef] 
[7] 李鹏磊. 多巴胺联合硝普钠治疗心梗后左心衰的临床探讨[J]. 疾病监测与控制, 2018, 12(4): 272-274.
[8] Thygesen, K., Alpert, J.S., Jaffe, A.S., et al. (2018) Fourth Universal Definition of Myocardial Infarction. Circulation, 138, e618-e651. [Google Scholar] [CrossRef] 
[9] 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018 [J]. 中华心血管病杂志, 2018, 46(10): 760-789.
[10] 韦沙. 阿托伐他汀治疗心肌梗死后无症状心衰患者的效果观察[J]. 现代医学与健康研究电子杂志, 2019, 3(6): 24-25.
[11] 张忠玲, 毛静远. 6分钟步行试验在慢性心力衰竭中的应用思考[J]. 吉林中医药, 2011, 31(7): 629-632.
[12] Valensi, P., Lorgis, L. and Cottin, Y. (2011) Prevalence, Incidence, Predictive Factors and Prognosis of Silent Myocardial Infarction: A Review of the Literature. Archives of Cardiovascular Diseases, 104, 178-188. [Google Scholar] [CrossRef] [PubMed]
[13] 张新超, 于学忠, 陈凤英, 朱华栋. 急性冠脉综合征急诊快速诊治指南(2019) [J]. 临床急诊杂志, 2019, 20(4): 253-262.
[14] 亢扬, 富路. 心力衰竭患者血浆B型利钠肽/氨基末端利钠肽原水平正常的研究进展[J]. 心血管病学进展, 2018, 39(4): 622-626.
[15] 孔巴提∙沙提别克, 孟岩, 王红. 急性心肌梗死并发初诊心力衰竭住院患者的急性期生存率分析[J]. 中国医学前沿杂志(电子版), 2016, 8(1): 59-62.
[16] 米玛. 急性心肌梗死后心力衰竭的临床特点及预后分析[J]. 中西医结合心血管病电子杂志, 2020, 8(12): 76.

为你推荐