【摘要】 目的:探讨规范化二级预防治疗对接受介入治疗后的急性冠脉综合征患者的生活方式、生化指标以及主要心脏事件发生情况中的作用。方法:入选298例PCI术后的急性冠脉综合征患者,随机分为规范化随访组(n=141)及常规随访组(n=157)。2年随访时评估两组患者在生化水平、生活方式及主要心脏事件上的差异。结果:共286例患者完成2年随访。对两组患者在随访1年时低密度脂蛋白胆固醇(LDL-C)水平(2.24mmol/L对2.50mmol/L,P<0.001)及运动达标率(43.6%对25.5%,P=0.001)具有显著差异,在主要心脏事件上无差异(P=0.128)。随访2年结果提示,两组患者在LDL-C水平具有显著差异(2.25mmol/L对2.66mmol/L,P<0.001),运动达标率也具有显著差异(58.3%对27.5%,P<0.001)。在吸烟亚组中,规范化随访组的戒烟率要显著高于常规随访组(68.3%对38.0%P=0.01)。主要心脏事件的发生方面,规范化随访组出现18例,常规随访组出现38例,具有统计学差异(P=0.016)。结论:规范化二级预防随访较常规随访能够有效改善急性冠脉综合征患者PCI术后血脂情况,有效规范患者的生活方式,降低术后主要心脏事件的发生率。更多还原

【Abstract】 Objective:To value the effect of secondary prevention on the patients who suffered acute coronary syndrome after percutaneous coronary intervention(PCI).Methods:A total of 298 patients undergoing PCI were randomly divided into standard group and general group.We compared the results of blood routine tests,lifestyle change,and MACE after a 2-year follow-up.Results:After 1-year follow-up,the level of LDL-C in standard group was lower than that in the general group(2.24 mmol/L vs 2.50 mmol/L,P<0.001).The ratio of regular physical exercise also showed a significant difference between the two groups(43.6% vs 25.5%,P=0.001).The MACE in two groups didn’t show the significant difference(P=0.128).After 2-year follow-up,the level of LDL-C also showed difference in 2 groups(2.25 mmol/L vs 2.66 mmol/L,P<0.001),but no differences were seen in the level of total cholesterol(3.88 mmol/L vs 4.14 mmol/L,P=0.729).Meanwhile there were 77 patients reaching the goal of physical exercise in standard group and 42 in general group(58.3% vs 27.5%,P<0.001).In the sub-group of smoking,there were 41 patients with successful smoking cessation in standard group and 27 in general group(68.3% vs 38.0% P=0.01).MACE occurred in 18 from standard group and in 38 from general group,which showed a significant difference(P=0.016).Conclusion:This study shows that standard secondary prevention of coronary heart disease may reduce the level of LDL-C and the occurrence of MACE in the patients after PCI effectively and also may exert an important influence on the rehabilitation of lifestyle.更多还原