【摘要】 目的:探讨医院与社区相结合的长期综合健康干预能否有效控制经皮冠状动脉介入(PCI)术后冠心病患者的危险因素,改善冠心病PCI患者的预后。方法:入选成功实施PCI手术的患者572例,获得知情同意后,将患者分为强化随访组(n=272)和常规随访组(n=270)。强化组接受定期随访、定期检测、系列健康讲座等,普通随访组采用普通门诊随访模式。比较两组患者一般资料、冠心病危险因素基线水平,随访18个月后两组服药依从性、冠心病危险因素控制达标率、心脏事件(包括死亡、再发心肌梗死、靶血管再次血运重建)发生率有无差别。结果:两组患者的一般资料、冠心病危险因素基线水平相似,强化随访组18个月后的服药率优于常规随访组,血压(82.5%对73.3%,P=0.03)、血糖(55.6%对34.5%,P=0.04)、血脂(87.5%对65.2%,P=0.043)的控制达标率较高,心脏事件(4%对8.1%,P=0.046)减少。结论:医院与社区相结合的综合健康干预有效可行,可以改善冠心病PCI后患者的预后。更多还原

【Abstract】 Objective: To explore if the follow-up of hospital combined with community could control the coronary risk factors for patients after percutaneous coronary intervention( PCI) and improve the prognosis.Methods: A total of 572 patients with coronary heart disease visiting Putuo district center hospital from September 2009 to March 2011 were investigated. The patients were divided into two groups: the community intensive management group( n = 272) and the general management group( n = 270). The two groups were observed in aspects of drug compliance,coronary risk factors and major adverse cardiac events( death,nonfatal myocardial infarction,and target vessel revascularization). Results: After 18-month follow-up,the percentages of patients taking statin( 97. 4% vs. 78. 5%,P < 0. 001),ACEI / ARB( 89. 8% vs. 81. 6%,P< 0. 01),and β receptor blocker( 89. 5% vs. 81. 2%,P < 0. 01) were higher in the community intensive management group than those in the general management group. The percentages of hypertension( 82. 5% vs.73. 3%,P = 0. 03),diabetes( 55. 6% vs. 34. 5%,P = 0. 04) and hyperlipemia( 87. 5% vs. 65. 2%,P =0. 043) controlled in the normal standard were higher in the community intensive management group than those in the general management group. The rate of cardiac event was lower( 4% vs. 8. 1%,P = 0. 046) in the community intensive management group than those in the general management group. Conclusion: The method of hospital combined with community is helpful to improve the drug compliance,control the coronary risk factors and reduce the rate of MACE.更多还原