中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
9期
911-913
,共3页
刘小娟%董宏伟%沈彬%朱正炎%刘燕%张爱华%牛翠%吕建华%唐立荣
劉小娟%董宏偉%瀋彬%硃正炎%劉燕%張愛華%牛翠%呂建華%唐立榮
류소연%동굉위%침빈%주정염%류연%장애화%우취%려건화%당립영
慢性心力衰竭%系统化干预%心功能%再住院率
慢性心力衰竭%繫統化榦預%心功能%再住院率
만성심력쇠갈%계통화간예%심공능%재주원솔
Chronic heart failure%Systematic management%Cardiac function%Readmission rate
目的 探讨系统化院外干预对慢性心力衰竭(CHF)患者心功能及再住院率的影响.方法 入选2008年7月至2010年7月中国医科大学北京顺义医院心内科住院CHF患者160例,按随机数字表法分为干预组79例,对照组81例.干预组患者根据心功能的变化和临床症状进行系统化干预,包括规范治疗方案,指导患者正确使用血管紧张素转换酶抑制剂和β-受体阻滞剂,并滴定其靶剂量等措施.对照组不做系统化干预,了解记录自用药情况和其他相关内容.6个月和12个月时分别对两组患者采用6分钟步行试验及超声心动图检查对患者的心功能状况进行评价,使用再住院率对患者临床症状改善进行评价.结果 6、12个月时干预组6分钟步行距离[(345.27±123.95)、(368.94±121.62) m]明显高于对照组[(282.53±94.63)、(260.07±86.13) m],差异有统计学意义(F组间=38.01,P＜0.01;F组内=19.62,P＜0.01;F交互=48.36,P＜0.01).干预组的左心室射血分数[6个月(43.48±8.42)％,12个月(41.21±6.23)％]明显高于对照组[(37.70±7.13)％、(37.15±6.83)％](P＜0.01).6个月时干预组再住院率有下降趋势,12个月时干预组再住院次数(26次)明显低于对照组(36次),差异有统计学意义(P =0.024).结论 CHF患者采用系统化干预可以改善其心功能并降低再住院率.
目的 探討繫統化院外榦預對慢性心力衰竭(CHF)患者心功能及再住院率的影響.方法 入選2008年7月至2010年7月中國醫科大學北京順義醫院心內科住院CHF患者160例,按隨機數字錶法分為榦預組79例,對照組81例.榦預組患者根據心功能的變化和臨床癥狀進行繫統化榦預,包括規範治療方案,指導患者正確使用血管緊張素轉換酶抑製劑和β-受體阻滯劑,併滴定其靶劑量等措施.對照組不做繫統化榦預,瞭解記錄自用藥情況和其他相關內容.6箇月和12箇月時分彆對兩組患者採用6分鐘步行試驗及超聲心動圖檢查對患者的心功能狀況進行評價,使用再住院率對患者臨床癥狀改善進行評價.結果 6、12箇月時榦預組6分鐘步行距離[(345.27±123.95)、(368.94±121.62) m]明顯高于對照組[(282.53±94.63)、(260.07±86.13) m],差異有統計學意義(F組間=38.01,P＜0.01;F組內=19.62,P＜0.01;F交互=48.36,P＜0.01).榦預組的左心室射血分數[6箇月(43.48±8.42)％,12箇月(41.21±6.23)％]明顯高于對照組[(37.70±7.13)％、(37.15±6.83)％](P＜0.01).6箇月時榦預組再住院率有下降趨勢,12箇月時榦預組再住院次數(26次)明顯低于對照組(36次),差異有統計學意義(P =0.024).結論 CHF患者採用繫統化榦預可以改善其心功能併降低再住院率.
목적 탐토계통화원외간예대만성심력쇠갈(CHF)환자심공능급재주원솔적영향.방법 입선2008년7월지2010년7월중국의과대학북경순의의원심내과주원CHF환자160례,안수궤수자표법분위간예조79례,대조조81례.간예조환자근거심공능적변화화림상증상진행계통화간예,포괄규범치료방안,지도환자정학사용혈관긴장소전환매억제제화β-수체조체제,병적정기파제량등조시.대조조불주계통화간예,료해기록자용약정황화기타상관내용.6개월화12개월시분별대량조환자채용6분종보행시험급초성심동도검사대환자적심공능상황진행평개,사용재주원솔대환자림상증상개선진행평개.결과 6、12개월시간예조6분종보행거리[(345.27±123.95)、(368.94±121.62) m]명현고우대조조[(282.53±94.63)、(260.07±86.13) m],차이유통계학의의(F조간=38.01,P＜0.01;F조내=19.62,P＜0.01;F교호=48.36,P＜0.01).간예조적좌심실사혈분수[6개월(43.48±8.42)％,12개월(41.21±6.23)％]명현고우대조조[(37.70±7.13)％、(37.15±6.83)％](P＜0.01).6개월시간예조재주원솔유하강추세,12개월시간예조재주원차수(26차)명현저우대조조(36차),차이유통계학의의(P =0.024).결론 CHF환자채용계통화간예가이개선기심공능병강저재주원솔.
Objective To explore the impact of systematic management on the cardiac function and readmission rate in patients with chronic heart failure(CHF).Methods One hundred and sixty CHF patients in Beijing Shunyi Hospital Affiliated to China Medical University from Jul.2008 to Jul.2010 were selected as our subjects and random divided into intervention (79 cases) and control group(81 cases).Patients in intervention group were received systematic therapy based on heart function and clinical syndrome including therapy plan and guiding the application of angiotensin converting enzyme inhibitor and beta blockers,and in control group were received regular therapy.The cardiac function were evaluated by 6-minute walking test (6MWT) and echocardiography,and readmission rate was observed.Results (1)The result of 6MWT in the intervention group at 6 months and 12 months were (345.27 ± 123.95) m,(368.94 ± 121.62) m,significantly higher than that of 6MWT in the control group ((282.53 ± 94.63) m,(260.07 ± 86.13) m; F between groups =38.01,P ＜0.01 ;F inner group =19.26,P ＜ 0.01 ; F across group =48.36,P ＜ 0.01).(2) Left ventricular ejection fraction in the intervention group at 6 months and 12 months were (43.48 ± 8.42) ％,(41.21 ± 6.23) ％,significantly higher than that in the control group ((37.70 ±7.13)％,(37.15 ±6.83)％ ;P ＜0.001).(3)The readmission rate in the intervention group showed a decreased trend but did not reach statistically significant difference at 6 months,while the readmission times in the intervention group at 12 months was 26,significantly lower than that in the control group (36,P =0.024).Conclusion The systematic management might improve the heart function and reduce readmission rates in patients with CHF.
