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目的了解影响急性冠状动脉综合征(ACS)患者预后的危险因素,制定个体化预防干预方案,为患者的心脏康复二级预防提供科学依据。方法以山西省心血管病医院冠心病监护病房(CCU)的ACS患者为研究对象,采用自行设计的调查问卷对患者的病例资料及院外随访资料进行调查。采用Log-rank检验对不同因素间复发率进行比较;采用Cox回归分析对影响ACS患者预后危险因素进行分析。结果 ACS患者的中位复发时间为(19.27±0.88)个月,Cox回归显示:肥胖、饮食油腻、不规律运动以及抑郁情绪是影响其预后的独立危险因素。结论 ACS患者的预后不能仅靠规律的药物来预防,合理的饮食、鼓励性的心理干预及规律的心脏康复运动同等重要。根据其相关危险因素及自身疾病特征建立有效的二级预防模式体系,进而降低患者再住院及死亡率的发生,提高患者的生活质量。
Objective To understand the risk factors affecting the prognosis of patients with acute coronary syndrome (ACS) and to develop individualized preventive intervention programs to provide a scientific basis for secondary prevention of cardiac rehabilitation in patients. Methods The ACS patients from the Cardiovascular Hospital of Shanxi Province were enrolled in this study. The patients’ case data and the follow-up data were investigated by self-designed questionnaire. The Log-rank test was used to compare the relapse rates among different factors. Cox regression analysis was used to analyze the prognostic risk factors in patients with ACS. Results The median time to recurrence in patients with ACS was (19.27 ± 0.88) months. Cox regression showed that obesity, oily diet, irregular exercise and depression were the independent risk factors for prognosis. Conclusion The prognosis of patients with ACS can not be prevented by regular drugs only. Rational diet, encouraging psychological intervention and regular heart rehabilitation exercise are equally important. According to its related risk factors and characteristics of their own disease to establish an effective secondary prevention mode system, thereby reducing the incidence of rehospitalization and mortality in patients and improve the quality of life of patients.