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中国人民解放军总医院
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解放军总医院医学创新研究部、国家老年疾病临床医学研究中心(解放军总医院)、解放军总医院第六医学中心心血管病医学部
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
传真:010-66936756
E-mail: zhlndqg@mode301.cn
创刊人 王士雯
主 编 范利
执行主编 陈韵岱
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
孔晓晅,曹瑞华,王慧泉,王盛书,芦婷婷,高姗,王亚斌,李天志,范利,曹丰.多生理参数的远程交互干预对居家老年共病患者的应用[J].中华老年多器官疾病杂志,2022,21(6):406~412
多生理参数的远程交互干预对居家老年共病患者的应用
Application of multiple physiological parameters remote interactive intervention for home-based elderly patients with comorbidity
投稿时间:2021-09-17  
DOI:10.11915/j.issn.1671-5403.2022.06.088
中文关键词:  老年人  共病  可穿戴设备  远程交互干预
英文关键词:aged  comorbidity  wearable devices  remote interaction intervention This work was supported by the Key Project of Central Health Care Scientific Research of National Health Commission in 2020
基金项目:国家卫生健康委员会2020年中央保健科研重点课题(2020ZD05);军委科技委基础加强项目(2021-JCJQ-JJ-1079)
作者单位E-mail
孔晓晅 中国人民解放军医学院,北京100853
中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
 
曹瑞华 中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
 
王慧泉 天津工业大学生命科学学院, 天津300387  
王盛书 中国人民解放军总医院老年医学研究所,北京100853  
芦婷婷 中国人民解放军医学院,北京100853
中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
 
高姗 中国人民解放军医学院,北京100853
中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
 
王亚斌 中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
 
李天志 中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
 
范利 中国人民解放军医学院,北京100853
中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
fl6698@163.comapplication 
曹丰 中国人民解放军医学院,北京100853
中国人民解放军总医院第二医学中心心血管内科,
国家老年疾病临床医学研究中心, 
fengcao8828@163.com 
摘要点击次数: 197
全文下载次数: 103
中文摘要:
      目的 探讨基于多参数血压、血糖监测设备观察远程交互干预新模式对老年冠心病、高血压和糖尿病共病患者健康管理的效果。方法 纳入2020年6月至2021年1月在中国人民解放军总医院第一医学中心门诊和第二医学中心病房明确诊断为冠心病、高血压和糖尿病的患者157例,利用随机种子获取随机数,将纳入患者随机分为对照组(90例)和远程试验组(67例)。远程试验组使用多参数监测设备,采用远程交互干预方式对血压、血脂及血糖等主要心血管风险指标进行管理;对照组采用传统就医模式进行血压、血脂及血糖控制干预。比较干预3个月前后患者的血压、血脂、血糖水平,以及服药依从性,并分析远程互动频次与血压、血脂及血糖控制效果的相关性。采用SPSS 25.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、非参数检验及χ2检验。采用Spearman相关性检验和线性回归模型分析改善效果与交流频次的关系。结果 本研究失访患者25例,最终完成随访患者132例,每组患者66例。2组在干预3个月后甘油三酯、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、血糖控制率较干预前均明显改善(均P<0.05);与对照组比较,远程试验组收缩压(P<0.05)、总胆固醇(P<0.01)、LDL-C(P<0.01)、FBG(P<0.05)水平均显著降低,血压控制率、血脂控制率、血糖控制率和服药依从性评分均显著升高(均P<0.05)。Pearson相关性分析显示,远程试验组干预后血压、血脂、血糖值与交流频次(2.01±0.54)次/周呈负相关(r=-0.652、-0.615、-0.527,P<0.01)。线性回归模型分析得出,交流频次>1.53、2.33、1.57次/周时,可分别对收缩压、LDL-C、FBG值达到控制效果。结论 基于多参数血压、血糖监测设备的居家远程医患交互干预新模式,通过远程交流与宣教的方式对老年共病患者进行健康管理,可有效改善血压、血脂、血糖指标,提高血压、血脂、血糖控制率,改善服药依从性。医患交互频次>2次/周有助于疾病的有效控制。
英文摘要:
      Objective To explore the effectiveness of remote interactive intervention on health management of elderly patients with comorbid coronary heart disease, hypertension and diabetes mellitus based on multi-parameter blood pressure and blood glucose monitoring equipment. Methods From June 2020 to January 2021, a total of 157 patients diagnosed with above comorbidities in the outpatient department of the First Medical Center and the inpatient department of the Second Medical Center of PLA General were enrolled in this study. They were randomly divided into control group (n=90) and remote intervention group (n=67). The patients from the remote intervention group were given multi-parameter monitoring equipment to make remote sensing and interactive intervention on blood pressure, blood lipid, blood glucose and other risk indexes for major cardiovascular system, and those of the control group underwent traditional medical model for blood pressure, blood lipid, and blood glucose control intervention. The blood pressure, blood lipid, blood glucose level and medication compliance were compared before and after 3 months of intervention and between the 2 groups. The correlation between remote interaction frequency and control effectiveness of blood pressure, blood lipid and blood glucose was analyzed. SPSS statistics 25.0 was used for statistical analysis. Data comparison between 2 groups was performed using student′s t test, non-parametric test or Chi-square test depending on data types. Spearman correlation analysis and linear regression model were used to analyze the relationship between improvement effect and remote communication frequency. Results There were 25 patients lost during follow-up, and in the 132 eligible patients finally, 66 ones were in the remote intervention group and 66 in the control group. After 3 months of intervention, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG) and blood glucose control rate were greatly improved in both groups (P<0.05). Systolic blood pressure (SBP, P<0.05), total cholesterol (P<0.01), LDL-C (P<0.01) and FBG (P<0.05) were significantly decreased, while the blood pressure control rate, blood lipid control rate, blood glucose control rate and medication compliance score were obviously increased (all P<0.05) in the remote intervention group than the control group. Pearson correlation analysis showed that blood pressure, blood lipid and blood glucose were negatively correlated with remote interaction frequency (2.01±0.54) times/week (r=-0.652, -0.615, -0.527, P<0.01). Linear regression model analysis indicated that when remote interaction frequency was greater than 1.53,2.33,1.57 times/week, respectively, SBP, LDL-C and FBG were well-controlled. Conclusion Based on multi-parameter blood pressure and glucose monitoring equipment, our new model of remote communication and education system can be used for health management in elderly comorbid patients to improve their blood pressure, lipid and glucose levels efficiently, increase the control rates, and promote medication compliance. The frequency of doctor-patient interaction greater than 2 times/week is helpful for effective control of the comorbidities.
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