心血管康复医学杂志2024，Vol.33Issue(4) ：439-445.DOI:10.3969/j.issn.1008-0074.2024.04.13

基于无缝管理理念的MDT模式对CHF患者的临床疗效及其H-FABP、cTnⅠ水平与心功能的关系研究

Clinical efficacy of MDT mode based on seamless management concept on CHF patients and the associa-tion of H-FABP,cTnⅠ levels with cardiac function

张峰 田亚男 张晓敏 王静
心血管康复医学杂志2024，Vol.33Issue(4) ：439-445.DOI:10.3969/j.issn.1008-0074.2024.04.13
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基于无缝管理理念的MDT模式对CHF患者的临床疗效及其H-FABP、cTnⅠ水平与心功能的关系研究

Clinical efficacy of MDT mode based on seamless management concept on CHF patients and the associa-tion of H-FABP,cTnⅠ levels with cardiac function

张峰 1田亚男 1张晓敏 1王静1
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作者信息

  • 1. 河北北方学院附属第一医院心内科,河北张家口 075000
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摘要

目的:探讨无缝管理理念下的多学科协作(MDT)模式对慢性心力衰竭(CHF)患者的临床疗效,并分析心型脂肪酸结合蛋白(H-FABP)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平与心功能指标的相关性.方法:纳入2020年11月 2021年11月本院收治的222例CHF患者,根据随机数字表法分为对照组(111例,采用MDT模式干预)和实验组(111例,采用无缝管理理念联合MDT模式干预).干预一个月后,采用心力衰竭自我管理量表评价两组患者临床疗效,并比较两组干预前后明尼苏达心力衰竭生活质量问卷(MLHFQ)评分、H-FABP、cTnⅠ水平及心功能指标,采用Pearson相关分析法分析H-FABP、cTnⅠ水平与心功能指标的相关性.结果:干预一个月后,与对照组比较,实验组心力衰竭自我管理量表得分[(50.04±6.08)分比(72.07±5.65)分]、左室射血分数(LVEF)[(36.23±3.68)％比(43.42±3.36)％]、6min 步行距离(6MWD)[(228.35±28.78)m 比(337.29±32.31)m]均显著增加,MLHFQ 评分[(40.14±3.25)分比(33.05±4.61)分]、H-FABP[(5.97±0.57)ng/ml 比(2.77±0.59)ng/ml]、cTnⅠ[(3.34±0.33)ng/ml 比(2.45±0.61)ng/ml]水平均显著降低(P均＜0.001).CHF 患者 H-FABP、cTnⅠ水平随心功能分级提升呈显著上升趋势(P均＜0.001).Pearson相关分析显示,H-FABP、cTnⅠ与LVEF、6MWD呈显著负相关(r=-0.745～-0.676,P均＜0.001),与BNP水平呈显著正相关(r=0.705、0.668,P均＜0.001).结论:无缝管理理念的MDT模式应用于CHF的临床治疗,能显著改善患者生活质量及心功能,联合H-FABP、cTnⅠ检测对指导CHF患者预后评估及心功能监测具有重要临床意义.

Abstract

Objective:To explore the clinical efficacy of the multidisciplinary team(MDT)mode under the seamless management concept on patients with chronic heart failure(CHF),and analyze the correlation among levels of heart-type fatty acid binding protein(H-FABP),cardiac troponin Ⅰ(cTnⅠ)and cardiac function indexes.Methods:A total of 222 CHF patients treated in our hospital from November 2020 to November 2021 were enrolled and divided into control group(n=111,MDT mode intervention)and experimental group(n=111,seamless man-agement concept combined MDT mode intervention)according to random number table.After 1-month interven-tion,heart failure self-management scale was used to assess clinical efficacy of two groups,score of Minnesota Liv-ing with Heart Failure Questionnaire(MLHFQ),H-FABP and cTnⅠ levels and cardiac function indexes were com-pared between two groups before and after intervention.Pearson correlation analysis was used to analyze the corre-lation among H-FABP,cTnⅠ levels and cardiac function indexes.Results:After one month,compared with con-trol group,there were significant rise in score of heart failure self-management scale[(50.04±6.08)points vs.(72.07±5.65)points],left ventricular ejection fraction(LVEF)[(36.23±3.68)％vs.(43.42±3.36)％],6min walking distance(6MWD)[(228.35±28.78)m vs.(337.29±32.31)m],and significant reductions in MLHFQ score[(40.14±3.25)points vs.(33.05±4.61)points],levels of H-FABP[(5.97±0.57)ng/ml vs.(2.77±0.59)ng/ml]and cTnⅠ[(3.34±0.33)ng/ml vs.(2.45±0.61)ng/ml]in experimental group(P＜0.001 all).H-FABP and cTnⅠ levels significantly increased in CHF patients as cardiac function class increased(P＜0.001 all).Pearson correlation analysis indicated that H-FABP and cTnⅠ levels were significant inversely correlated with LVEF and 6MWD(r=-0.745～-0.676,P＜0.001 all),and significant positively correlated with BNP level(r=0.705,0.668,P＜0.001 both).Conclusion:Seamless management concept-based MDT mode can significantly improve the quality of life and cardiac function in CHF patients.Combined detection of H-FABP and cTnⅠ has im-portant clinical significance in guidance of prognosis assessment and cardiac function monitoring in CHF patients.

关键词

心力衰竭/病人医护管理/脂肪酸结合蛋白类/肌钙蛋白Ⅰ

Key words

Heart failure/Patient care management/Fatty acid-binding proteins/Troponin Ⅰ

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出版年

2024
心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子：1.157
ISSN：1008-0074
参考文献量10
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