首页|心力衰竭患者发生房颤的影响因素及家属赋能模式对策分析

心力衰竭患者发生房颤的影响因素及家属赋能模式对策分析

Influencing factors of atrial fibrillation in patients with heart failure and analysis of family empower-ment mode strategy

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目的:探究心力衰竭(HF)患者发生房颤(AF)的影响因素及家属赋能模式对策的效果.方法:选择2020年4月~2021年3月中国人民解放军空军军医大学第一附属医院接诊的220例HF患者,根据是否出现AF将其分为AF组(n=80)和无AF组(n=140);给予AF组家属赋能模式对策管理干预.干预3个月后,比较AF组干预前后自护行为量表和生活质量量表评分的变化;采用多因素Logistic回归分析HF患者发生AF的影响因素,受试者工作特征(ROC)曲线分析危险因素对HF患者发生AF的诊断价值.结果:与无AF组比较,AF组脑钠肽(BNP)水平、左心室内径和置入支架数量均显著增加(P均<0.001).多因素Logistic回归分析结果显示,BNP>400pg/ml、左心室内径>40mm和置入支架数量>2个为HF患者发生AF的独立危险因素(OR=1.349~2.501,P均<0.01);ROC曲线结果显示,BNP、左心室内径和置入支架数量预测HF患者发生AF的AUC分别为0.819、0.812和0.745,均具有较好的诊断价值.与干预前比较,干预3个月后AF组HF患者自护行为量表的自我护理维持、自我护理管理及自我护理信心维度分均显著升高,HF生活质量量表的身体领域、情绪领域及其它领域得分均显著降低(P均<0.001).结论:BNP、左心室内径和置入支架数量是心力衰竭患者发生房颤的危险因素,家属赋能模式管理后患者自我管理和生活质量均明显改善.
Objective:To explore the influencing factors of atrial fibrillation(AF)in patients with heart failure(HF)and the effects of family empowerment mode strategy.Methods:A total of 220 HF patients who were trea-ted in First Affiliated Hospital of Chinese PLA Air Force Military Medical University between April 2020 and March 2021 were selected.According to presence of AF or not,they were divided into AF group(n=80)and no AF group(n=140);patients in AF group received family empowerment mode strategy management for 3 months.Scores of self-care behavior scale and quality of life scale were compared between before and after intervention in AF group.Multivariate Logistic regression was used to analyze influencing factors of AF in HF patients,receiver operating characteristic(ROC)curve was used to analyze diagnostic value of above risk factors for AF in HF patients.Results:Compared with no AF group,patients in AF group had significant higher level of brain natriuretic peptide(BNP),left ventricular diameter and number of implanted stents(P<0.001 all).Multivariate Logistic regression indicated that BNP>400pg/ml,left ventricular diamcter>40mm and number of implanted stents>2 were independent risk factors for AF in HF patients(OR=1.349~2.501,P<0.01 all).ROC curve indicated that AUC of BNP,left ven-tricular diameter and number of implanted stents predicting AF in HF patients was 0.819,0.812 and 0.745 respec-tively,all of them had good diagnostic value.Compared with before intervention,there were significant rise in di-mensional scores of self-care maintenance,self-care management and self-care confidence of HF patient self-care behavior scale,and significant reductions in scores of physical domain,emotional domain and other domain of HF quality of life scale in AF group after 3-month intervention(P<0.001 all).Conclusion:BNP,left ventricular diameter and number of implanted stents are risk factors for atrial fibrillation in patients with heart failure.Self-management and quality of life significantly improve after family empowerment mode management in these patients.

Heart failureAtrial fibrillationRoot cause analysisPrognosis

陈竹梅、文汉丽、曹媛、刘雅、杨菲、赵清

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中国人民解放军空军军医大学第一附属医院门诊部,陕西西安 710032

心力衰竭 心房颤动 影响因素分析 预后

陕西省科技统筹创新工程计划项目

2016TZC-S-15-12

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
年,卷(期):2024.33(5)