强化生活方式干预对新疆地区老年非瓣膜性持续性心房颤动患者生活质量的影响
The Influence of Intensified Lifestyle Intervention on the Quality of Life of Elderly Patients with Non-valvular Persistent Atrial Fibrillation in Xinjiang Region
许严锴 1董润甜 1龙睿 2刘克坚3
作者信息
- 1. 832000 新疆维吾尔自治区石河子市，石河子大学第一附属医院全科医学科;832000 新疆维吾尔自治区石河子市，国家卫生健康委员会中亚高发病防治重点实验室;832000 新疆维吾尔自治区石河子市，石河子大学临床医学院
- 2. 832000 新疆维吾尔自治区石河子市，石河子大学第一附属医院心血管一科;832000 新疆维吾尔自治区石河子市，国家卫生健康委员会中亚高发病防治重点实验室;832000 新疆维吾尔自治区石河子市，石河子大学临床医学院
- 3. 832000 新疆维吾尔自治区石河子市，石河子大学第一附属医院心血管一科;832000 新疆维吾尔自治区石河子市，国家卫生健康委员会中亚高发病防治重点实验室
- 折叠
摘要
背景 老年非瓣膜性持续性心房颤动（nPsAF）的发病率持续上升，易导致严重并发症。生活方式干预作为一种低成本、低风险的非药物治疗手段，已被指南推荐为心房颤动的第4种治疗方法，nPsAF的管理不仅需要抗凝与节律控制，更需关注可改变的危险因素。目的 强化生活方式干预对老年nPsAF患者生活质量及综合临床指标的影响。方法 采用前瞻性随机对照研究设计，纳入2023年10月—2024年9月新疆维吾尔自治区4家医院的100例≥65岁nPsAF患者，采用随机数字表法分为对照组（n=50）和干预组（n=50）。对照组患者接受常规综合管理，干预组在此基础上接受强化生活方式干预（涵盖饮食、运动等），比较两组患者干预前和干预12个月后的心房颤动特异性生活质量量表（AFEQT）、欧洲五维健康量表5水平版（EQ-5D-5L），以及饮食和运动情况、血压和血脂控制情况、心电图检查标及血清系统性炎症反应指数（SIRI）等。结果 对照组50例、干预组48例完成了干预及随访。干预前，两组患者AFEQT得分和EQ-5D-5L得分比较，差异无统计学意义（P>0.05）；干预后，两组患者AFEQT得分和EQ-5D-5L得分均较干预前升高，且干预组患者AFEQT得分和EQ-5D-5L得分高于对照组（P<0.05）。干预组患者的AFEQT得分和EQ-5D-5L得分较基线的改善幅度高于对照组（P<0.05），AFEQT得分的Cohen's d=0.838（大效应），EQ-5D-5L的Cohen's d=0.682（中等偏强效应）。干预后，干预组患者的饮食得分高于对照组，收缩压、校正QT间期（QTc）、低密度脂蛋白胆固醇（LDL-C）、SIRI低于对照组（P<0.05）。结论 在常规管理基础上实施强化生活方式干预，能改善老年nPsAF患者的生活质量，在饮食、血压、血脂及炎症状态方面产生积极变化。
Abstract
BackgroundThe incidence of non-valvular persistent atrial fibrillation (nPsAF) in the elderly is continuously increasing, which can lead to serious complications. Lifestyle intervention, as a low-cost and low-risk non-drug treatment method, has been recommended by guidelines as the fourth treatment option for atrial fibrillation. The management of nPsAF not only requires anticoagulation and rhythm control, but also needs to pay attention to modifiable risk factors. ObjectiveThis study aims to explore the impact of enhanced lifestyle intervention on the quality of life and comprehensive clinical indicators of elderly patients with nPsAF. MethodsA prospective randomized controlled study design was adopted. A total of 100 patients aged 65 and above with non-valvular atrial fibrillation (nPsAF) from four hospitals in Xinjiang from October 2023 to September 2024 were included. According to the random number table method, they were divided into the intervention group (n=50) and the control group (n=50). The control group received routine comprehensive management, while the intervention group received enhanced lifestyle intervention (covering diet, exercise, etc.) on top of this. Comparison of the Atrial Fibrillation-Specific Quality of Life Questionnaire (AFEQT), EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L), diet and physical activity status, blood pressure and blood lipid control, electrocardiogram parameters, and systemic inflammation response index (SIRI) between the two groups at baseline and 12 months after intervention. ResultsA total of 50 patients in the control group and 48 patients in the intervention group completed the intervention and follow-up. Before the intervention, there was no statistically significant difference in the AFEQT scores and EQ-5D-5L scores between the two groups (P>0.05); after the intervention, the AFEQT scores and EQ- 5D-5L scores of both groups increased compared to before the intervention, and the AFEQT scores and EQ-5D-5L scores of the intervention group were higher than those of the control group (P<0.05). The improvement in the AFEQT scores and EQ-5D-5L scores of the intervention group patients compared to the baseline was greater than that of the control group (P<0.05), with Cohen's d for AFEQT being 0.838 (large effect) and for EQ-5D-5L being 0.682 (moderately strong effect). After the intervention, the dietary scores of the intervention group patients were higher than those of the control group, and their systolic blood pressure, QTc, LDL-C, and SIRI were lower than those of the control group (P<0.05). ConclusionImplementing intensified lifestyle intervention on the basis of conventional management can improve the quality of life of elderly patients with nPsAF, and bring about positive changes in diet, blood pressure, blood lipids and inflammatory status.关键词
非瓣膜性持续性心房颤动/强化生活方式干预/生活质量/老年人/随机对照研究/新疆Key words
Non-valvular persistent atrial fibrillation/Intensive lifestyle intervention/Quality of life/Elderly/Randomized controlled study/Xinjiang引用本文复制引用
许严锴,董润甜,龙睿,刘克坚.强化生活方式干预对新疆地区老年非瓣膜性持续性心房颤动患者生活质量的影响[EB/OL].(2026-11-09)[2026-11-11].https://chinaxiv.org/abs/202611.00089.学科分类
内科学
