摘要
目的评价慢型克山病患者自我治疗效果。方法对黑龙江省富裕县克山病患者进行临床调查，筛查出20名慢型克山病患者，分别于治疗前、治疗3个月、治疗6个月时3次对这些患者实施自我治疗管理，包括宣传教育、一般指导、药物治疗，并指导患者根据病情变化调整用药。比较自我治疗前、治疗3个月、治疗6个月时患者的症状、心率、超声心动图结果及心功能分级的变化。结果20名慢型克山病患者的主要症状积分在自我治疗前为（15．03±6．77）分，自我治疗3个月和6个月时分别为（7．25±4．82）、（6．70±4．90）分，治疗后显著降低（P〈0．01）；心率自我治疗前为（76．40±12．06）次／min，自我治疗3个月和6个月时分别为（69．95±12．63）次／min、（67．15±9．76）次／min，治疗后明显减慢（P〈0．01）。超声心动图检测左房内径（LAd）、左室舒张末期内径（LVEDd）自我治疗前分别为（37．85±5．23）、（52．49±9．38）mm，自我治疗3个月时分别为（36．77±5．63）、（52．15±9．24）mm，自我治疗6个月时分别为（35．29±5．50）、（50．81±8．88）mm，治疗后均明显缩小（P〈0．01或〈0．05）；左室射血分数（LVEF）自我治疗前为（55．15±15．80）％，自我治疗3个月和6个月时分别为（57．35±12．51）％、（60．30±13.42）％，治疗后显著升高（P〈0．05）；二尖瓣血流E／A比值自我治疗前后比较，差异无统计学意义（P〉0．05）；心功能分级治疗3个月时较治疗前有明显改善（T=36．0，P〈0．05），治疗6个月时较治疗前无明显改善（T=17．5，P〉0．05）。结论对慢型克山病现患的自我治疗取得了较好的疗效，值得坚持和进一步推广。
Objective To evaluate the self-treatment effectiveness on patients with chronic Keshan disease. Methods Twenty patients with chronic Keshan disease were selected from individuals with Kesban disease in Fuyu County, Heilongjiang Province. They were trained three times every three months of self management including pathogenetic condition education, general guidance, drug therapy, and they also taught how to adjust the dose of drug according to their illness. Major symptom score, heart rate （HR）, ultrasoundcardiogram （UCG） index and cardiac functional grading of these patients at baseline, after 3 months and 6 months of treatment were compared. Results The 20 patients rated their main symptoms score as （15.03 ± 6.77） before self- treatment, and significantly decreased to （7.25 ± 4.82） and （6.70 ± 4.90） after 3 and 6 months treatment（P 〈 0.01）; the heart rate （HR） was （76.40 ± 12.06） beats per minute （bpm） before self-treatment, and dramatically decreased to （69.95 ± 12.63）, （67.15± 9.76）bpm after 3 and 6 months treatment（P 〈 0.01）. As for UCG detecting index, left atrial diameter （LAd） and left ventricular end-diastolic diameter（LVEDd） was （37.85 ± 5.23）mm and （52.49 ± 9.38）mm separately before self-treatment, and notablely decreased to （36.77 ± 5.63）, （52.15 ± 9.24）mm, and （35.29 ± 5.50）, （50.81 ± 8.88）mm respectively after 3 and 6 months of treatment（P 〈 0.01 or 〈 0.05 ） ; left ventricular ejection fraction（LVEF） markedly inereased（P 〈 0.05）, from （55.15 ± 15.80）% at baseline to （57.35 ±12.51 ）% at 3 months and （60.30 ± 13.42）% at 6 months; there were no significant differences in mitral flow E/A ratio changes before and after treatment （P 〉 0.05）; compared with prior to the treatment, cardiac function grading was significantly better after treatment for 3 months （T = 36.0, P 〈 0.05）, but not after 6 months （T = 17.5,P 〉 0.05）. Conclusions The patients＇ self-treatment is effective, which we recommend to uphold and widespread.
出处
《中国地方病学杂志》
CAS
CSCD
北大核心
2008年第5期566-569,共4页
Chinese Jouranl of Endemiology
基金
黑龙江省自然科学基金重点项目（ZJY04-07）
中国疾病预防控制中心及卫生部委托项目（2007）：哈尔滨医科大学创新群体基金（2006）
关键词
克山病
治疗
结果评价
自我管理
Keshan disease
Therepy
Outcome assessment
Self-management
