老年综合评估辅助房颤ABC结构化管理对老年房颤病人生活质量评分的影响

doi:10.3969/j.issn.1003-9198.2025.11.015

摘要/Abstract

摘要： 目的探究老年综合评估与干预辅助房颤ABC结构化管理对老年心房颤动(房颤)病人生活质量评分的影响,为老年房颤病人的综合管理提供借鉴。方法纳入2023年8月至2024年12月在南京医科大学附属老年医院以及医联体内2个社区卫生服务中心就诊的100例老年非瓣膜性房颤病人,采用双组知情同意zelen’s设计随机对照研究,将病人分为常规组(n=50)和研究组(n=50)。常规组病人进行房颤ABC综合管理,研究组病人进行老年综合评估与干预辅助房颤ABC综合管理。比较2组病人管理前后房颤特异性生活质量量表(AFEQT)评分、规范抗凝率、血压及心率控制情况、房颤症状分级、CHA2DS2-VASc-60评分、HAS-BLED评分的差异。结果干预前,2组病人AFEQT总分、症状维度、日常活动维度及治疗焦虑维度得分差异均无统计学意义(P>0.05)。干预后,研究组AFEQT总分、症状维度得分、治疗焦虑维度得分均较干预前显著降低(P<0.05),且AFEQT总分、症状维度得分、日常活动维度得分均低于常规组,差异有统计学意义(P<0.05)。干预后,研究组SBP水平、有症状病人比例均较干预前明显下降,差异有统计学意义(P<0.05)。结论老年综合评估和干预辅助老年房颤病人ABC结构化管理可以减轻房颤病人症状,提高生活质量。

关键词: 非瓣膜性房颤, 老年综合评估, 房颤ABC路径, 生活质量

Abstract: Objective To explore the effects of comprehensive geriatric assessment and intervention combined with the atrial fibrillation(AF) ABC structured pathway on the quality of life of the elderly patients with AF, and to provide a reference for the comprehensive management of the elderly AF patients. Methods From August 2023 to December 2024, a total of 100 elderly patients diagnosed with non-valvular AF were enrolled from the Geriatric Hospital of Nanjing Medical University and two community health service centers within its medical consortium. A randomized controlled trial using a two-group informed consent Zelen’s design was conducted. The patients were divided into the conventional group (n=50)and the study group (n=50). The conventional group received standard AF ABC comprehensive management, while the study group received comprehensive geriatric assessment and AF ABC comprehensive management. The AF-specific Quality of Life (AFEQT) score, standardized anticoagulation rate, blood pressure and heart rate control rate, atrial fibrillation symptom severity grade, CHA2DS2-VASc-60 score, and HAS-BLED score were compared between the two groups before and after management. Results Before the intervention, no statistically significant differences were observed between the two groups in the total AFEQT score, symptom domain, daily activities domain, and treatment concerns domain (P>0.05). After the intervention, the study group showed significant reductions in the total AFEQT score, symptom domain, and treatment concerns domain compared to the baseline values (P<0.05). Moreover, the study group showed significantly lower scores of total AFEQT, symptom domain, and daily activities domain than those of the conventional group, with statistically significant differences (P<0.05). In addition, systolic blood pressure and the proportion of symptomatic patients in the study group were significantly decreased after the intervention (P<0.05). Conclusions The application of comprehensive geriatric assessment and intervention as an adjunct to the ABC structured management in elderly AF patients can alleviate AF symptoms and improve their quality of life.

Key words: non-valvular atrial fibrillation, comprehensive geriatric assessment, atrial fibrillation ABC pathway, quality of life

中图分类号:

R 541.75

张慧妹, 窦毓, 郭红梅, 王凤, 熊亚晴. 老年综合评估辅助房颤ABC结构化管理对老年房颤病人生活质量评分的影响[J]. 实用老年医学, 2025, 39(11): 1145-1149.

ZHANG Huimei, DOU Yu, GUO Hongmei, WANG Feng, XIONG Yaqing. Effects of comprehensive geriatric assessment-assisted atrial fibrillation ABC structured management on the quality of life in elderly patients with atrial fibrillation[J]. Practical Geriatrics, 2025, 39(11): 1145-1149.

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