2026 年第 5 期 第 21 卷

数字化健康教育结合认知行为疗法对老年冠心病合并心律失常伴认知障碍患者治疗依从性及睡眠质量的影响

Effects of digital health education combined with cognitive behavioral therapy on treatment compliance and sleep quality in elderly patients with coronary atherosclerotic heart disease, arrhythmia and cognitive impairment

作者：桑小红1陈霞1吴红瑾2邵勇3龙德勇1

英文作者：Sang Xiaohong1 Chen Xia1 Wu Hongjin2 Shao Yong3 Long Deyong1

单位：1首都医科大学附属北京安贞医院心律失常中心二病区，北京100029；2首都医科大学附属北京安贞医院心内冠心病中心一区，北京100029；3首都医科大学附属北京安贞医院心脏康复中心，北京100029

英文单位：1Second Ward Arrhythmia Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2The First Ward of Coronary Atherosclerotic Heart Disease Center Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 3Cardiac Rehabilitation Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；心律失常；认知障碍；健康宣教；认知行为；家庭支持

英文关键词：Coronaryatheroscleroticheartdisease;Arrhythmia;Cognitiveimpairment;Healtheducation; Cognitivebehavior;Familysupport

• 摘要：

• 目的 探讨数字化健康教育结合认知行为疗法（CBT）治疗及家庭支持在老年冠心病（冠状动脉粥样硬化性心脏病，CHD）合并心律失常伴认知障碍患者中的应用及对治疗依从性和睡眠质量的影响。方法 采用前瞻性研究方法，经随机数字表法将2023年1月至2025年1月在首都医科大学附属北京安贞医院住院的450例老年CHD合并心律失常伴认知障碍患者分为对照组和观察组。对照组227例患者接受常规干预，观察组223例患者在常规干预基础上接受数字化健康教育结合CBT治疗及家庭支持。分析2组患者的一般资料、心律失常、睡眠、认知、生活质量改善情况及治疗依从性。结果 干预后，2组心律失常持续时间、发作频率均较干预前缩短/下降，且观察组心律失常持续时间、发作频率短于/低于对照组（均P<0.05）。干预后，2组匹兹堡睡眠质量指数量表（PSQI）评分均较干预前下降，且观察组PSQI评分低于对照组（均P<0.05）。干预后，2组蒙特利尔认知评估量表（MoCA）、简明健康状况调查量表（SF-36）评分均较干预前升高，且观察组MoCA、SF-36评分均高于对照组（均P<0.05）。观察组治疗依从率高于对照组［96.0%（214/223）比81.5%（185/227）］，差异有统计学意义（P<0.05）。结论 数字化健康教育结合CBT治疗及家庭支持能提高老年CHD合并心律失常伴认知障碍患者的治疗依从性，减少心律失常发作时间及频率，提高睡眠质量，改善认知功能及生活质量。

• Objective To investigate the application of digital health education combined with cognitive behavioral therapy (CBT) and family support in elderly patients with coronary atherosclerotic heart disease (CHD), arrhythmia and cognitive impairment, and its effects on treatment compliance and sleep quality. Methods A prospective study was conducted. A total of 450 elderly patients with CHD, arrhythmia and cognitive impairment admitted to Beijing Anzhen Hospital, Capital Medical University from January 2023 to January 2025 were divided into control group and observation group by random number table method. The control group (227 cases) received routine intervention, and the observation group (223 cases) received digital health education combined with CBT and family support on the basis of routine intervention. The general data, arrhythmia, sleep, cognition, quality of life improvement and treatment compliance were analyzed between the two groups. Results After intervention, the duration and frequency of arrhythmia in both groups were shorter/decreased than those before intervention, and those in the observation group were shorter/lower than those in the control group (all P<0.05). After intervention, the scores of Pittsburgh sleep quality index (PSQI) in both groups were lower than those before intervention, and the score in the observation group was lower than that in the control group (all P<0.05). After intervention, the scores of Montreal cognitive assessment (MoCA) and 36-item short form health survey (SF-36) in both groups were higher than those before intervention, and the scores in the observation group were higher than those in the control group (all P<0.05). The treatment compliance rate in the observation group was higher than that in the control group ［96.0%(214/223) vs 81.5%(185/227)］(P<0.05). Conclusion Digital health education combined with CBT and family support can improve treatment compliance, reduce the duration and frequency of arrhythmia, improve sleep quality, cognitive function and quality of life in elderly patients with CHD, arrhythmia and cognitive impairment.