2026 年第 6 期 第 21 卷

基于主动健康行为理念的患者管理对老年冠心病经皮冠状动脉介入术后康复质量的影响

Effect of patient management based on the concept of active health behavior on rehabilitation quality of elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention

作者：杜银凤1张楠2李春营3

英文作者：Du Yinfeng1 Zhang Nan2 Li Chunying3

单位：1首都医科大学附属北京安贞医院冠心病中心五区，北京100029；2清华大学附属垂杨柳医院药剂中心，北京100022；3清华大学附属垂杨柳医院门诊办公室，北京100022

英文单位：1Fifth Division Department of Coronary Heart Disease Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Pharmacy Chuiyangliu Hospital Affiliated to Tsinghua University Beijing 100022 China; 3Outpatient Office Chuiyangliu Hospital Affiliated to Tsinghua University Beijing 100022 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；主动健康行为；经皮冠状动脉介入；患者管理；自我管理

英文关键词：Coronaryatheroscleroticheartdisease;Activehealthbehavior;Percutaneouscoronaryintervention;Patientmanagement;Self-management

• 摘要：

• 目的 评价基于主动健康行为理念的患者管理对老年冠心病（冠状动脉粥样硬化性心脏病）患者经皮冠状动脉介入（PCI）术后康复质量的影响。方法 选取首都医科大学附属北京安贞医院于2024年12月至2025年5月收治的接受PCI的400例老年冠心病患者为研究对象。完全随机分为对照组和观察组，各200例。对照组实施科室常规管理，观察组患者在常规管理的基础上采取以主动健康行为理念为指导的系统干预，2组均随访3个月。比较2组自我效能、生活质量、心理状态及心血管不良事件发生情况差异。结果 随访期间，对照组失访15例，观察组失访10例，最终分别纳入185例与190例。干预后1个月与3个月，观察组自我效能感与自我管理能力、生活质量、疾病相关危险因素认知情况、治疗依从性、主动健康行为水平相关评分均显著高于对照组，心理状态相关评分均显著低于对照组（均P＜0.001）。观察组心血管不良事件总发生率低于对照组［16.3%（31/190）比47.6%（88/185）］（χ2=42.259，P<0.001）。结论 基于主动健康行为理念的患者管理能够显著提高老年冠心病PCI术后患者的主动健康行为水平、自我效能感和自我管理能力，改善生活质量和心理健康状态，降低心血管不良事件发生率。

• Objective To evaluate the effect of patient management based on the concept of active health behavior on rehabilitation quality in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention. Methods A total of 400 elderly patients with coronary atherosclerotic heart disease who underwent percutaneous coronary intervention and were admitted to Beijing Anzhen Hospital, Capital Medical University from December 2024 to May 2025 were enrolled as research subjects. They were randomly divided into control group and observation group, with 200 cases in each group. The control group received routine department management, while the observation group received systematic intervention guided by the concept of active health behavior on the basis of routine management. Both groups were followed up for 3 months. The differences in self-efficacy, quality of life, psychological state and incidence of cardiovascular adverse events were compared between the two groups. Results During the follow-up period, 15 cases were lost to follow-up in the control group and 10 cases in the observation group, with 185 and 190 cases finally included respectively. At 1 month and 3 months after intervention, the scores related to self-efficacy, self-management ability, quality of life, cognition of disease-related risk factors, treatment compliance and active health behavior level in the observation group were significantly higher than those in the control group, while the scores related to psychological state were significantly lower than those in the control group (all P＜0.001). The total incidence of cardiovascular adverse events in the observation group was lower than that in the control group ［16.3%(31/190) vs 47.6%(88/185)］(χ2=42.259, P＜0.001). Conclusions Patient management based on the concept of active health behavior can significantly improve the level of active health behavior, self-efficacy and self-management ability, optimize quality of life and mental health status, and reduce the incidence of cardiovascular adverse events in elderly patients with coronary atherosclerotic heart disease after percutaneous coronary intervention.