广西医学

目的探讨基于ADOPT模式的家庭心脏康复在老年冠心病伴衰弱患者中的应用效果。方法将128例老年冠心病伴衰弱患者随机分为研究组和对照组，每组64例。给予对照组常规家庭心脏康复，研究组在对照组基础上基于ADOPT模式开展家庭心脏康复。比较干预前后两组患者Tilburg衰弱量表评分、左室射血分数（LVEF）、左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、无氧阈（AT）、最大摄氧量值（VO2max）、6 min步行试验（6MWD）、健康状况调查简表（SF⁃36）评分，以及干预期间两组患者主要不良心血管事件（MACE）的发生率。结果干预后，除社会衰弱维度得分外，两组患者Tilburg衰弱量表的其他维度得分及总分低于干预前，且研究组的上述得分低于对照组，研究组社会衰弱维度得分亦低于干预前及对照组（P<0.05）；研究组LVEF、6MWD、AT及VO2max高于或长于干预前及对照组，LVESD、LVEDD低于干预前及对照组，SF⁃36各维度得分高于干预前及对照组，MACE总发生率低于对照组（P<0.05）。结论基于ADOPT模式的家庭心脏康复有助于改善老年冠心病伴衰弱患者的衰弱状况，提高心肺功能和生活质量，降低MACE发生率。

Objective To explore the application effect of home‑based cardiac rehabilitation based on ADOPT mode in elderly patients with coronary heart disease and concomitant frailty. Methods A total of 128 elderly patients with coronary heart disease and concomitant frailty were randomly divided into research group or control group, with 64 cases in each group. The control group received routine home‑based cardiac rehabilitation, based on which the research group received home‑based cardiac rehabilitation base on ADOPT mode. The Tilburg frailty scale score, left ventricular ejection fraction (LVEF), left ventricular end‑systolic diameter (LVESD), left ventricular end‑diastolic diameter (LVEDD), anaerobic threshold (AT), maximum oxygen uptake value (VO2max), 6-minute walking distance (6MWD), and 36-Item Short Form of Health Survey (SF⁃36) score, as well as the incidence rate of major adverse cardiac events (MACE) during intervention were compared between patients of the two groups. Results After intervention, except for social frailty dimension score, scores of the remaining dimensions of Tilburg frailty scale, and total score of Tilburg frailty scale in both groups were lower as compared with before intervention, and the research group exhibited lower scores as above as compared with the control group; in addition, the research group yielded a lower social frailty dimension score of Tilburg frailty scale as compared with before intervention and the control group (P<0.05). After intervention, the research group depicted higher LVEF, longer 6MWD, higher AT, and higher VO2max, whereas lower LVESD and LVEDD, and higher scores of various dimensions of SF‑36 as compared with before intervention and the control group, as well as a lower total incidence rate of MACE as compared with the control group (P<0.05). Conclusion Home‑based cardiac rehabilitation based on ADOPT mode can ameliorate frailty states in elderly patients with coronary heart disease and concomitant frailty, improve cardiopulmonary function and life quality, and decrease the incidence rate of MACE.