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基于聚类分析鉴别最可能从门诊心脏康复中获益的患者:一项前瞻性、多中心研究。

Cluster Analysis to Distinguish Patients Most Likely to Benefit from Outpatient Cardiac Rehabilitation-A Prospective, Multicenter Study.

机构信息

Medical Projects Department, COPERNICUS Healthcare Entity, 80-803 Gdansk, Poland.

First Department of Cardiac Arrhythmias, National Institute of Cardiology, 04-628 Warsaw, Poland.

出版信息

Int J Environ Res Public Health. 2022 Sep 2;19(17):11000. doi: 10.3390/ijerph191711000.

Abstract

Offering cardiac rehabilitation to people who can benefit most could improve the outcomes in the context of limited availability. We used cluster analysis to distinguish three patient groups based on clinical and laboratory variables and then compared the outcomes of 6-month outpatient cardiac rehabilitation between these groups. The outcomes included blood pressure, blood lipids, fasting blood glucose, and uric acid concertation in serum. Group 1 consisted primarily of men with obesity, increased blood pressure, favourable lipid profiles and increased fasting glucose. Group 2 consisted of men or women with normal weight, normal blood pressure, favourable lipid profiles, and normal fasting glucose. Group 3 consisted primarily of women with overweight, normal blood pressure, unfavourable lipid profiles, and normal fasting glucose. After 6 months of cardiac rehabilitation, blood lipids improved in group 3, whereas blood pressure improved in groups 1 and 3, but the outcomes did not change significantly in group 2. We did not see any effect of cardiac rehabilitation on fasting blood glucose and serum uric acid concentration in any group. Concentrations of glucose and uric acid did not change significantly in any group. In conclusion, an adequate selection of patients should maximise the benefits of cardiac rehabilitation.

摘要

为最能从中受益的人群提供心脏康复治疗,在资源有限的情况下可能改善预后。我们使用聚类分析根据临床和实验室变量将患者分为三组,然后比较三组患者在 6 个月门诊心脏康复治疗后的结果。结果包括血压、血脂、空腹血糖和血清尿酸浓度。第 1 组主要由肥胖、血压升高、血脂谱良好和空腹血糖升高的男性组成。第 2 组由体重正常、血压正常、血脂谱正常和空腹血糖正常的男性或女性组成。第 3 组主要由超重、血压正常、血脂谱不佳和空腹血糖正常的女性组成。心脏康复治疗 6 个月后,第 3 组的血脂得到改善,而第 1 组和第 3 组的血压得到改善,但第 2 组的结果没有明显变化。我们没有观察到心脏康复治疗对任何组的空腹血糖和血清尿酸浓度有任何影响。任何一组的血糖和尿酸浓度均无明显变化。总之,适当选择患者可以最大限度地提高心脏康复治疗的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30bb/9518514/459e7b34cda9/ijerph-19-11000-g001.jpg

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