全-专结合下老年骨质疏松症患者闭环管理效果评价

Evaluation of effects of closed-loop management under of a general-specialized combination model on elderly patients with osteoporosis

中文关键词: 老年  骨质疏松症  全-专结合  闭环管理  应用效果

英文关键词: elderly  osteoporosis  general-specialized combination  closed-loop management  application effect

中文摘要:

      目的 评价以全-专结合的模式管理老年骨质疏松症(OP)患者的疗效分析.方法 选取2023 年1 月至12 月在上海某社区卫生服务中心门诊或体检筛查出的260 例老年OP患者,按照随机数字表随机分为对照组和试验组.对照组予以门诊常规处理,试验组实施全-专结合下闭环管理的随访模式,比较 2 组管理模式的治疗 6 个月和 1 年后的效果情况.结果 治疗6 个月后、治疗1 年后,对照组和试验组患者骨钙蛋白(OC)水平均较治疗前显著升高,差异有统计学意义(F=27.33、35.34,P＜0.05);而对照组和试验组患者beta-Ⅰ型胶原交联C-末端肽(β-CTX)水平则随治疗时间延长而显著降低,差异有统计学意义(F=56.43、68.47,P＜0.05);治疗6 个月后、治疗1 年后,对照组和试验组患者健康调查简表(SF-36)评分和自我效能量表(GSES)评分均较治疗前显著升高,差异均有统计学意义(F=16.34、27.46、42.54、56.42,P＜0.05);随治疗时间变化,对照组与试验组患者OC和β-CTX水平变化趋势不同,提示治疗时间与治疗方式存在显著交互效应(F=3.49、8.24,P均＜0.05),随治疗时间变化,对照组与试验组患者的SF-36 评分和GSES评分改善趋势不同,提示治疗时间与治疗方式存在显著交互效应(F=7.49、8.24,P均＜0.05).试验组在干预后用药依从性高于对照组,差异有统计学意义(P＜0.05)、知识健康知晓率高于对照组,差异有统计学意义(P＜0.001).结论 充分发挥全-专结合下闭环管理与时间的协同作用,既能有效改善老年 OP患者的骨代谢水平(双向调节骨形成与骨吸收),又能提升其生活质量与自我效能感,同时增强用药依从性与疾病认知度.

英文摘要:

      Objective To evaluate the effects of a general-specialized management combination model on elderly patients with osteoporosis(OP).Methods A total of 260 elderly OP patients screened through outpatient visits or health examinations in a community health center in Shanghai from January to December 2023 were selected and randomly divided into control group and experimental group according to a random number table.The control group received routine outpatient treatment,while the experimental group implemented a follow-up model of a general-specialized management.The therapeutic effects of the two management models were compared between the two groups at 6 months and 1 year after treatment.Results After 6 months and 1 year of treatment,osteocalcin(OC)levels in both groups were significantly higher than those in the same group before treatment,with statistically significant differences(F=27.33,35.34,P＜0.05).In contrast,beta-Ⅰtype collagen cross-linked C-terminal peptide(β-CTX)levels in both groups decreased significantly over time,with statistically significant differences(F=56.43,68.47,P＜0.05).After 6 months and 1 year of treatment,the scores of SF-36 and GSES in both groups were significantly higher than those in the same group before treatment,with statistically significant differences(F=16.34,27.46,42.54,56.42,P＜0.05).With the change of treatment time,the changing trends of the levels of OC and β-CTX in both groups were different,suggesting a significant interaction effect between the treatment time and treatment methods(F=3.49,8.24;both P＜0.05).Similarly,the changing trends in the scores of SF-36 and GSES differed between the two groups,also suggesting a significant interaction effect between the treatment time and treatment methods(F=7.49,8.24;both P＜0.05).The medication compliance of the experimental group after the intervention was higher than that of the control group,and the difference was statistically significant(P＜0.05).The awareness rate of health knowledge in the experimental group was higher than that in the control group,and the difference was statistically significant(P＜0.001).Conclusion Fully leveraging the synergistic effect of closed-loop management under a general-specialized combination model and treatment duration not only effectively improves bone metabolism level in elderly OP patients(bidirectional regulation of bone formation and resorption),but also enhances their quality of life and self-efficacy,and strengthen their medication compliance and disease awareness.