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JAMA：手机短信能减少心血管疾病风险！！！

2015-09-24 Mechront 译 MedSci原创

移动健康冠心病短信
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在对心血管疾病进行预防和管理的策略里，养成良好的生活方式占有很重要的一席之地，然而实践中由于各种各样的现实因素，该策略却很少得到充分应用。丢失如此好的策略，岂不是很可惜；把握不住好好生活的机会，岂不是等于自杀。不过随着科技化以及信息化的发展，移动健康策略的推进，该问题的理想和现实间的差距或许可以得到缩小，但目前没有关于移动健康在此方面的效果的研究及评价。

Clara K等人设计了一项单盲的随机对照临床研究，在一段时间内对研究对象发送个人定制的强调生活方式的手机短信（移动健康策略），根据一系列心血管疾病相关检查指标数值的变化情况，评估该方式对预防心血管疾病的效果。

该研究纳入了2011年9月-2013年11月间，在悉尼的大型三级医院确诊冠心病（心肌梗死病史或冠脉造影）的710名患者，平均年龄58岁，SD=9.2；男性占82%；目前吸烟人群占53%。研究对象被随机分为实验组(n = 352)和对照组(n = 358)。

实验组在为期6个月的研究期间，除了常规治疗外，还能在每周收到4条个性化定制的关注生活方式的手机短信。短信内容通常是提供建议、对患者鼓励（激励）、支持改变生活方式等；短信的发出是由电脑根据患者的人口统计学资料以及其他生活方式等资料，自动选择合适的内容，自动发送的。而对照组在研究期间则只接受常规治疗。该研究统计了第6个月研究对象的低密度脂蛋白胆固醇(LDL-C)水平；以及收缩压、BMI、运动、吸烟情况等。

经过6个月的研究后发现，实验组LDL-C 水平平均低于对照组5 mg / dL（95% CI,−9 0;P = .04)；收缩压平均降低7.6mm Hg（95% CI, −9.8 to −5.4; P < .001)和BMI平均下降1.3(95% CI, −1.6 to −0.9; P < .001)；运动量显著增加，每周至少增加293代谢当量（95% CI, 102 to 485;P = .003)；吸烟人群明显减少 26% vs 44%，RR=0.61(95% CI, 0.48 to 0.76；P <.001)。绝大多数反馈手机短信提醒方式是有用的(91%)、容易理解的(97%)，并且每周4次的频率非常合适(86%)。

研究结果表明，对CHD患者发送关注生活方式的手机短信，与常规治疗相比，可以降低LDL-C，以及改善其他心血管疾病的危险因素。因该研究为期仅6个月，因此移动健康策略能都改善患者预后，仍需进一步研究。

原始出处：

Chow, C. K., Redfern, J., Hillis, G. S. & et al. Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: A randomized clinical trial. JAMA 314, 1255-1263, doi:10.1001/jama.2015.10945 (2015).

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  1. [GetPortalCommentsPageByObjectIdResponse(id=37725, encodeId=920f3e725e5, content=这也可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cab51623450, createdName=sanshengshi, createdTime=Mon Oct 05 21:14:00 CST 2015, time=2015-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1472969, encodeId=8cb614e29696e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497911, encodeId=132b149e911a6, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37231, encodeId=f0023e231b9, content=这也能发表?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Thu Sep 24 15:30:00 CST 2015, time=2015-09-24, status=1, ipAttribution=)]
    2015-10-05 sanshengshi

    这也可以

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=37725, encodeId=920f3e725e5, content=这也可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cab51623450, createdName=sanshengshi, createdTime=Mon Oct 05 21:14:00 CST 2015, time=2015-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1472969, encodeId=8cb614e29696e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497911, encodeId=132b149e911a6, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37231, encodeId=f0023e231b9, content=这也能发表?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Thu Sep 24 15:30:00 CST 2015, time=2015-09-24, status=1, ipAttribution=)]
    2015-09-26 花花1368

    #疾病风险#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=37725, encodeId=920f3e725e5, content=这也可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cab51623450, createdName=sanshengshi, createdTime=Mon Oct 05 21:14:00 CST 2015, time=2015-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1472969, encodeId=8cb614e29696e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497911, encodeId=132b149e911a6, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37231, encodeId=f0023e231b9, content=这也能发表?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Thu Sep 24 15:30:00 CST 2015, time=2015-09-24, status=1, ipAttribution=)]
    2015-09-26 andy2090

    #血管疾病#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=37725, encodeId=920f3e725e5, content=这也可以, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=cab51623450, createdName=sanshengshi, createdTime=Mon Oct 05 21:14:00 CST 2015, time=2015-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1472969, encodeId=8cb614e29696e, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1497911, encodeId=132b149e911a6, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Sat Sep 26 02:38:00 CST 2015, time=2015-09-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=37231, encodeId=f0023e231b9, content=这也能发表?, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Thu Sep 24 15:30:00 CST 2015, time=2015-09-24, status=1, ipAttribution=)]
    2015-09-24 medcardio

    这也能发表?

    0