- 期刊
衛教急性心肌梗塞病人遵從地中海飲食模式對血脂之影響
The Effect of Mediterranean Diet Adherence on Blood Lipid Levels on Nutrition Education for Patients With Acute Myocardial Infarction
摘要
研究顯示，遵循地中海飲食對降低心血管疾病風險有益。本研究旨在探討營養衛教對急性心肌梗塞病人地中海飲食遵從度、生化值的關聯性以及改善效果。研究對象為收集2020年間於本院診斷為急性心肌梗塞收案之病人，營養師給予兩次營養衛教，並以地中海飲食遵從度問卷評估病人飲食狀況，具完整臨床資料及問卷內容者共42人。以配對t檢定分析營養衛教前後地中海飲食遵從度分數、血壓及生化值之改變量。結果顯示，營養衛教後，地中海飲食遵從度分數增加4.8±3.3分，總膽固醇、低密度膽固醇及三酸甘油酯分別減少47.6±36.5 mg/dL、43.9±31.6 mg/dL及56.4±122.3 mg/dL，高密度膽固醇則增加3.0±9.0 mg/dL，以上皆達顯著性差異（p<0.05）。以淨相關（partial Pearson correlation）分析，調整性別及年齡，總膽固醇改變量與地中海遵從度分數改變量呈顯著負相關（r=-0.433, p=0.022），而與低密度膽固醇、三酸甘油酯及高密度膽固醇無相關。以配對t檢定分析接受營養衛教後<3個月以及3～12個月兩組血脂肪的改變量，結果顯示，總膽固醇（-58.5±42.8 mg/dL vs. -42.2±32.4 mg/dL）、低密度膽固醇（-47.7±36.7 mg/dL vs. -42.0±29.3 mg/dL）及三酸甘油脂（-58.1±124.8 mg/dL vs. -55.5±123.3 mg/dL），在兩組皆維持下降效果，但無達顯著差異。故本研究顯示，急性心肌梗塞病人接受營養衛教後，有益於一年內總膽固醇之控制，且其變化量與地中海飲食遵從度分數呈現負相關，未來可增加樣本數及延長追蹤時間確認效果是否維持。
並列摘要
The Mediterranean diet has been established as a beneficial dietary pattern to reduce cardiovascular disease risks. This study aimed to explore the correlation and improvement effect of nutritional education on Mediterranean diet adherence and biochemical values in patients with acute myocardial infarction. The study recruited patients (n = 42) diagnosed with acute myocardial infarction in our hospital in 2020. The dietitians consulted the patient twice and evaluated the patient's dietary status using the Mediterranean diet adherence questionnaire. A total of 42 patients had complete clinical data and questionnaire content. A paired t-test was used to analyze the changes in Mediterranean diet adherence score, blood pressure, and biochemical values before and after nutritional education. The results showed that, after nutritional education, the Mediterranean diet adherence score increased by 4.8 ± 3.3 points, while total cholesterol, low density lipoprotein cholesterol, and triglycerides decreased by 47.6 ± 36.5 mg/dL, 43.9 ± 31.6 mg/dL, and 56.4 ± 122.3 mg/dL, respectively, while high density lipoprotein cholesterol increased by 3.0 ± 9.0 mg/dL; all showed significant differences (p < 0.05). After adjusting for sex and age using partial correlation, the change in total cholesterol was significantly negatively correlated with the change in Mediterranean adherence score (r = -0.433, p = 0.022) but not with low density lipoprotein cholesterol, triglycerides, and high density lipoprotein cholesterol. The paired t-test was used to analyze the changes in blood lipids in the < 3 and 3-12 months groups after receiving nutritional education. The results showed that trends of total cholesterol (-58.5 ± 42.8 mg/dL vs. -42.2 ± 32.4 mg/dL), low density lipoprotein cholesterol (-47.7 ± 36.7 mg/ dL vs. -42.0 ± 29.3 mg/dL), and triglyceride (-58.1 ± 124.8 mg/dL vs. -55.5 ± 123.3 mg/ dL) levels remained unchanged. Therefore, this study shows that nutritional education for patients after acute myocardial infarction is beneficial to control total cholesterol within a 1-year period, and its change is negatively correlated with the Mediterranean diet adherence scores. For future studies, it is necessary to increase the sample size and extend the follow-up time to confirm the maintenance effect.