心導管治療之冠心病患者的飲食及生活型態探討

Effects of Diet and Lifestyle on Patients with Coronary Heart Disease before a Cardiac Catheterization Intervention

本研究針對新北市某醫學中心50位首次施行心導管治療之住院冠心病患進行飲食生活型態頻率問卷調查，探討可能影響血管阻塞之飲食相關問題。結果發現個案身體質量指數（body mass index, BMI）、腰圍（waist circumference, WC）、糖化血色素（glycated hemoglobin, HbA1c）、高密度脂蛋白膽固醇（high-density lipoprotein cholesterol, HDL-C）、低密度脂蛋白膽固醇（lowdensity lipoprotein cholesterol, LDL-C）異常者比例高。個案多數無運動及有抽煙習慣，研究發現生活型態與飲食習慣有相關性，有運動與不抽菸者的飲食習慣較健康。調查發現速食、香腸與火腿、蛋黃等食物攝取與HbA1c 呈正相關（ <0.05），紅肉、湯汁拌飯攝取頻率與血清總膽固醇呈正相關（ <0.05），丸類及鬆類加工品攝取頻率與HDL-C 呈負相關（ <0.05）。速食、外食攝取頻率較高其腰圍及BMI較高（ <0.05），且BMI與腰圍有明顯正相關（ <0.05）。結論：經由本研究發現冠心病患者體位及生化值異常者比例高；且高油食物、加工食品及外食影響血糖、血脂及體位。故飲食衛教時不僅需著重於疾病營養認知問題，更要依個別情況指導健康食物的選擇與外食技巧、維持理想體重與合適腰圍、戒煙及配合適度運動，以防治冠心病。

This study investigated 50 coronary heart disease（CHD）inpatients, who had first received a cardiac catheterization intervention in a medical center in New Taipei City, Taiwan. Objectives of the study were to use a dietary lifestyle frequency questionnaire to survey possible impacts of diet and lifestyle on CHD. It was found that subjects had higher values for the body-mass index （BMI）, waist circumference（WC）, glycated hemoglobin（HbA1c）, and low-density lipoprotein cholesterol（LDL-C）, and a lower value of high-density lipoprotein cholesterol（HDL-C）than expected. Most subjects did not regularly exercise and had the smoking habit. Results showed that lifestyle and eating habits were correlated, and subjects who were non-smokers and exercised had better eating habits. This survey found that high frequencies of intake of fast foods, sausage, ham, and egg yolks were positively correlated with HbA1c levels（ <0.05）. Red meat and mixed sauces on rice were positively correlated with serum total cholesterol（ <0.05）. Processed foods such as meatballs and dried meat floss were negatively correlated with HDL-C（ <0.05）. Fast foods and eating out were positively correlated with the WC and BMI（ <0.05）. The BMI and WC were also significantly positively correlated（ <0.05）. This study found that CHD patients had higher abnormal values of anthropometric and biochemical data, and results showed that high-fat foods, processed foods, and eating out influenced blood glucose, lipids, and anthropometric measurements. So, nutrition education for CHD patients should not only focus on knowledge, but also needs to guide healthy food choices and eating skills, depending on individualized conditions, to maintain an ideal body weight and an appropriate WC. Patients also need to quit smoking and do moderate exercise to prevent and ameliorate CHD.