目的： 探讨电话回访延续健康教育和指导对2型糖尿病患者冠状动脉斑块进展的影响。方法： 研究入选符合条件的825例2型糖尿病患者,均因冠心病接受冠状动脉造影和介入手术,并于随访1年后再次行冠状动脉造影评估斑块进展。收集患者入院后相关资料。以轮流选择方式入选397例患者为研究组,428例为对照组。住院期间对2组进行健康教育。出院后,研究组每3个月1次由专科团队给予电话回访延续健康教育、疾病症状随访和督促血糖、血压监测,以及相应药物治疗指导。而对照组无延续随访。结果： 随访1年后,研究组冠状动脉斑块进展的发生率和程度显著低于对照组,并且在自我行为管理、自我血糖监测、自我血压监测和遵医嘱服药等方面显著优于对照组（均P<0.05）。多元回归分析显示电话回访方式延续健康教育和指导是斑块进展的独立干预因素,而吸烟、高血压和血糖控制差则促进斑块进展（均P<0.05）。结论： 电话回访延续健康教育和指导有助于干预2型糖尿病患者冠状动脉斑块进展。

Objective To investigate the effects of tele-nursing education and guidance on coronary atherosclerotic plaque progression in patients with type 2 diabetes mellitus (T2DM). Methods This study included 825 T2DM patients who underwent coronary artery angiography and had the coronary plaque reevaluated approximately one year thereafter. The baseline clinical characteristics and laboratory parameters were documented and routine healthcare education was given at hospital. The participants were than divided into tele-nursing education group (n=397), who were offered tele-nursing education and guidance after discharge (once every three months), and control group (n=428). Results Tele-nursing education group had significantly lower ratio of coronary plaque progression than control group (P<0.05). Significant difference was also observed between the two group patients regarding self-management behavior, self-monitering of blood glucose level, self-monitering of blood pressure, and medication compliance (all P<0.05). Multivariate regression analysis revealed that tele-nursing education was independently associated with ameliorated coronary plaque progression in T2DM patients, while smoking, high blood pressure and glucose level were risk factor for the progression of coronary plaque. Conclusions Tele-nursing education and guidance exert positive effect on coronary plaque progression in T2DM patients.