中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
2期
135-138
,共4页
孙兆青%郑黎强%张大义%张新忠%张心刚%刘双双%许长禄%李觉%胡大一%孙英贤
孫兆青%鄭黎彊%張大義%張新忠%張心剛%劉雙雙%許長祿%李覺%鬍大一%孫英賢
손조청%정려강%장대의%장신충%장심강%류쌍쌍%허장록%리각%호대일%손영현
高血压%氢氯噻嗪%尼群地平%农村人口
高血壓%氫氯噻嗪%尼群地平%農村人口
고혈압%경록새진%니군지평%농촌인구
Hypertension%Hydrochlorothiazide%Nitrendipine%Rural population
目的 评价小剂量氢氯噻嗪联合尼群地平治疗农村地区高血压的疗效.方法 2006年6月,按整群随机抽样方法,在辽宁省阜新县选取原发高血压患者5292例,分为健康教育组(对照组)及药物干预组(干预组);干预组以阶梯式加药方式给予氢氯噻嗪、尼群地平及卡托普利,观察药物的降压效果及对脑卒中发病的影响.结果 5292例高血压患者平均随访15个月.至随访结束共有308例失访(失访率为5.8%).进入队列的4984例完成各种指标检测,其中干预组2530例,对照组2454例.经过健康教育及药物干预后,干预组平均血压下降16.1/9.4 mm Hg(1 mm Hg=0.133kPa),对照组平均血压下降6.7/3.5 mmHg.干预组的血压控制率高于对照组(33.1%比15.1%,P＜0.001).药物干预后,干预组比对照组非致死性脑卒中发病风险减少57.3%,总脑卒中发病风险减少59.4%.差异有统计学意义(P＜0.05).至随访结束,两组人群的严重低血钾发生率及新发糖尿病发生率差异无统计学意义.结论 以噻嗪利尿剂为基础的低成本降压方案,降压效果好,安全性高,显示良好的价效比,适合在中国农村地区推广.
目的 評價小劑量氫氯噻嗪聯閤尼群地平治療農村地區高血壓的療效.方法 2006年6月,按整群隨機抽樣方法,在遼寧省阜新縣選取原髮高血壓患者5292例,分為健康教育組(對照組)及藥物榦預組(榦預組);榦預組以階梯式加藥方式給予氫氯噻嗪、尼群地平及卡託普利,觀察藥物的降壓效果及對腦卒中髮病的影響.結果 5292例高血壓患者平均隨訪15箇月.至隨訪結束共有308例失訪(失訪率為5.8%).進入隊列的4984例完成各種指標檢測,其中榦預組2530例,對照組2454例.經過健康教育及藥物榦預後,榦預組平均血壓下降16.1/9.4 mm Hg(1 mm Hg=0.133kPa),對照組平均血壓下降6.7/3.5 mmHg.榦預組的血壓控製率高于對照組(33.1%比15.1%,P＜0.001).藥物榦預後,榦預組比對照組非緻死性腦卒中髮病風險減少57.3%,總腦卒中髮病風險減少59.4%.差異有統計學意義(P＜0.05).至隨訪結束,兩組人群的嚴重低血鉀髮生率及新髮糖尿病髮生率差異無統計學意義.結論 以噻嗪利尿劑為基礎的低成本降壓方案,降壓效果好,安全性高,顯示良好的價效比,適閤在中國農村地區推廣.
목적 평개소제량경록새진연합니군지평치료농촌지구고혈압적료효.방법 2006년6월,안정군수궤추양방법,재요녕성부신현선취원발고혈압환자5292례,분위건강교육조(대조조)급약물간예조(간예조);간예조이계제식가약방식급여경록새진、니군지평급잡탁보리,관찰약물적강압효과급대뇌졸중발병적영향.결과 5292례고혈압환자평균수방15개월.지수방결속공유308례실방(실방솔위5.8%).진입대렬적4984례완성각충지표검측,기중간예조2530례,대조조2454례.경과건강교육급약물간예후,간예조평균혈압하강16.1/9.4 mm Hg(1 mm Hg=0.133kPa),대조조평균혈압하강6.7/3.5 mmHg.간예조적혈압공제솔고우대조조(33.1%비15.1%,P＜0.001).약물간예후,간예조비대조조비치사성뇌졸중발병풍험감소57.3%,총뇌졸중발병풍험감소59.4%.차이유통계학의의(P＜0.05).지수방결속,량조인군적엄중저혈갑발생솔급신발당뇨병발생솔차이무통계학의의.결론 이새진이뇨제위기출적저성본강압방안,강압효과호,안전성고,현시량호적개효비,괄합재중국농촌지구추엄.
Objective To evaluate the therapeutic effects of combination administration of hydrochlorothiazide and nitrendipine at low dosage in the treatment of rural hypertension patients.Methods By the method of cluster random sampling,5292 primary hypertension patients from Fuxin,Liaoning Province were divided into health education group(control group)and drug intervention group in June 2006.The drug intervention group were treated with hydrochlorothiazide,nitrendipine and captopril by stepwise approach and we observe the antihypertensive effect of drug and the effect on the onset of stroke.Results The average follow-up time was 15 months.At last,308 patients were lost to follow-up(the lost follow-up rate was 5.8 percent).The 4984 in cohort,including 2530 of intervention group and 2454 of control group,had examination of all indicators.Through health education and drug intervention,the average blood pressure in drug intervention group decreased by 16.1/9.4 mm Hg(1 mm Hg=0.133 kPa)while the average blood pressure in control group decreased by 6.7/3.5 mm Hg.The control rate of blood pressure in drug intervention group was higher than control group(33.1%vs.15.1%,P＜0.001).Through drug intervention,the morbidity risk of nonfatal stroke in drug intervention group decreased by 57.3%compared to control group,the total morbidity risk of stroke decreased by 59.4%.The results had significant statistical difference.And,the morbidity of severe hypopotassaemia(K~+＜3.0 mmol/L)and diabetes mellitus had no significant statistical diffefence between two groups.Conclusions The low-cost antihypertensive program based on thiazide had good antihypertensive effect,high safety and good cost-effect ratio.The program could be used in rural areas of China.
