目的 探讨综合干预、定期随访对健康体检中诊断为原发性高血压患者的高血压知晓率、治疗率、控制率及其并发症发生率的影响.方法 选择2007年1月至2009年1月在健康体检中心体检时确诊为原发性高血压的患者1 183例,按照分层随机分组法分为干预组587例和对照组596例.对照组在入组后进行1次健康教育,之后由患者自行管理,对治疗和行为不做要求,每年进行1次随访.干预组给予定期随访及综合性治疗干预措施(包括药物和非药物),按评估→计划→实施→评价4个基本步骤循环进行,定期跟踪随访3年.结果 综合干预3年后,干预组高血压治疗率和控制率(分别为89.8％,69.5％)明显高于对照组(分别为36.4％,22.1％),组间差异有统计学意义(x2值分别为360.92,267.34；P均＜0.01)；干预组饮食控制、参加体育活动、限酒和戒烟者的比率(分别为68.5％,71.9％,88.9％,87.4％)均高于对照组(分别为37.2％,58.2％,49.3％,66.9％),组间差异有统计学意义(x2值分别为117.94,30.62,220.62,71.18;P均＜0.01)；干预组胆固醇、甘油三酯、血糖、血清肌酐和BMI值[分别为(4.3 ±0.7) mmol/L,(1.52±0.5)mmol/L,(5.3±0.8)mmol/L,(93.2±12.5) μmol/L,(23.7±4.4) kg/m2]均低于对照组[分别为(4.9±0.4)mmol/L,(1.76±0.6)mmol/L,(5.7±0.7)mmol/L,(99.5±15.8) μmol/L,(26.6 ±4.8)kg/m2],组间差异有统计学意义(t值分别为18.134,7.468,9.156,7.598,10.828；P均＜0.05).结论 实施个性化药物及非药物综合干预措施,可以降低各种危险因素,提高原发性高血压患者对保健知识的认知度,纠正不良行为方式和生活习惯,减轻心理压力和紧张情绪,提高患者的药物依从性,从而提高对高血压的知晓率、治疗率和控制率,有效地控制并延缓并发症的发生.
目的 探討綜閤榦預、定期隨訪對健康體檢中診斷為原髮性高血壓患者的高血壓知曉率、治療率、控製率及其併髮癥髮生率的影響.方法 選擇2007年1月至2009年1月在健康體檢中心體檢時確診為原髮性高血壓的患者1 183例,按照分層隨機分組法分為榦預組587例和對照組596例.對照組在入組後進行1次健康教育,之後由患者自行管理,對治療和行為不做要求,每年進行1次隨訪.榦預組給予定期隨訪及綜閤性治療榦預措施(包括藥物和非藥物),按評估→計劃→實施→評價4箇基本步驟循環進行,定期跟蹤隨訪3年.結果 綜閤榦預3年後,榦預組高血壓治療率和控製率(分彆為89.8％,69.5％)明顯高于對照組(分彆為36.4％,22.1％),組間差異有統計學意義(x2值分彆為360.92,267.34；P均＜0.01)；榦預組飲食控製、參加體育活動、限酒和戒煙者的比率(分彆為68.5％,71.9％,88.9％,87.4％)均高于對照組(分彆為37.2％,58.2％,49.3％,66.9％),組間差異有統計學意義(x2值分彆為117.94,30.62,220.62,71.18;P均＜0.01)；榦預組膽固醇、甘油三酯、血糖、血清肌酐和BMI值[分彆為(4.3 ±0.7) mmol/L,(1.52±0.5)mmol/L,(5.3±0.8)mmol/L,(93.2±12.5) μmol/L,(23.7±4.4) kg/m2]均低于對照組[分彆為(4.9±0.4)mmol/L,(1.76±0.6)mmol/L,(5.7±0.7)mmol/L,(99.5±15.8) μmol/L,(26.6 ±4.8)kg/m2],組間差異有統計學意義(t值分彆為18.134,7.468,9.156,7.598,10.828；P均＜0.05).結論 實施箇性化藥物及非藥物綜閤榦預措施,可以降低各種危險因素,提高原髮性高血壓患者對保健知識的認知度,糾正不良行為方式和生活習慣,減輕心理壓力和緊張情緒,提高患者的藥物依從性,從而提高對高血壓的知曉率、治療率和控製率,有效地控製併延緩併髮癥的髮生.
목적 탐토종합간예、정기수방대건강체검중진단위원발성고혈압환자적고혈압지효솔、치료솔、공제솔급기병발증발생솔적영향.방법 선택2007년1월지2009년1월재건강체검중심체검시학진위원발성고혈압적환자1 183례,안조분층수궤분조법분위간예조587례화대조조596례.대조조재입조후진행1차건강교육,지후유환자자행관리,대치료화행위불주요구,매년진행1차수방.간예조급여정기수방급종합성치료간예조시(포괄약물화비약물),안평고→계화→실시→평개4개기본보취순배진행,정기근종수방3년.결과 종합간예3년후,간예조고혈압치료솔화공제솔(분별위89.8％,69.5％)명현고우대조조(분별위36.4％,22.1％),조간차이유통계학의의(x2치분별위360.92,267.34；P균＜0.01)；간예조음식공제、삼가체육활동、한주화계연자적비솔(분별위68.5％,71.9％,88.9％,87.4％)균고우대조조(분별위37.2％,58.2％,49.3％,66.9％),조간차이유통계학의의(x2치분별위117.94,30.62,220.62,71.18;P균＜0.01)；간예조담고순、감유삼지、혈당、혈청기항화BMI치[분별위(4.3 ±0.7) mmol/L,(1.52±0.5)mmol/L,(5.3±0.8)mmol/L,(93.2±12.5) μmol/L,(23.7±4.4) kg/m2]균저우대조조[분별위(4.9±0.4)mmol/L,(1.76±0.6)mmol/L,(5.7±0.7)mmol/L,(99.5±15.8) μmol/L,(26.6 ±4.8)kg/m2],조간차이유통계학의의(t치분별위18.134,7.468,9.156,7.598,10.828；P균＜0.05).결론 실시개성화약물급비약물종합간예조시,가이강저각충위험인소,제고원발성고혈압환자대보건지식적인지도,규정불량행위방식화생활습관,감경심리압력화긴장정서,제고환자적약물의종성,종이제고대고혈압적지효솔、치료솔화공제솔,유효지공제병연완병발증적발생.
Objective To explore the influence of comprehensive intervention and regular follow-up on hypertension awareness,treatment rate,control rate and its complications incidence rate of the patients who were diagnosed as primary hypertension in physical examination.Methods Selected 1 183 cases that were diagnosed as primary hypertension in our health examination center from January 2007 to January 2009,which were divided into the intervention group (n =587) and the control group (n =596) randomly.The control group was given a health education at the first,then the patients managed themselves,their treatment and behavior were not required,and we followed them annual.The intervention group was given regular follow-up and comprehensive treatment intervention (including drug and non-drug),we followed the four basic steps that assessment→plan→implementation→ evaluation in circulation,and regular followed-up for 3 years.Results After 3 years,hypertension treatment rate and control rate in the intervention group (89.8％,69.5％) was higher than that in the control group (36.4％,22.1％),and the difference was statistically significant (x2 =360.92,267.34,respectively; P ＜ 0.01).The ratio of diet control,participate in sports activities,wine limited and smoking cessation in the intervention group (68.5％,71.9％,88.9％,87.4％) were higher than those in the control group (37.2％,58.2％,49.3％,66.9％),and the differences between the two groups were statistically significant (x2 =117.94,30.62,220.62,71.18,respectively; P ＜ 0.01).The values of cholesterol,triglycerides,blood glucose,serum creatinine,and BMI in the intervention group [(4.3 ±0.7) mmol/L,(1.52 ±0.5)mmol/L,(5.3 ±0.8)mmol/L,(93.2 ± 12.5)mol/L,(23.7 ±4.4)kg/m2] were lower than those in the control group [(4.9 ± 0.4) mmol/L,(1.76 ± 0.6) mmol/L,(5.7 ± 0.7) mmol/L,(99.5 ± 15.8) mol/L,(26.6 ± 4.8) kg/m2],and the differences were statistically significant (t =18.134,7.468,9.156,7.598,10.828,respectively; P ＜ 0.05).Conclusions The implementation of personalized drug and non-drug intervention can reduce a variety of risk factors,improve the awareness of health care knowledge in hypertension patient,correct bad behavior and habits,reduce the psychological stress and tension,improve patient medication compliance,so as to improve the rates of hypertension awareness,treatment and control,and control and delay the complications effectively.
