CAJ | 학술논문

目的探讨社区高血压患者不同就诊方式对血压控制情况的影响.方法采用整群抽样方法,对浦东某社区两个居委≥35岁患有高血压且最近6个月连续服用高血压药物的患者使用自行设计的问卷进行调查.根据高血压患者的就诊情况将调查对象分为社区就诊组和非社区就诊组两组.比较两组最近6个月以来服用高血压药物的种类、服药依从性、高血压危险因素知晓率以及高血压控制率等方面的差异.结果两个居委年龄≥35周岁的登记居民为5 166人,4 763人接受了调查,应答率92.2％.高血压患病率为23.2％(1 105/4 763).服药治疗超过6个月的1 012例患者中社区就诊组为878例(86.8％),非社区就诊组为134例(13.2％).社区就诊组和非社区就诊组患者在性别、年龄、文化程度、工作状态的分布上差异无统计学意义(P＞0.05).社区就诊≥10年以上高血压病史者占44.3％ (389/878),非社区就诊组占56.7％ (76/134),P=0.011;社区就诊组危险分层为高危者占28.6％(251/878),非社区就诊组危险分层为高危者占47.8％(64/134),P＜0.001,差异均有统计学意义.两组对高血压危险因素的知晓率分别为83.9％、95.5％,P＜0.001,差异有统计学意义.两组服药依从性、血压控制率分别为93.2％比84.3％ (P ＜0.001)、68.6％比51.5％(P＜0.001),差异有统计学意义.结论社区高血压患者绝大部分在社区医院就诊;社区就诊的高血压患者的服药依从性、血压控制率优于不在社区就诊者.
목적 탐토사구고혈압환자불동취진방식대혈압공제정황적영향.방법 채용정군추양방법,대포동모사구량개거위≥35세환유고혈압차최근6개월련속복용고혈압약물적환자사용자행설계적문권진행조사.근거고혈압환자적취진정황장조사대상분위사구취진조화비사구취진조량조.비교량조최근6개월이래복용고혈압약물적충류、복약의종성、고혈압위험인소지효솔이급고혈압공제솔등방면적차이.결과 량개거위년령≥35주세적등기거민위5 166인,4 763인접수료조사,응답솔92.2％.고혈압환병솔위23.2％(1 105/4 763).복약치료초과6개월적1 012례환자중사구취진조위878례(86.8％),비사구취진조위134례(13.2％).사구취진조화비사구취진조환자재성별、년령、문화정도、공작상태적분포상차이무통계학의의(P＞0.05).사구취진≥10년이상고혈압병사자점44.3％ (389/878),비사구취진조점56.7％ (76/134),P=0.011;사구취진조위험분층위고위자점28.6％(251/878),비사구취진조위험분층위고위자점47.8％(64/134),P＜0.001,차이균유통계학의의.량조대고혈압위험인소적지효솔분별위83.9％、95.5％,P＜0.001,차이유통계학의의.량조복약의종성、혈압공제솔분별위93.2％비84.3％ (P ＜0.001)、68.6％비51.5％(P＜0.001),차이유통계학의의.결론 사구고혈압환자절대부분재사구의원취진;사구취진적고혈압환자적복약의종성、혈압공제솔우우불재사구취진자.
Objective To compare blood pressure control in community hypertensive patients with different management methods.Methods Two neighborhood committees in a community of Pudong were selected as study area using cluster sampling method.A total of 5 166 residents aged ≥35 y were screened for blood pressure; the subjects with high blood pressure and had antihypertensive medication in last 6 months were included,and patients with secondary hypertension was excluded.The patients who entered community hypertension management program and got medication from community were included in community group; those who did not enter in community management program and/or not get medication from community were included in non-community group.Self-designed questionnaire was used for investigation.The medication compliance,awareness of hypertension risk factors and high blood pressure control were compared between two groups.Results Among 5 166 residents 4 763 were surveyed for hypertension with a response rate of 92.2％ and hypertension prevalence rate of 23.2％ (1 105/4 763).Among 1 012 patients with drug treatment for more than 6 months,there were 878 cases in community (86.8％) and 134 cases (13.2％) in non-community group.There were no significant differences in gender,age,education,working condition between community group and non-community group (P ＞ 0.05).44.3％ (389/878) patients in community group had a history of high blood pressure ＞ 10 y and that was 56.7％ (76/134) in non-community group (P =0.011) ; 28.6％ (251/878) patients in community group were at high risk for risk stratification and that in non-community group was 47.8％ (64/134) (P ＜0.001).The awareness of hypertension risk factors in community group and non-community group was 83.9％ and 95.5％,respectively (P ＜ 0.001).The medication compliance and blood pressure control rates in two groups were 93.2 ％ and 84.3 ％ (P ＜ 0.001),68.6％ and 51.5 ％,respectively (P ＜ 0.001).Conclusion The outcomes of hypertension management in terms of medication compliance and blood pressure control in community group are better than those in non-community group.