CAJ | 학술논문

目的：研究使用动态血压指导轻中度原发性高血压患者时辰服药治疗6个月的生存质量。方法将所有128例研究对象分为两组，时辰服药组和常规服药组，分别在调整用药前、治疗后6个月对患者进行动态血压监测，并发放S F‐36生存质量调查表和自制的一般情况和服药情况调查表，对患者生存质量予以评估，分析患者时辰服药治疗后生存质量的变化及影响因素。结果两组患者的动态血压参数均明显改善，与常规服药组比较，时辰服药组在夜间平均收缩压（nSBP ）、夜间平均舒张压（nD‐BP）、夜间平均动脉压（nMAP）、高危时段的平均舒张压（DDBP）、平均收缩压（DSBP）、平均动脉压（DMAP）、夜间血压下降率（NBPDR）方面差异有统计学意义（P＜0．05或 P＜0．01）。降压治疗6个月后，两组在情感职能、精神健康、生理机能、生理职能方面差异有统计学意义（P＜0．05或 P＜0．01）。多元回归分析显示高血压患者生存质量的影响因素包括年龄、BMI、服药时间、家庭人均月收入、医保类型、文化程度、职称。其中，高龄、BM I高、服药时间延长会降低生存质量，而家庭人均月收入高、文化程度高、参加保障更高的医保、职称高则会改善生存质量。结论对轻中度高血压患者，时辰服药治疗比常规服药治疗能更加显著改善患者动态血压参数、生存质量。改善患者经济状况、BM I ，医疗有保障，文化程度高有助于提高患者生存质量。
목적：연구사용동태혈압지도경중도원발성고혈압환자시신복약치료6개월적생존질량。방법장소유128례연구대상분위량조，시신복약조화상규복약조，분별재조정용약전、치료후6개월대환자진행동태혈압감측，병발방S F‐36생존질량조사표화자제적일반정황화복약정황조사표，대환자생존질량여이평고，분석환자시신복약치료후생존질량적변화급영향인소。결과량조환자적동태혈압삼수균명현개선，여상규복약조비교，시신복약조재야간평균수축압（nSBP ）、야간평균서장압（nD‐BP）、야간평균동맥압（nMAP）、고위시단적평균서장압（DDBP）、평균수축압（DSBP）、평균동맥압（DMAP）、야간혈압하강솔（NBPDR）방면차이유통계학의의（P＜0．05혹 P＜0．01）。강압치료6개월후，량조재정감직능、정신건강、생리궤능、생리직능방면차이유통계학의의（P＜0．05혹 P＜0．01）。다원회귀분석현시고혈압환자생존질량적영향인소포괄년령、BMI、복약시간、가정인균월수입、의보류형、문화정도、직칭。기중，고령、BM I고、복약시간연장회강저생존질량，이가정인균월수입고、문화정도고、삼가보장경고적의보、직칭고칙회개선생존질량。결론대경중도고혈압환자，시신복약치료비상규복약치료능경가현저개선환자동태혈압삼수、생존질량。개선환자경제상황、BM I ，의료유보장，문화정도고유조우제고환자생존질량。
Objective To study the quality of life(QOL) of patients with mild to moderate primary hypertension after treatment adjusted medication time by ambulatory blood pressure .Methods All 128 cases were divided into two groups randomly including chronos medication group and normal medication group .We tested ambulatory blood pressure ,QOL and influencing factors before medication and 6 months later .Results It′s observed the parameters of the ambulatory blood pressure improved significantly in all of the groups .There existed significant difference in nSBP ,nDBP ,nMAP ,SBP in dangerous night time ,and nocturnal blood pres‐sure decline rate between two groups (P<0 .05) .There existed very significant difference in DBP and MAP in dangerous night time (P<0 .01) .There were significant difference in the fields of MH (mental health) and RE (role limitation because of emotional health problem) (P<0 .05) ,and very significant difference in the fields of PF (physical functioning) ,RP (role limitation because of physical health) ,VT(vitality) (P<0 .01) .Multiple regression analysis indicate the influencing factors of the quality of life about patients with hypertension are age ,BMI index number ,medication time ,average family income ,medical insurance type ,culture de‐gree and job title .Age ,BMI index number and medication time depress QOL of patient with hypertension while average family in‐come ,better medical insurance type ,culture degree and job title improve it .Conclusion It′s possible to improved the parameters of the ambulatory blood pressure for patients with mild to moderate primary hypertension by chronos medication compared with nor‐mal medication more significantly .It′s useful to improve the QOL of patient with hypertension by improving average family income , medical insurance type and culture degree .