CAJ | 학술논문

目的：探讨高校医院对教职工高血压患者开展家庭自测血压管理的干预效果。方法选取2013年7—12月于北京林业大学医院就诊的本校教职工高血压患者728例为调查对象。于2014年2月采用自行设计的调查问卷，调查患者基本信息和自测血压情况。共回收问卷681份，回收率93.5%，其中466例患者目前进行家庭自测血压。选择调查问卷填写完整、自测血压采用的血压计为经国际认证的上臂式电子血压计患者136例纳入本研究，2014年4—9月进行为期6个月的家庭自测血压管理干预。患者每周于门诊测量血压1次，于每日清晨起床服药前在家自测血压，根据血压是否达标调整测量频率和用药方案。结果136例患者完整随访126例，失访率7.4%。患者干预后门诊收缩压较干预前下降（2.1±1.4）mm Hg（t=3.070，P<0.05）；患者干预后门诊舒张压较干预前下降（0.7±0.2）mm Hg，差异无统计学意义（t=1.851，P>0.05）；患者干预后门诊血压达标率为86.5%，高于干预前的70.6%（χ2=9.428，P<0.05）。患者干预后清晨收缩压、舒张压分别较干预前下降（3.3±1.6）、（1.0±0.3）mm Hg（t=4.188、2.641，P<0.05）；患者干预后清晨血压达标率为93.7%，高于干预前的78.6%（χ2=11.978，P<0.05）。患者干预后遵医行为、服药行为依从性评分比较，差异无统计学意义（ t=-1.587、-0.846，P>0.05）；患者干预后日常生活管理、烟酒嗜好依从性评分及总评分高于干预前（ t=-4.675、-2.384、-4.599，P<0.05）。结论高校医院开展家庭自测血压管理，可有效降低教职工高血压患者收缩压，改善门诊及清晨血压达标率。
목적：탐토고교의원대교직공고혈압환자개전가정자측혈압관리적간예효과。방법선취2013년7—12월우북경임업대학의원취진적본교교직공고혈압환자728례위조사대상。우2014년2월채용자행설계적조사문권，조사환자기본신식화자측혈압정황。공회수문권681빈，회수솔93.5%，기중466례환자목전진행가정자측혈압。선택조사문권전사완정、자측혈압채용적혈압계위경국제인증적상비식전자혈압계환자136례납입본연구，2014년4—9월진행위기6개월적가정자측혈압관리간예。환자매주우문진측량혈압1차，우매일청신기상복약전재가자측혈압，근거혈압시부체표조정측량빈솔화용약방안。결과136례환자완정수방126례，실방솔7.4%。환자간예후문진수축압교간예전하강（2.1±1.4）mm Hg（t=3.070，P<0.05）；환자간예후문진서장압교간예전하강（0.7±0.2）mm Hg，차이무통계학의의（t=1.851，P>0.05）；환자간예후문진혈압체표솔위86.5%，고우간예전적70.6%（χ2=9.428，P<0.05）。환자간예후청신수축압、서장압분별교간예전하강（3.3±1.6）、（1.0±0.3）mm Hg（t=4.188、2.641，P<0.05）；환자간예후청신혈압체표솔위93.7%，고우간예전적78.6%（χ2=11.978，P<0.05）。환자간예후준의행위、복약행위의종성평분비교，차이무통계학의의（ t=-1.587、-0.846，P>0.05）；환자간예후일상생활관리、연주기호의종성평분급총평분고우간예전（ t=-4.675、-2.384、-4.599，P<0.05）。결론고교의원개전가정자측혈압관리，가유효강저교직공고혈압환자수축압，개선문진급청신혈압체표솔。
Objective To evaluate home blood pressure self-test managed by university hospitals in order to make intervention on hypertensive patients among teaching and administrative staff. Methods We enrolled 728 hypertensive patients among the teaching and administrative staff of Beijing Forestry University who received treatment in the university hospital from July 2013 to December 2013. On February 2014,self-design questionnaire survey was conducted to investigate the basic data and the status of home blood pressure self-test of the patients. A total of 681 questionnaires were returned,with a recovery rate of 93. 5%. Among them,466 patients had been doing home blood pressure self -test. At last,136 patients who had their questionnaires finished completely and used hemopiezometer with international certification were included in the study. From April to September 2014,a 6 - month intervention on home blood pressure self - test was conducted on the subjects. The subjects were asked to receive blood pressure test in the outpatient department once every week and conduct home blood pressure test every morning before taking medicine. Test frequency and drug use were adjusted according to whether blood pressure reached standard. Results Of 136 subjects,126 subjects finished the entire follow -up,with a loss rate of 7. 4%. After intervention,the outpatient systolic pressure of the subjects decreased by(2. 1 ±1. 4)mm Hg(t=3. 070,P<0. 05),and the outpatient diastolic pressure of the subjects decreased by(0. 7 ±0. 2)mm Hg(t=1. 851,P>0. 05);after intervention,the outpatient rate of reaching standard blood pressure was 86. 5%, higher than that before intervention which was 70. 6%(χ2 =9. 428,P<0. 05). After intervention,the morning systolic pressure and diastolic pressure decreased by(3. 3 ± 1. 6)and (1. 0 ±0. 3)mm Hg respectively(t=4. 188,2. 641;P<0. 05);the morning rate of reaching standard blood pressure was 93. 7%,higher than that before intervention which was 78. 6%(χ2 =11. 978,P <0. 05). After intervention,the subjects were not significantly different in the scores of treatment compliance and drug administration compliance ( t = - 1. 587,-0. 846;P > 0. 05 );the subjects had higher daily life management score, higher score of smoking and alcohol control compliance and higher general score than those before intervention ( t = - 4. 675, - 2. 384, - 4. 599;P < 0. 05 ). Conclusion Home blood pressure self - test managed by university hospitals can effectively lower the systolic and diastolic pressure of hypertensive patients among teaching and administrative staff and increase the rate of reaching standard blood pressure in the outpatient department and in the morning.