目的 了解社区规范化管理后高血压患者血压控制状况及其影响因素。方法 选取2015年1月至2017年12月在合肥市蜀山区琥珀街道社区卫生服务中心及其各卫生服务站建立高血压专项档案的患者共1 741例,进行随访管理,分析影响血压控制的因素。结果 1 741例高血压患者,管理前收缩压为(144.3±16.8) mmHg,舒张压为(85.6±10.2) mmHg,管理后收缩压和舒张压分别为(136.6±16.4) mmHg、(81.3±11.3) mmHg,差异均有统计学意义(P＜0.05)。单因素分析结果显示规范用药、高血压家族史、合并心血管病史、饮食偏咸、体育锻炼和干预时间是血压控制的影响因素(P＜0.05)。多因素logistic分析,规范用药(OR=0.781,95%CI:0.665~0.915)是保护因素、有高血压家族史(OR=1.345,95%CI:1.030~1.757)、饮食偏咸(OR=1.116,95%CI:1.107~1.126)和干预时间短(OR=0.754,95%CI:0.636~0.893)不利于血压控制。结论 社区规范化管理有助于高血压患者的血压控制,社区医生可结合血压控制的影响因素对高血压患者进行综合干预。
Abstract
Objective To explore the situation of blood pressure control and the impacts of the programs among those hypertensive patients. Methods From January 2015 to December 2017,1 741 patients who had established hypertension special files in Hupo street community health service center and its health service stations in Shushan District of Hefei city were selected for follow-up management,and the factors influencing blood pressure control were analyzed. Results Compared with the blood pressure before standardized management,there was a significant drop of blood pressure after community-based standardization management.Single factor analysis showed that standardized medication,history of hypertension,history of cardiovascular disease,salty diet and intervention time were influence factors of hypertension control.By logistic regression analysis,result showed that hypertension control rate was related with standardized medication (OR=0.781,95%CI=0.665-0.915),history of hypertension (OR=1.345,95%CI=1.030-1.757),salty diet (OR=1.116,95%CI=1.107-1.126) and intervention time(OR=0.754,95%CI=0.636-0.893). Conclusion Community standardized management is helpful for blood pressure control of patients with hypertension.Community doctors can carry out comprehensive intervention on hypertension patients combined with influencing factors of blood pressure control.
关键词
原发性高血压 /
社区规范管理 /
影响因素 /
基本公共卫生服务 /
慢性病管理
Key words
Hypertension /
Community normalization management /
Influence factors /
Basic public health services /
Chronic disease management
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参考文献
[1] Lu J,Lu Y,Wang X.et al.Prevalence,awareness,treatment,and control of hypertension in China:data from 1.7 million adultsin a population-based screening study(China PEACE Million Persons Project)[J].Lancet,2017,390(10112):2549-2558.
[2] 郎俊杰,金来润,刘凌,等.中国大学生高血压患病率的Meta分析[J].中国学校卫生,2018,39(8):1220-1223.
[3] World Health Organization.Community-based efforts to reduce blood pressure and stroke in Japan[EB/OL].https://www.who.int/features/2013/japan_blood_pressure/en/.
[4] 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[5] 李立明.中国原发性高血压社会防治的进展[J].中华流行病学杂志,2000,21(4):298-299.
[6] Campbell NR,Sheldon T.The Canadian effort to prevent and control hypertension: can other countries adopt Canadian strategies?[J].CurrOpinCardiol,2010,25(4):366-372.
[7] 李芳健,王增武,王家骥,等.广州市高血压社区规范化管理患者血压控制状况及影响因素分析[J].中华疾病控制杂志,2015,19(3):222-225.
[8] 曾权威,官映清,吴仲军,等.深圳社区规范化管理对高血压患者血压控制效果及其影响因素分析[J].慢性病学杂志,2017,18(5):499-502.
[9] 钱岳晟,张怡,张瑾,等.上海市普陀区高血压社区规范管理的模式和效果探讨[J].中华高血压杂志,2012,20(1):26-30.
[10] 马福元,韩志成.社区规范管理对老年原发性高血压合并2型糖尿病患者血压及血糖的影响[J].中国社区医师,2012,14(29):121.
[11] 张芹,穆柯瀚,陈思红,等.高血压社区规范化管理5年及以上患者血压控制及心血管事件发生情况分析.现代预防医学,2016,43(6):1033-1036.
[12] 蔡婷,黄晓玲,曾雁冰,等.中国居民高血压的危险因素Meta分析[J].现代预防医学,2015,42(5):831-836.
[13] Jones LM,Veinot T,Pressler SJ,et al.Exploring predictors of information use to self-manage blood pressure in Midwestern African American women with hypertension[J].J Immigr Minor Health,2018,20(3): 569-576.
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