强化干预对社区高血压伴代谢综合征人群心脑血管事件影响  

Influence of strengthen intervention to hypertension with metabolic syndrome in community population

作　　者：陈志强 黄慧[2] 杨泽[3] 胡才友[2] 吕泽平[2] 吕渊[2] 余其美[4] 朱其秀[4] 刘红[5] 李绍刚[6] 

机构地区：[1]广西桂林市第二人民医院,广西桂林541001 [2]广西壮族自治区江滨医院,广西南宁541001 [3]卫生部老年医学研究所,北京100730 [4]广西大学医院,广西南宁530000 [5]广西医科大学第一附属医院,广西南宁530000 [6]广西财经学院医院,广西南宁530000

出　　处：《吉林医学》2010年第22期3672-3675,共4页Jilin Medical Journal

基　　金：广西科技攻关项目(桂科攻0472002-19);中央保健专项资金科研课题(0627160)

摘　　要：目的:了解药物综合干预对社区高血压伴代谢综合征人群心脑血管事件的影响。方法:采用随机整群抽样南宁市两个社区的1215人为研究对象,随机分成强化干预组和对照组。强化干预组按照是否患有高血压及其相关疾病分别采取不同的强化治疗方案进行干预;对照组人员维持志愿就诊和志愿服药的正常医疗状态,随访43.5个月,记录发生心脑血管事件情况。结果:前瞻性随访研究43.5个月后结果,①两组高血压和MS患者收缩压和舒张压较干预前明显降低(P<0.01);其中干预组较对照组下降更明显(P<0.01或0.05);②高血压伴MS患者收缩压和舒张压分别降低了14.11、7.59mmHg和6.59、5.57mmHg,除对照组收缩压外,均较干预前明显降低(P<0.01)。③本组心脑血管事件发生率为4.0%,高血压明显高于非高血压者(P<0.01),其中对照组无论高血压或非高血压者均明显高于干预组(P<0.01或<0.05)。④高血压伴MS者事件发生率为4.2%,高于非高血压和非MS者,低于高血压组或MS组,但均无显著性差异(P>0.05)。结论:综合强化干预可明显降低社区高血压、高血压伴代谢综合征人群血压水平,降低心脑血管事件发病风险。Objective To understand the impact of comprehensive drug intervention on happen of cardiovascular and cerebrovascular events in patients with hypertension with metabolic syndrome （MS） .Method We used a random cluster sampling of nanning city in line with the two communities included in the standard 1 215 as an integrated intervention in the treatment of subjects,which were randomly divided into strengthening intervention group and the control group.Strengthening intervention group received the different strengthening intervention according to whether the patients suffered from hypertension or not and its related diseases;in the control group,remained voluntary medical staff.The follow-up time was 43.5 months and the cardiovascular and cerebrovascular events were recorded.Results After 43.5 months of forward-looking follow-up study,①Systolic and diastolic blood pressure were significantly lower than that of before intervention in the patients with hypertension with MS in two groups（P〈0.01） ;one intervention group than in the control group decreased more significantly （P〈0.01 or 0.05） ;②The systolic and diastolic blood pressure reduced 14.11,7.59 mm Hg and 6.59,5.57 mm Hg in patients with hypertension with MS,all significantly lower than before intervention（P〈0.01） ,except the control group;③The cardiovascular and cerebrovascular event incidence in this group was 4.0% ,and that of hypertension patients were significantly higher than non-hypertensive （P〈0.01） ,and in the control group,whether with hypertension or not,the cardiovascular and cerebrovascular event incidence were significantly higher than the intervention group（P〈0.01 or P〈0.05） ;④The incidence of hypertension with MS were 4.2% ,higher than the non-hypertensive and non-MS patients,and lower than the hypertension or the MS group,but had no significant difference（P〉0.05） .Conclusion Comprehensive strengthen intervention can significantly lower the blood pressure levels of community hypertension and hyperte

关 键 词：高血压 代谢综合征 社区人群 心血管事件风险 随访 

分 类 号：R544.1[医药卫生—心血管疾病]