女性冠心病患者血压控制达标率的现状调查  

Status of blood pressure control among female outpatients with coronary heart disease in China

作　　者：朱芸[1] 王净[2] 李军[1] 李觉[1] 梁锦标 林猷恩[1] 

机构地区：[1]同济大学心肺血管中心,上海200092 [2]同济大学附属同济医院妇产科,上海200072 [3]江西省高安市人民医院心血管内科,江西高安330800

出　　处：《同济大学学报（医学版）》2011年第4期96-100,104,共6页Journal of Tongji University(Medical Science)

基　　金：中国医师协会循证医学专业委员会(20060626)

摘　　要：目的了解中国女性冠心病(coronary heart disease,CHD)患者血压达标现况。探讨影响女性CHD患者血压达标的相关危险因素。方法入选2006年6月至2007年1月,上海、北京、天津、广东、浙江和新疆等6个地区城市66家医院心内科门诊诊断为CHD的女性患者。将血压≤130/80 mmHg作为CHD患者血压达标目标值。结果女性CHD患者血压达标率为16.7%。血压非达标组总胆固醇≥5.7mmol/L及低密度脂蛋白胆固醇(LDL-C)>3.6mmol/L患者比例高于血压达标组(P<0.01)。二分类Logistic向前逐步回归分析显示,影响女性CHD患者血压达标的相关因素的OR值分别为:糖尿病家族史1.70(95%CI:1.02～2.82)、LDL-C>3.6 mmol/L者1.92(95%CI:1.34～2.76)、办公室工作者0.66(95%CI:0.48～0.90)。收缩压<110 mmHg和(或)舒张压<60 mmHg组急性心肌梗死史、冠脉造影显示≥2支冠脉病变及有介入手术史的患者比例均高于收缩压≥110 mmHg且舒张压≥60 mmHg组(P<0.05)。结论我国女性CHD患者的血压达标率较低,糖尿病家族史及LDL-C>3.6 mmol/L是影响女性CHD患者血压达标的危险因素。Objective To investigate status of blood pressure （BP） treatment-goal attainment among female outpatients with coronary heart disease （CHD） and to identify factors associated with the goal achievement. Methods In this cross-sectional study, female participants with CHD were recruited from 66 hospitals in Beijing, Shanghai, Tianjin, Guangdong, Zhejiang and Xinjiang in China. Using systolic blood pressure（SBP） 〈 130 mmHg and diastolic blood pressure（DBP） 〈 80 mmHg as BP goal attainment. Results The success rate for achieving BP goal among female CHD patients withhypertension was only 16.7%. The risk factors associated with achieving the BP goal for female CHD outpatients with hypertension were family history of diabetes（ OR： 1.70; 95% CI： 1.02 ～ 2.82）, LDL-C 〉 3.6 mmol/L （ OR： 1.92 ; 95% CI： 1.34 - 2.76 ）, and office work （ OR ： 0.66 ; 95% CI： 0.48 -0.90）. The prevalence of acute myocardial infarction, percutaneous coronary intervention and coronary angiography showing more than one team of coronary lesions were significantly higher among CHD outpatients with SBP 〈 110 mmHg and/or DBP 〈60 mmHg than those with SBP≥ll0 mmHg and DBP I〉60 mmHg （ P 〈 0.05 ）. Conclusion The BP control goal attainment is low among female CHD outpatients with hypertension. Family history of diabetes, LDL-C 〉 3.6 mmol/L and office work are significantly associated with achieving BP goal.

关 键 词：冠状动脉疾病 高血压 达标率 

分 类 号：R544[医药卫生—心血管疾病]