社区高血压管理模式对高血压病患者并发脑卒中的影响  

Impact of Community Hypertension Management on the Incidence and Recurrence of Stroke in Hypertensive Patients

作　　者：沈菲[1] 吴学智[2] 白元[3] 李长舜 韩一平[5] 

机构地区：[1]第二军医大学附属长海医院全科,上海市200433 [2]昆明医学院公共卫生学院 [3]第二军医大学附属长海医院心血管内科 [4]上海市长宁区新泾镇社区卫生服务中心 [5]第二军医大学附属长海医院呼吸内科

出　　处：《中国全科医学》2011年第34期3956-3958,共3页Chinese General Practice

摘　　要：目的探讨社区高血压管理模式对高血压病患者并发脑卒中的影响。方法选取自2005年1月起上海市某社区高血压病病史≥10年的患者共200例,分为普通模干预组和纳入模式组,各100例,研究两组患者在2005年1月—2010年12月发生脑卒中的概率、血压控制情况及服药情况。结果纳入模式组社区高血压管理的患者脑卒中发病率为11%,复发率18.2%,普通干预组发病率为26%,复发率30.8%。两组患者脑卒中发病率间差异有统计学意义(χ2=7.461,P<0.05);但复发率间差异无统计学意义(P=0.688)。纳入模式组血压控制率在140/90 mm Hg以下的为43%,普通干预组22%,两组患者血压控制情况间差异有统计学意义(χ2=11.740,P<0.05)。纳入模式组随访结束后服用1种降压药物的比例为36%,2种为47%,≥3种为17%,普通干预组分别为58%、36%、6%,两组患者服药种类间差异有统计学意义(χ2=12.035,P<0.05)。结论社区高血压管理模式对高血压病患者的健康管理尤为重要,不仅可以有效控制血压、规范高血压病患者服药情况,还减少了脑卒中的发病率,提高了居民的整体生活质量。Objective To explore the impact of community hypertension management on the incidence and recurrence of stroke in hypertensive patients. Methods A total of 200 hypertensive participants with disease courses of more than ten years in Shanghai were enrolled since jan.2005,divided into ordinary intervention group and into the model group,each 100 cases.Incidence and recurrence of stroke,blood pressure control rates and the types of drugs used between Jan.2005 and Dec.2010 were studied in both groups. Results The incidence rate and recurrence rate of stroke were 11% and 18.2% in the model group and were 26% and 30.8% in the ordinary intervention group,with significant differences in the incidence rates between the two groups（χ2=7.461,P〈0.05） but no significant differences in recurrence rates（P=0.688）.Adequate control rates（with blood pressure below 140/90 mm Hg） was 43% in the management group and 22% in the control group（χ2=11.740,P〈0.05）.Rates of antihypertensive drug usage were 36%,47%,and 17% for one kind,two kinds and more than three kinds respectively in the management group and were 58%,36%,and 6% in the control group（χ2=12.035,P〈0.05）. Conclusion The findings indicate that community hypertension management is particularly important in the management of community health care for hypertensive patients.They help the patients to effectively control blood pressure,as well as standardize the usage of antihypertensive medications.The community management reduces the incidence of stroke and improves the overall quality of life for the residents.

关 键 词：高血压病 脑卒中 慢病管理 全科医生 

分 类 号：R544.1[医药卫生—心血管疾病]