盐敏感人群筛查对社区高血压管理的影响研究  

Screening Salt-sensitive Population and Its Impacts on Community Hypertension Management

作　　者：查滨 胡秋玲 曲涛 

机构地区：[1]哈尔滨二四二医院友协社区卫生服务中心,黑龙江省哈尔滨市150066 [2]哈尔滨二四二医院心内科,黑龙江省哈尔滨市150066 [3]哈尔滨二四二医院建安社区卫生服务站,黑龙江省哈尔滨市150066

出　　处：《中国全科医学》2014年第17期2011-2014,共4页Chinese General Practice

摘　　要：目的探讨盐敏感人群筛查对社区高血压管理的影响。方法选择2012年3月在友协社区卫生服务中心参加慢性高血压管理的原发性高血压病患者989例作为观察组,同时选择2012年3月在建安社区卫生服务中心参加慢性高血压管理的原发性高血压病患者914例作为对照组。观察组进行盐负荷试验,并对其中筛查出的盐敏感人群采取个体化治疗方案,对照组未行盐负荷试验;两组均按照社区要求进行常规随访及健康指导。测量两组患者研究前及研究3、6个月后的平均动脉压(MABP)及研究6个月时主要心脑血管疾病的发生率(包括脑梗死、短暂脑缺血发作、冠心病、心绞痛急性发作、急性心肌梗死及心脑血管疾病死亡事件)。结果观察组筛查出盐敏感患者614例,占62.1%。两组研究前后MABP比较,差异均有统计学意义(P<0.05)。组间比较,两组研究前MABP比较,差异无统计学意义(P>0.05);观察组研究3、6个月后的MABP均低于对照组(P<0.05)。组内比较,两组研究3、6个月后的MABP均低于研究前,且两组研究6个月后的MABP低于研究3个月后﹙P<0.05﹚。对照组主要心脑血管疾病的发生率为19.1%(175/914),高于观察组的9.6%(95/989),差异有统计学意义(χ2=25.7,P<0.05)。其中观察组脑梗死和短暂性脑缺血发作发生率低于对照组(P<0.05)。结论进行盐敏感人群筛查,并给予个体化治疗可以改善社区高血压管理患者的血压水平,同时降低心脑血管疾病发生率,为社区高血压管理提供了有益的参考价值。Objective To explore the effects of salt-sensitive population screening on community hypertension management.Methods March 2012 a total of 989 essential hypertension（EH） patients participating chronic hypertension management program（CHMP） in Youxie Community Health Service Center（CHSC） were enrolled as study group,another 914 EH patients participating CHMP in Jianan CHSC as control group.A salt load test was made in study group and the screened-out salt-sensitive patients were given individualized treatments.The 2 groups had conventional follow-ups and health guidance.Mean arterial pressure（MABP） was measured before research and in months 3,6 after,and the incidences of the main cardiovascular and cerebrovascular diseases including cerebral infarction（CI）,transient ischemic attack（TIA）,coronary heart disease,angina pectoris,acute myocardial infarction,cardiovascular disease deaths at 6 months folluwed-up.Results A total of 614 salt-sensitive patients were screened out,accounting for 62.1% of EH patients.There was significant difference between pre-and post-treatment MABP between 2 groups（P〈0.05）.There was no difference in MABP between 2 groups before research（P〈0.05）.MABP was lower in study group than in control group in months 3,6 after research（P〈0.05）,and lower in months 3,6 after research than before,and lower in months 6 than in months 3 between 2 groups（P〈0.05）.The 68.3%（676/989） patients had drops of blood pressure（BP） in study group.The incidence of the main cardiovascular and cerebrovascular diseases was 19.1%（175 /914） in control group,higher than that of study group 〔9.6%（95 /989） 〕,the difference was significant（χ^2= 25.7,P〈0.05）.The incidences of CI,TIA were lower in study group than in control group（P〈0.05）.Conclusion Salt-sensitivity screening and individualized treatments can improve the BP of hypertensive patients participating CHMP and reduce the incidence of cardiovascular and cerebrovascular diseases,to provide us

关 键 词：盐敏感 社区 高血压 管理 

分 类 号：R544.1[医药卫生—心血管疾病]