轻中度原发性高血压患者时辰服药治疗后生存质量的病例对照研究  

A case control study about quality of life of patients with mild to moderate primary hypertension with chronos medication

作　　者：张波[1,2] 陈瑜[1,3] 向常清[1,2] 杨维华[1,2] 周敬群[1,2] 

机构地区：[1]三峡大学仁和医院 [2]三峡大学第二临床医学院心内科,湖北宜昌443002 [3]三峡大学第二临床医学院心功能室,湖北宜昌443002

出　　处：《重庆医学》2015年第5期619-622,共4页Chongqing medicine

基　　金：三峡大学2010年科学基金项目(KJ2010A019)

摘　　要：目的研究使用动态血压指导轻中度原发性高血压患者时辰服药治疗6个月的生存质量。方法将所有128例研究对象分为两组,时辰服药组和常规服药组,分别在调整用药前、治疗后6个月对患者进行动态血压监测,并发放SF-36生存质量调查表和自制的一般情况和服药情况调查表,对患者生存质量予以评估,分析患者时辰服药治疗后生存质量的变化及影响因素。结果两组患者的动态血压参数均明显改善,与常规服药组比较,时辰服药组在夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、夜间平均动脉压(nMAP)、高危时段的平均舒张压(DDBP)、平均收缩压(DSBP)、平均动脉压(DMAP)、夜间血压下降率(NBPDR)方面差异有统计学意义(P<0.05或P<0.01)。降压治疗6个月后,两组在情感职能、精神健康、生理机能、生理职能方面差异有统计学意义(P<0.05或P<0.01)。多元回归分析显示高血压患者生存质量的影响因素包括年龄、BMI、服药时间、家庭人均月收入、医保类型、文化程度、职称。其中,高龄、BMI高、服药时间延长会降低生存质量,而家庭人均月收入高、文化程度高、参加保障更高的医保、职称高则会改善生存质量。结论对轻中度高血压患者,时辰服药治疗比常规服药治疗能更加显著改善患者动态血压参数、生存质量。改善患者经济状况、BMI,医疗有保障,文化程度高有助于提高患者生存质量。Objective To study the quality of life（QOL）of patients with mild to moderate primary hypertension after treatment adjusted medication time by ambulatory blood pressure.Methods All 128 cases were divided into two groups randomly including chronos medication group and normal medication group.We tested ambulatory blood pressure,QOL and influencing factors before medication and 6months later.Results It′s observed the parameters of the ambulatory blood pressure improved significantly in all of the groups.There existed significant difference in nSBP,nDBP,nMAP,SBP in dangerous night time,and nocturnal blood pressure decline rate between two groups（P〈0.05）.There existed very significant difference in DBP and MAP in dangerous night time（P〈0.01）.There were significant difference in the fields of MH（mental health）and RE（role limitation because of emotional health problem）（P〈0.05）,and very significant difference in the fields of PF（physical functioning）,RP（role limitation because of physical health）,VT（vitality）（P〈0.01）.Multiple regression analysis indicate the influencing factors of the quality of life about patients with hypertension are age,BMI index number,medication time,average family income,medical insurance type,culture degree and job title.Age,BMI index number and medication time depress QOL of patient with hypertension while average family income,better medical insurance type,culture degree and job title improve it.Conclusion It′s possible to improved the parameters of the ambulatory blood pressure for patients with mild to moderate primary hypertension by chronos medication compared with normal medication more significantly.It′s useful to improve the QOL of patient with hypertension by improving average family income,medical insurance type and culture degree.

关 键 词：动态血压监测 时辰治疗 生存质量 

分 类 号：R544.1[医药卫生—心血管疾病]