远程无线实时多参数监控改善高血压合并2型糖尿病患者的血压及血糖控制  

The application of remote wireless real-time multi-parameter monitoring to improve the control rate of blood pressure and blood glucose in essential hypertensive patients complicated with type 2 diabetes mellitus

作　　者：陈青萍[1,2] 梁驰[1,2] 尚晓斌[1,2] 黄宁[1,2] 黄学成[1,2] 陈颖[1,2] 陈婷[1,2] 农美虹 

机构地区：[1]广西医科大学第三附属医院 [2]南宁市第二人民医院心电诊断科,广西南宁530031

出　　处：《中华高血压杂志》2015年第7期656-660,共5页Chinese Journal of Hypertension

基　　金：南宁市科技专项重大项目(20133143)

摘　　要：目的探讨远程无线实时心电、血压和血糖同步监测及远程干预指导能否提高社区原发性高血压(EH)合并2型糖尿病(T2DM)患者的血压及血糖控制率。方法选择EH合并T2DM患者420例,分为远程监控组(n=200)和常规控制组(n=220),两组患者在常规治疗干预前及观察结束后行24h动态血压及空腹、餐后2h血糖测定,远程监控组在观察期同时行连续72h远程无线实时心电、血压及血糖同步监测或随时监测。对全部患者进行为期8周的血压、血糖干预治疗(包括监测心电、血压及血糖水平、指导生活方式、调整药物治疗等),比较两组血压、血糖控制达标情况。结果在8周治疗干预过程中,远程监控组接受远程信息指导达22.7次/例,平均每周2.8次/例。患者主动联系医生询问相关事宜的比例在远程监控组为84.5%,常规控制组为17.2%(χ2=189.42,P<0.01)。远程监控组24h平均收缩压(98.5%比39.1%)、舒张压(97.5%比43.6%)、清晨血压(97.0%比40.5%)及空腹血糖(84.0%比41.8%)、餐后2h血糖(98.0%比48.2%)的达标率明显高于常规控制组,且前者杓型血压比例(98.5%比41.8%)、24h平均收缩压下降幅度[(52.0±11.9)比(31.7±14.2)mm Hg]及舒张压下降幅度[(31.0±8.2)比(15.9±6.4)mm Hg]亦高于后者(均P<0.05)。结论在常规治疗基础上对EH合并T2DM者行远程无线实时多参数监测,通过实时信息给予及时指导,可提高患者对自身血压、血糖的关注度以及主动参与意识,有利于血压、血糖控制达标。Objective To monitor blood pressure and blood glucose using remote wireless real-time electrocardiogram（ECG）,aiming to see whether this technique together with remote intervention guidance can increase the control rates of blood pressure and blood glucose in essential hypertensive patients complicated with type 2diabetes mellitus（T2DM）. Methods A total of 420 essential hypertensive patients with T2 DM were selected and randomly assigned to the remote monitoring（RMON）group（n=200）or the conventional control group（n=220）. All study patients underwent 24-hour ambulatory blood pressure monitoring and fasting,2-hour postprandial blood glucose measurement before formal treatment and after observation. The RMON group also underwent 72-hour continuous real-time remote wireless ECG,and simultaneous or any time monitoring of blood pressure and blood glucose during the observation period.All study patients experienced 8 weeks of blood pressure and blood glucose management,including ECG,blood pressure,blood glucose,lifestyle guide,adjustment of drug treatment,and blood pressure and blood glucose levels of these two groups were compared. Results During the 8-weeks＇ management,patients in the RMON group received telematics guidance 22.7times per case on average,weekly（22.7/8）2.8times per case,and 84.5 % of patients actively called doctors for enquiring related issues. By contrast,only 17.2% of patients in the conventional control group took the initiative to contact doctors（χ^2=189.42,P〈0.01）. The compliance rates of 24-hour average systolic（98.5% vs 39.1%）and diastolic blood pressure（97.5% vs 43.6%）,morning blood pressure（97.0% vs 40.5%）,fasting blood-glucose（84.0% vs 41.8%）and 2-hour postprandial blood glucose（98.0% vs 48.2%）in the RMON group were significantly higher than that in the conventional control group（all P〈0.05）. Dipper type blood pressure appeared in 98.5% of patients in the RMON group and 41.8%in the control group. The reduction of 24-hour average systoli

关 键 词：高血压 2型糖尿病 控制率 远程多参数监测 

分 类 号：R544.1[医药卫生—心血管疾病]