向基层医院推广高血压管理适宜技术的多中心研究  

Appropriate technology for the hypertension management in the primary hospitals:an multi-center research

作　　者：冯瑞[1] 雷家俨[2] 

机构地区：[1]重庆医科大学附属第一医院心血管内科,重庆400016 [2]重庆医科大学附属第一医院人事处,重庆400016

出　　处：《重庆医科大学学报》2016年第4期347-350,共4页Journal of Chongqing Medical University

基　　金：国家科技支持计划资助项目(编号:2013BAI05B02)

摘　　要：目的:本研究根据高血压患者的食盐摄入量及尿蛋白情况,对高血压患者采取个体化治疗,制定出适合基层医疗机构管理高血压患者的有效方法。方法:根据整群随机,在重庆市抽取9个社区(共757人),随机分为5个干预社区组(干预组,313人)和4个对照社区组(对照组,444人)。干预组根据食盐摄入量及尿白蛋白情况,给予个体化药物干预治疗;对照组根据医生经验进行常规治疗。随访3个月,观察降压幅度、血压达标情况及尿蛋白改善情况。结果:(1)干预组收缩压和舒张压下降幅度均明显高于对照组[15(8,24)mm Hg vs.10(2,21)mm Hg,8(2,14)mm Hg vs.4(-2,10)mm Hg,P=0.000]。(2)干预组血压控制达标率高于对照组(58.47%vs.47.07%,P=0.002)。(3)干预组尿蛋白阴转率高于对照组(35.09%vs.16.85%,P=0.012)。结论:基于高血压患者的食盐摄入量及尿蛋白情况给予个体化治疗,可有效控制血压、减少蛋白尿,适用于基层医院。Objective：To look into the salt intake and urine protein of hypertension patients,to take individualized treatment in patients with hypertension,and to develop a suitable effective method of hypertension management for the patients in the primary hospitals. Methods：According to the cluster random,9 communities（757 people）extracted in Chongqing,divided into 5 intervention communities（intervention group,313 people）and 4 control communities（control group,444 people）. The intervention group was given the individualized drug treatment based on the salt intake and urine protein;control group was given the general treatment based on the clinical experience of the doctors in primary hospitals. All groups were followed up for 3 months,the decrease of the blood pressure,the control rate of the high blood pressure and urine protein were observed. Results：The systolic pressure and diastolic pressure was obviously decreased in the intervention group than in control group[15（8,24）mm Hg vs. 10（2,21）mm Hg,8（2,14）mm Hg vs. 4（-2,10）mm Hg,P=0.000]. The intervention group was better than the control group regarding the control rate in blood pressure（58.47%vs. 47.07%,P=0.002）. The intervention group was better than the control group in the negative conversion rates of urine protein（35.09%vs. 16.85%,P=0.012）. Conclusion：This method can control the blood pressure and urine protein effectively in hypertension treatment;it is suitable for primary hospitals.

关 键 词：基层医院 高血压 尿蛋白 食盐摄入量 

分 类 号：R544.1[医药卫生—心血管疾病]