社区高血压患者家庭血压纸质记录和电子导出记录一致性及其影响因素  

Concordance between manual and digital home blood pressure recordings and its determinants in hypertensive patients from community

作　　者：王飞[1] 王亚娟[2] 王彦[1] 程艾邦 陈凌[2] 钱岳晟[1] 张瑾[1] 唐晓峰[1] 李燕[1] 朱鼎良[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院上海市高血压研究所,上海200025 [2]上海市闵行区莘庄社区卫生服务中心

出　　处：《中华高血压杂志》2016年第7期657-662,共6页Chinese Journal of Hypertension

基　　金：国家十二五科技支撑计划课题(2011BAI11B04)

摘　　要：目的研究社区高血压患者是否能准确可靠地记录及报告家庭自测血压值,以及影响纸质记录和电子导出记录一致性的因素。方法邀请上海莘庄社区高血压患者,使用欧姆龙HEM-7080-IC电子血压计,在家中每天早晚2次,连续7 d自测血压,并同时在日记本中记录每次测量的时间及血压。采用配对t检验及一致性检验等方法比较纸质记录与血压计导出值之间的符合率,采用Logistic回归分析影响纸质记录符合率的因素。结果 103例患者(男性占48.5%,平均年龄68.7岁)纸质记录的3788组血压读数中,3038组(80.2%)与导出值完全一致。以导出记录为参照,患者纸质记录符合率的中位数为92.9%,42例(40.8%)纸质记录符合率≤90%。93例(90.3%)导出血压多于纸质记录,5例(4.9%)纸质记录多于导出记录。导出记录显示有65例(63.1%)测量时间>7 d,即使到监测第5天,仍有35例(34.0%)测量次数>6次。根据纸质记录比根据导出记录计算的家庭血压平均值略高(P<0.01),而血压控制率略低(P<0.05)。纸质报告符合率与患者性别、年龄及高血压病程等因素的相关性无统计学意义(P>0.05)。结论社区高血压患者记录的家庭自测血压数值存在报告偏倚。研究支持目前的指南建议,即最好选择有记忆功能的血压计进行家庭血压监测,利用血压计导出值进行家庭血压管理。Objective To investigate whether or not hypertensive patients in the community could accurately and reliably record self-measured home blood pressure and to analyze the determinants of concordance between manual and digital home blood pressure recordings. Methods Hypertensive patients from the Shanghai Xinzhuang community were invited to selfmeasure their blood pressure at home twice daily for 7 consecutive days with the use of the Omron HEM-7080-IC monitors and simultaneously record measurement time and blood pressure values in the logbook. Paired t test and agreement test were performed to determine the concordance between logbook entries and exported values from the device memory,and Logistic regression to explore the determinants of reporting concordance. Results Among the 3788 blood pressure readings manually recorded in the logbook by the 103 patients（ men 48. 5%,mean age 68. 7 years）,3038（ 80. 2%） were identical to the digital recordings. The median of reporting concordance was 92. 9%,and 42 patients（ 40. 8%） had a reporting concordance of ≤90%. In total,93 patients（ 90. 3%） had more digital than manual recordings,while 5 patients（ 4. 9%） had more manual than digital readings. The exported data showed that 65 patients（ 63. 1%） measured blood pressure for more than 7 days,and even at the 5th day,35 patients（ 34. 0%） measured for more than 6 times per day. The average home blood pressure calculated based on the logbook recordings were slightly higher than that based on exported readings（ P 〈0. 01）,and the control rate were slightly lower（ P〈 0. 05）. There was no statistically significant correlation between reporting concordance and factors such as sex,age,hypertension duration and etc（ all P 〉0. 05）. Conclusion Reporting bias is existed in self-measured home blood pressure monitoring among hypertensive patients in the community. Our study supports current guidelines and recommendations that it is better to use a memory-equipped device for home blood pressure m

关 键 词：高血压 家庭血压监测 报告偏倚 

分 类 号：R544.1[医药卫生—心血管疾病]