社区综合干预治疗H型高血压的效果评估  

Evaluation of the effect of community comprehensive intervention in the treatment of H-type hypertension

作　　者：陈敏[1] 王剑波 朱惠仙[1] 马勇[1] 汪志良 王慧 王继伟 CHEN Min;WANG Jianbo;ZHU Huixian;MA Yong;WANG Zhiliang;WANG Hui;WANG Jiwei(Outpatient Clinic of General Practice of Xujiahui Community Health Service Center of Xuhui District, Shanghai 200030, China;Office of the Eighth People’s Hospital, Shanghai 200233, China;Office of Hongmei Community Health Service Center of Xuhui District, Shanghai 200233, China;Department of Health Behavior and Health Education of Public Health School of Fudan University, Shanghai 200032, China)

机构地区：[1]上海市徐汇区徐家汇街道社区卫生服务中心全科门诊,上海200030 [2]上海市第八人民医院院办,上海200233 [3]上海市徐汇区虹梅街道社区卫生服务中心院办,上海200233 [4]上海市复旦大学公共卫生学院健康行为与健康教育教研室,上海200032

出　　处：《上海医药》2019年第18期35-38,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市卫健委科研课题(20134352)

摘　　要：目的:评估社区综合干预治疗H型高血压(原发性高血压合并高同型半胱氨酸血症)的效果。方法:选取社区H型高血压患者176人,分为对照组(原降压方案+安慰剂)57人,叶酸干预组(原降压方案+叶酸0.8 mg/次,1次/d)59人、综合干预组(原降压方案+叶酸片0.8 mg/次,1次/d+健康宣教及生活方式干预)60人。干预时间12周,比较干预前后各组血浆同型半胱氨酸(Hcy)和血压的变化。结果:干预后,叶酸干预组和综合干预组患者的血浆Hcy水平有明显降低,差异具有统计学意义(P <0.01);第12周时,叶酸干预组患者的血浆Hcy下降幅度大于对照组,综合干预组患者的血浆Hcy下降幅度大于叶酸干预组,差异均有统计学意义(P <0.05)。对照组,叶酸干预组和综合干预组干预前后的血压水平差异均无统计学意义(P> 0.05)。结论:全科医生指导下的健康宣教和生活方式干预联合降压方案和叶酸补充可更好的降低H型高血压患者的Hcy水平。Objective: To evaluate the effect of community comprehensive intervention in the treatment of H-type hypertension. Methods: A randomized controlled trial design was used to select 176 community patients with essential hypertension complicated with hyperhomocysteinemia(HHcy) and divided into a control group(original hypotension + placebo) with 57 people, a folic acid intervention group(original hypotensive regimen + folic acid 0.8 mg/time, once a day) with 59 people, and a comprehensive intervention group(original hypotension program + folic acid tablet 0.8 mg/time, once a day + health education and lifestyle intervention) with 60 people. The intervention time was 12 weeks, and the changes of plasma Hcy and blood pressure were compared before and after the intervention. Results: Compared with the control group, the plasma Hcy levels in the folic acid intervention group and the comprehensive intervention group were significantly lower, and the difference was statistically significant(P<0.01). At the 12 th week, the decrease of plasma Hcy in the folic acid intervention group was greater than that in the control group, the plasma Hcy of patients in the comprehensive intervention group was greater than that in the folic acid intervention group, and the difference was statistically significant(P<0.05). There was no significant difference in blood pressure between the control group, folic acid intervention group and comprehensive intervention group before and after intervention(P>0.05). Conclusion: Health education and lifestyle intervention under the guidance of general practitioners combined with antihypertensive regimen and folic acid supplementation can better reduce the level of Hcy in patients with H-type hypertension.

关 键 词：H型高血压 叶酸 综合干预 同型半胱氨酸 血压 

分 类 号：R544.1[医药卫生—心血管疾病]