成都社区抗高血压药物使用现状及血压控制率分析  

Analysis of Current Status of Antihypertensive Drugs Use and Blood Pressure Control Rate in Chengdu Community

作　　者：胥建君[1] 陈新云[1] 蒋小晶[1] 杨绍清 鲁红梅 冯益身 周林霞 李斌[6] 罗娟 Xu Jianjun;Chen Xinyun;Jiang Xiaojing(Department of Cardiology and Key Laboratory of Hypertension and Related Diseases,Chengdu First People′s Hospital,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市第一人民医院心血管内科,高血压及相关疾病重点研究室,四川成都610041 [2]成都市石羊社区卫生服务中心,四川成都610000 [3]成都市中和社区卫生服务中心,四川成都610000 [4]成都市双流区第二人民医院,四川成都610219 [5]成都市双流区中医医院,四川成都610219 [6]都江堰市中医医院,四川成都611830 [7]成都市芳草社区卫生服务中心,四川成都610041

出　　处：《四川医学》2020年第3期239-244,共6页Sichuan Medical Journal

基　　金：成都市科技惠民项目(编号:2015-HM02-00049-SF)。

摘　　要：目的了解成都社区抗高血压药物使用现状及血压控制概况。方法采用整群随机抽样,抽取6个社区、18岁以上居民共计5022人,对个体采用问诊、查体及填写统一调查问卷等方式收集相关资料。结果高血压患者规律治疗率为44.49%,使用抗高血压药物87.03%为指南推荐药物,各类药物(血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体拮抗剂(ARB)、β受体阻滞剂(B)、钙通道阻滞剂(CCB)、利尿剂(D))使用率分别为9.25%、15.02%、8.70%、73.12%和4.03%。联合用药率为45.28%,ACEI/ARB+CCB、ACEI/ARB+D、CCB+B、新型复方制剂等优选联合方案分别占20.34%、1.20%、7.01%和11.97%。治疗控制率为41.31%,单用ACEI/ARB、β受体阻滞剂、CCB、利尿剂的患者血压控制率无统计学差异(P=0.235);ACEI/ARB+CCB、ACEI/ARB+D、CCB+B联合方案及新型复方制剂患者血压控制率无统计学差异(P=0.371)。多因素Logistic回归分析显示,女性(OR=1.346)、老年(OR=0.595)、血脂异常(OR=0.735)为血压控制率影响因素(P<0.05)。结论成都社区抗高血压药物使用总体遵循指南规范,联合用药率、新型复方制剂和指南推荐的优选联合方案使用现状有改善。但在优选长效制剂、合理联合等方面仍存在不足,仍需加强合理用药指导和个体化高血压管理。Objective To understand the current status of antihypertensive use and blood pressure control in the Chengdu community.Methods The cluster random sampling was used to select 5022 residents from 6 communities and residents over 18 years old.Individuals were collected through questionnaires,physical examinations and filling in a unified questionnaire.Results The regular treatment rate of patients with hypertension is 44.49%,and 87.03%of antihypertensive drugs are recommended as guidelines.The use rates of various drugs(angiotensin converting enzyme inhibitor(ACEI),angiotensin receptor antagonist(ARB),beta blockers(B),calcium channel blockers(CCB),diuretics(D))were 9.25%,15.02%,8.70%,73.12%and 4.03%,respectively.The combined drug rate was 45.28%,and the preferred combinations such as ACEI/ARB+CCB,ACEI/ARB+D,CCB+B,and new compound preparations accounted for 20.34%,1.20%,7.01%,and 11.97%,respectively.The treatment control rate was 41.31%.There was no statistically significant difference in blood pressure control rate among patients using ACEI/ARB,β-blockers,CCB,and diuretics alone(P=0.235).There was no statistically significant difference in blood pressure control rates in patients with the combined ACEI/ARB+CCB,ACEI/ARB+D,CCB+B and new compound preparations(P=0.371).Multivariate Logistic regression analysis showed that female(OR=1.346),elderly(OR=0.595),and dyslipidemia(OR=0.735)were the influencing factors of blood pressure control rate(P<0.05).Conclusion The use of antihypertensive drugs in the metropolitan community generally follows the guidelines,and the current status of the use of combined medications,new compound preparations,and the preferred combination regimens recommended by the guidelines has improved.However,there are still shortcomings in the selection of long-acting preparations and rational combination,so it is still necessary to strengthen the guidance of rational drug use and individualized hypertension management.

关 键 词：高血压 抗高血压药物 使用现状 控制率 

分 类 号：R541.3[医药卫生—心血管疾病]