月坛社区高血压患者用药及血压控制情况调查  

Investigation on medication and blood pressure control of hypertension patients in Yuetan community

作　　者：李肖肖[1] 边立立[1] 董玉明[1] 李娟 刘丹丹 LI Xiao-xiao;BIAN Li-li;DONG Yu-ming;LI Juan;LIU Dan-dan(Yuetan Community Health Service Center, Fuxing Hospital Affiliated to Capital Medical University, Beijing 100045, China)

机构地区：[1]首都医科大学附属复兴医院月坛社区卫生服务中心,北京100045

出　　处：《基础医学与临床》2021年第1期93-96,共4页Basic and Clinical Medicine

基　　金：西城区2018—2019年度优秀人才项目(2018-2019)。

摘　　要：目的调查与分析月坛社区高血压患者用药及血压控制情况。方法随机抽取2018年6月1日至2019年1月31日在月坛社区卫生服务中心及下属站就诊的高血压患者504例,通过调查问卷方法了解患者的用药情况;通过血压测量了解患者的血压控制是否达标;通过查阅健康档案及就诊记录获取高血压患者的化验及检查结果。结果本调查将低于高血压诊断标准的血压值判定为血压达标,即收缩压<140 mmHg并且舒张压<90 mmHg。结果显示高血压患者诊室血压的达标率为62.3%,规律用药率为96%,服用1种降压药和联合应用2种降压药的比例最高,分别为40.3%和39.1%。服用2种降压药的患者中以血管紧张素转化酶抑制剂(ACEI)/血管紧张素受体拮抗剂(ARB)(A)+β受体阻滞剂(B)+钙离子拮抗剂(CCB)(C)组合比例最高(54.8%),其次是A+C+利尿剂(D)组合(29.0%)。服用2种降压药的组合当中以A+C组合最多(46.2%),其次为B+C(31.5%),而A+D组合比例较低(9.6%)。单药治疗以CCB类最多(63.5%),其次为ACEI/ARB类(26.6%)。单药治疗以利尿剂所占比例最低(1.0%)。结论此次调查结果显示月坛社区卫生服务中心高血压治疗用药中利尿剂的应用比例相对较低,尤其是在单药治疗和两药联合治疗的高血压患者中应用较少。建议临床医生提高对利尿剂的重视程度与合理使用,尤其对于盐摄入量高的高血压患者,应考虑优先使用低至中剂量的噻嗪类利尿剂。Objective To investigate and analyse the medication and blood pressure control of patients with hypertension in Yuetan community.Methods During June 1,2018 to January 31,2019,totally 504 patients with hypertension from the community were investigated,by questionnaire to survey the medication,The blood pressure of patientswere checked by clinic measurement and their history and records were reviewed.Results Systolic blood pressure(SBP)<140 mmHg and diastolic blood pressure(DBP)<90 mmHg,were defined as standard blood pressures in this investigation.The survey showed that the clinic blood pressure compliance rate was 62.3%,the rate of regular medication was 96%,and the proportion of taking one kind of antihypertensive medicine and combining two kinds of antihypertensive medicine was the highest(40.3%and 39.1%,respectively).Among the patients taking three types of antihypertensive medicine,angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptorblocker(ARB)(A)+beta blocker(B)+calcium antagonist(CCB)(C),accounted for the highest proportion(54.8%).The second was the combination of A+C+diuretic(D)(29.0%).Among the two antihypertensive medicine combinations,A+C took the largest proportion(46.2%),followed by B+C(31.5%),while the combination of A+D was lower(9.6%).CCB accounted for the largest proportion(63.5%)in single medicine treatment,followed by ACEI/ARB(26.6%),and diuretic was the lowest(1.0%).Conclusions The proportion of diuretics prescription in hypertension medication in Yuetan community is relatively low,especially in the mono-therapy treatment and in group of patients with two antihypertensive medicines.It is suggested that clinicians should pay more attention to diuretics and its rational use,especially for hypertension patients with high salt intake.In such a situation,low to medium doses thiazide diuretics should be given with priority.

关 键 词：社区 高血压药物治疗 血压达标率 

分 类 号：R452[医药卫生—治疗学]