基于队列的高血压患者管理服务效果分析  

Effect of hypertension management service based on a cohort study

作　　者：李思萱[1] 崔军[1] 应焱燕[1] 纪威[2] 包凯芳 刘慧慧[3] Li Sixuan;Cui Jun;Ying Yanyan;Ji Wei;Bao Kaifang;Liu Huihui(Department of Chronic and Noncommunicable Disease Control and Prevention,Ningbo Municipal Center for Disease Control and Prevention,Ningbo 315010,China;Department of Big Data,Ningbo Center for Disease Control and Prevention,Ningbo 315010,China;Chinese Field Epidemiology Training Program,Graduate School of Chinese Center for Disease Control and Prevention,Beijing 100032,China)

机构地区：[1]宁波市疾病预防控制中心慢性非传染性疾病防制所,宁波315010 [2]宁波市疾病预防控制中心大数据所,宁波315010 [3]中国疾病预防控制中心研究生院中国现场流行病学培训项目,北京100032

出　　处：《国际流行病学传染病学杂志》2024年第2期104-109,共6页International Journal of Epidemiology and Infectious Disease

基　　金：宁波市医学品牌学科(PPXK2018-10);中国现场流行病学培训项目(720024);宁波市卫生健康科技计划项目(2022Y25)。

摘　　要：目的了解宁波地区高血压患者管理服务的实施效果。方法从宁波市成人慢病监测队列(2015—2019年)人群中选取参与高血压管理服务满1年及以上的高血压患者,对其2015年和2019年血压控制率、各项体格检查和生化指标进行对比分析。结果共纳入569名调查对象, 血压控制率从2015年的49.21%(280/569), 上升到2019年的71.53%(407/569)。不同亚组的血压控制率从2015年至2019年均有所上升, 差异均有统计学意义(配对卡方检验, P均<0.05)。城市人群从56.99%(208/365)上升到80.82%(295/365), 农村人群从35.29%(72/204)上升到54.90%(112/204), 男性从44.44%(108/243)上升到72.84%(177/243), 女性从52.76%(172/326)上升到70.55%(230/326), 糖尿病患者从58.74%(84/143)上升到73.43%(105/143), 血脂异常患者从50.48%(155/307)上升到76.55%(235/307)。同时, 调查对象的收缩压下降8.00 mmHg(1 mmHg=0.133 kPa), 舒张压下降4.50 mmHg, BMI下降0.47 kg/m2, 总胆固醇下降0.05 mmol/L, 高密度脂蛋白胆固醇上升0.09 mmol/L, 低密度脂蛋白胆固醇下降0.15 mmol/L。结论宁波地区高血压患者在接受患者管理服务期间, 血压下降的同时, 血脂调节和体重管理也出现了积极的转变。Objective:To investigate the implementation effect of hypertension management service in Ningbo.Methods:Hypertensive patients who participated in hypertension management service for at least 1 year from the adult chronic disease monitoring cohort in Ningbo City(2015-2019)were enrolled.A comparative analysis was conducted on their blood pressure control rates,physical examinations,and laboratory tests in 2015 and 2019.Results:A total of 569 participants were enrolled.The blood pressure control rate increased from 49.21%(280/569)in 2015 to 71.53%(407/569)in 2019.The blood pressure control rates of different subgroups increased from 2015 to 2019 with significant differences(paired chi-square test,P all<0.05).In urban populations,it increased from 56.99%(208/365)to 80.82%(295/365),and in rural populations,it increased from 35.29%(72/204)to 54.90%(112/204).For males,it increased from 44.44%(108/243)to 72.84%(177/243),and for females,it increased from 52.76%(172/326)to 70.55%(230/326).Among diabetic patients,it increased from 58.74%(84/143)to 73.43%(105/143),and among patients with abnormal blood lipids,it increased from 50.48%(155/307)to 76.55%(235/307).Additionally,the systolic blood pressure decreased by 8.00 mmHg(1 mmHg=0.133 kPa),diastolic blood pressure decreased by 4.50 mmHg,body mass index decreased by 0.47 kg/m 2,total cholesterol decreased by 0.05 mmol/L,high-density lipoprotein cholesterol increased by 0.09 mmol/L,and low-density lipoprotein cholesterol decreased by 0.15 mmol/L among the surveyed subjects.Conclusions:Hypertensive patients receiving hypertension management service in Ningbo not only experience a decrease in blood pressure but also show positive changes in blood lipid regulation and weight management.

关 键 词：高血压 队列研究 患者管理 血脂异常 体重 

分 类 号：R544.1[医药卫生—心血管疾病]