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目的:探讨社区高血压患者血压控制效果的影响因素。方法:基于经济发展水平和地理位置,选择16个省250个社区卫生服务中心(站)和卫生院,利用基层高血压规范化管理方案对社区医务人员进行培训,由受培训的基层医务人员对高血压患者实施规范化管理1年。高血压患者的基线和随访资料采用统一设计的调查问卷收集。构造logistic回归模型对高血压控制效果的影响因素进行分析。结果:调查人群高血压治疗控制率为75.2%,年龄大、女性、高中以上、中东部地区和社会医疗保险是高血压控制的有利因素,而新型农村合作医疗、有并发症、2~3级高血压、高危和单片复方制剂是高血压控制的不利因素。结论:在高血压社区规范化管理中,应加强对年轻、有并发症、2~3级高血压以及高危患者的教育与管理,做到早发现、早治疗;同时,卫生行政部门应针对慢性病完善新型农村合作医疗制度,提高患者抗疾病经济风险能力。
Objective: To explore the influencing factors of blood pressure control in community-based hypertensive patients. Methods: Based on the level of economic development and geographical location, 250 community health service centers (stations) and health centers in 16 provinces were selected. Community-based medical personnel were trained by standardized management of primary hypertension, Blood pressure patients to implement standardized management for 1 year. Hypertensive patients with baseline and follow-up data collected using a unified design questionnaire. Construct logistic regression model to analyze the influencing factors of hypertension control effect. Results: The control rate of hypertension in the surveyed population was 75.2%. The older, female, above middle and high school, middle eastern region and social medical insurance were the favorable factors for the control of hypertension. However, the new rural cooperative medical system had complication, grade 2 to 3 Hypertension, high risk, and monolithic compounds are unfavorable factors for hypertension control. Conclusion: In the standardized management of hypertensive community, we should strengthen the education and management of young patients with complications, grade 2 to 3 hypertension and high-risk patients so as to achieve early detection and early treatment. At the same time, the health administrative department should improve the chronic disease New rural cooperative medical system to improve patients’ ability to resist economic risks.