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目的比较分析工作场所干预条件下,不同药物组合对高血压患者的降压效应。方法 2009-04-2010-05对开滦集团有限责任公司井下及井下辅助单位在岗患高血压的职工进行综合干预[共5367例,其中男性4023例,女性67例,年龄(45.5±6.5)岁]。干预措施包括免费发放降压药物,宣传教育和行政干预。免费发放的降压药为下列组合之一:①尼群地平5mg2次/d+卡托普利12.5mg2次/d(A组,1115例);②尼群地平5mg2次/d+螺内酯20mg1次/d(B组,704例);③氢氯噻嗪12.5mg1次/d+卡托普利12.5mg2次/d(C组,794例);④氢氯噻嗪12.5mg1次/d+螺内酯20mg1次/d(D组,1477例)。干预期间每2周随访1次并测量血压,观察干预前后的血压变化情况。结果干预后收缩压[(134.1±13.1)比(147.6±17.5)mmHg]、舒张压[(86.6±8.9)比(96.9±10.9)mmHg]下降(均P<0.01)。A、B、C、D组收缩压分别下降(14.1±23.3)、(11.4±23.0)、(12.1±21.7)和(14.8±20.9)mmHg,舒张压分别下降(9.5±15.5)、(7.4±14.8)、(10.2±14.4)和(12.1±13.6)mmHg,组间比较差异有统计学意义(均P<0.01),D组血压下降值大于其他组。A、B、C、D组的总有效率分别为67.0%、62.9%、68.5%和77.3%,D组的总有效率高于其他组(P<0.01)。结论工作场所不同抗高血压药物组合能有效降低高血压患者的血压水平。
Objective To compare and analyze the antihypertensive effects of different drug combinations in patients with hypertension under workplace intervention. Methods 2009-04-2010-05 A total of 5367 workers (4023 males, 67 females, 45.5 ± 6.5 years old) were involved in the intervention of KuLuan Group Co., Ltd’s underground and underground auxiliary units ]. Interventions include the free distribution of antihypertensive drugs, education and administrative interventions. The antihypertensive drugs distributed for free are one of the following combinations: ① nitrendipine 5mg 2 times / d + captopril 12.5mg 2 times / d (group A, 1115 cases); ② nitrendipine 5mg 2 times / d + spironolactone 20mg 1 times / d (Group B, 704 cases); ③ hydrochlorothiazide 12.5mg1 times / d + captopril 12.5mg2 times / d (group C, 794 cases); ④ hydrochlorothiazide 12.5mg1 times / d + spironolactone 20mg1 times / d ). Follow-up was performed every two weeks during the intervention period and blood pressure was measured to observe changes in blood pressure before and after intervention. Results After the intervention, systolic blood pressure (134.1 ± 13.1) vs 147.6 ± 17.5 mmHg] and diastolic blood pressure (86.6 ± 8.9) (96.9 ± 10.9) mmHg decreased (all P <0.01). The systolic blood pressure in group A, B, C and D decreased by (14.1 ± 23.3), (11.4 ± 23.0), (12.1 ± 21.7) and (14.8 ± 20.9) mmHg, and decreased by 9.5 ± 15.5 and 7.4 ± 14.8), (10.2 ± 14.4) and (12.1 ± 13.6) mmHg, respectively. There was significant difference between the two groups (all P <0.01). The total effective rates in groups A, B, C and D were 67.0%, 62.9%, 68.5% and 77.3%, respectively. The total effective rate in group D was higher than that in other groups (P <0.01). Conclusion Different combinations of antihypertensive drugs in the workplace can effectively reduce the blood pressure of hypertensive patients.