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目的研究社区高血压患者是否能准确可靠地记录及报告家庭自测血压值,以及影响纸质记录和电子导出记录一致性的因素。方法邀请上海莘庄社区高血压患者,使用欧姆龙HEM-7080-IC电子血压计,在家中每天早晚2次,连续7 d自测血压,并同时在日记本中记录每次测量的时间及血压。采用配对t检验及一致性检验等方法比较纸质记录与血压计导出值之间的符合率,采用Logistic回归分析影响纸质记录符合率的因素。结果 103例患者(男性占48.5%,平均年龄68.7岁)纸质记录的3788组血压读数中,3038组(80.2%)与导出值完全一致。以导出记录为参照,患者纸质记录符合率的中位数为92.9%,42例(40.8%)纸质记录符合率≤90%。93例(90.3%)导出血压多于纸质记录,5例(4.9%)纸质记录多于导出记录。导出记录显示有65例(63.1%)测量时间>7 d,即使到监测第5天,仍有35例(34.0%)测量次数>6次。根据纸质记录比根据导出记录计算的家庭血压平均值略高(P<0.01),而血压控制率略低(P<0.05)。纸质报告符合率与患者性别、年龄及高血压病程等因素的相关性无统计学意义(P>0.05)。结论社区高血压患者记录的家庭自测血压数值存在报告偏倚。研究支持目前的指南建议,即最好选择有记忆功能的血压计进行家庭血压监测,利用血压计导出值进行家庭血压管理。
Objective To investigate whether family hypertension patients can accurately and reliably record and report family self-test blood pressure values, as well as the factors influencing the consistency of paper records and electron export records. Methods Shanghai Xinzhuang Community Hypertensive Patients were invited to use OMRON HEM-7080-IC electronic sphygmomanometer twice a day in the morning and evening for self-test blood pressure for 7 consecutive days. At the same time, the diurnal time and blood pressure of each measurement were recorded. The coincidence rates between paper records and sphygmomanometers were compared by paired t-test and consistency test, and Logistic regression was used to analyze the factors that affected the coincidence rate of paper records. Results Of the 3788 (80.2%) blood pressure readings of 103 patients (48.5% of men with a mean age of 68.7 years) in paper records, the values were exactly the same as the derived values. Taking the derived records as the reference, the median compliance rate of patients with paper records was 92.9% and the compliance rate of paper records of 42 patients (40.8%) was less than or equal to 90%. 93 cases (90.3%) derived more blood pressure than paper records, and 5 cases (4.9%) had more paper records than export records. Export records showed 65 cases (63.1%) of the measurement time> 7 d, 35 cases (34.0%) were measured even more than 6 times by the 5th day of monitoring. Blood pressure control was slightly lower (P <0.05) based on a slightly higher average (P <0.01) and a lower rate of blood pressure control (P <0.05) based on paper records than calculated on the basis of derived records. There was no significant correlation between the coincidence rate of paper report and patient’s sex, age and duration of hypertension (P> 0.05). Conclusion There is a reported bias in family-based BP readings in community-based hypertensive patients. The study supports the current guidelines and recommends that home-based blood pressure monitoring with a memory-based sphygmomanometer be preferred and home-blood pressure management be based on the sphygmomanometer derived value.