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目的了解开展高血压社区规范化管理对于高血压患者血压控制及心脑血管病预后的效果,评价高血压规范化管理的远期效果。方法选取1~3个前期参加全国高血压规范化管理项目的医疗机构及1~2个前期未参加过全国高血压规范化管理项目的医疗机构,采用随机抽样方法,选取参加实施高血压规范化管理患者(管理组)2 000例,未参加高血压规范化管理患者(非管理组)1 000例,并进行随访工作。结果患者的收缩压平均值为(132.05±9.77)mm Hg,低于非管理组(135.01±9.27)mm Hg,差异有统计学意义(t=-7.82,P=0.00)。管理组舒张压均值为(82.04±7.34)mm Hg,非管理组为(82.36±6.39)mm Hg,差异无统计学意义(t=-1.18,P=0.24)。管理组血压控制率为72.13%,高于非管理组的61.31%,差异有统计学意义(χ~2=33.90,P=0.00)。不同性别及年龄组,除了30~49岁外,其他情况管理组血压控制率高于非管理组(P<0.05)。管理组的服药率为79.50%,低于非管理组的84.28%,差异有统计学意义(χ~2=15.93,P=0.00);管理组的心脑血管病发生率4.65%,低于非管理组7.40%,差异有统计学意义(χ~2=9.59,P=0.00);而心脑血管死亡率管理组与非管理差异无统计学意义(χ~2=0.79,P=0.38)。结论高血压社区规范化管理可以提高患者血压控制率、服药率、减少心脑血管病的发生,提高患者的生存质量,是提高高血压人群防治效果的有效途径。
Objective To understand the effect of standardized management of hypertension community on the control of blood pressure and the prognosis of cardiovascular and cerebrovascular diseases in hypertensive patients and to evaluate the long-term effects of standardized management of hypertension. Methods One to three medical institutions that participated in the national standardized hypertension management project and one to two medical institutions that did not participate in the national standardized hypertension management project were enrolled in the study. Random sampling method was adopted to select the patients who participated in the standardized management of hypertension Management group) 2 000 cases, did not participate in the standardized management of hypertension patients (non-management group) 1 000 cases, and follow-up work. Results The average systolic blood pressure of patients was (132.05 ± 9.77) mm Hg, which was lower than that of non-management group (135.01 ± 9.27) mm Hg. The difference was statistically significant (t = -7.82, P = 0.00). The mean diastolic blood pressure was (82.04 ± 7.34) mm Hg in the management group and (82.36 ± 6.39) mm Hg in the non-management group, with no significant difference (t = -1.18, P = 0.24). The rate of blood pressure control in the management group was 72.13%, which was higher than that in the non-management group (61.31%) (χ ~ 2 = 33.90, P = 0.00). In different genders and age groups, the blood pressure control rates of other situation management groups were higher than those of non-management groups except 30-49 years old (P <0.05). The medication rate of the management group was 79.50%, which was lower than 84.28% of the non-management group (χ ~ 2 = 15.93, P = 0.00). The incidence of cardiovascular and cerebrovascular diseases in the management group was 4.65% Management group was 7.40%, the difference was statistically significant (χ ~ 2 = 9.59, P = 0.00). There was no significant difference between cardiovascular management group and non-management group (χ ~ 2 = 0.79, P = 0.38). Conclusion Hypertensive community standardized management can improve blood pressure control rate, medication rate, reduce the incidence of cardiovascular disease and improve the quality of life of patients is an effective way to improve the prevention and treatment of hypertension.