摘要
目的探讨在多重心血管危险因子的中重度高血压病人中实施社区综合干预对心脑血管事件发生的影响。方法在广州荔湾区2个卫生服务站收治中重度高血压病人,分为治疗组(n=70)和对照组(各70人,常规治疗并无特殊方案),治疗组接受钙拮抗剂和利尿剂治疗,并接受健康教育等非药物治疗以及定期随访,对照组按高血压病系统管理,定期随访鼓励坚持服药等。结果治疗组患者基础收缩压(179.4±14.1)mmHg,舒张压(101.3±8.1)mmHg,总胆固醇(6.4±1.5)mmol/L,甘油三酯(1.7±1.1)mmol/L,血尿酸(438.0±110.3)μmol/L,血糖(6.2±1.3)mmol/L。治疗3年后收缩压(138.0±9.1)mmHg,舒张压(78.8±5.5)mmHg,总胆固醇(5.3±1.2)mmol/L,甘油三酯(1.6±0.9)mmol/L,血尿酸(342.9±94.9)μmol/L,血糖(5.2±1.3)mmol/L较治疗前有显著性下降(P<0.01),也较对照组有显著性下降(P<0.01),两组血压控制率分别为71%(治疗组),16%(对照组)。治疗组有1例因心脑血管病入院及死亡(1.4%),对照组有12例因心脑血管病入院(17%),4例死亡(5.7%),治疗组明显减少心脑血管死亡及入院率(P<0.01)。结论良好血压控制及健康教育可以显著减少心脑血管疾病的发生和死亡。饮食治疗是控制高血脂等心脑血管危险因子的基础,应该全面推行高血压社区综合防治,以控制迅速增加的高血压患病率以及心脑血管并发症。
Objective To study the effects of comprehensive intervention for moderate and serious hypertension patients in a community. Methods One hundred forty cases of moderate and serious hypertension patients were randomized into intervention group （n= 70 ） and control group （n= 70 ） in two health service centers in Liwan District in Guangzhou city. The patients receivedd drug treatment with calcium antagonists and diuretics in intervention group. They were also provided with advices on ＂appropriate diet＂, ＂stress managemant＂ and ＂physical activities＂. Patients were monitored closely and visited physicians regularly. In control group a routine treatment was carred out without special program. Results After 3 years treatment, BP was lowered from 179±14/101±8 to 138±9/79±6 mm Hg vs control group from 176±14/99±8 to 153±13/87±11 mm Hg （P〈0. 01）. 71% of patients in intervention group reached the goal BP vs only 16% in control group（P〈0.01 ）. The blood lipid, blood glucose, blood uric acid decreased significantly in intervention group. One case （ 1.4 % ） fatal stroke was found in intervention group compared with 4 cases （5.7%, P〈0.05） of fatal stroke and 12 cases of cero-cardiovascular events （17%, P〈0.01）in control group. Conclusion Comprehensive intervention in communities signifcantly decrease complications of hypertension and cardiovascular death.
出处
《高血压杂志》
CSCD
北大核心
2006年第5期393-395,共3页
Chinese Journal of Hypertension
基金
广州市科研立项课题(2002Z3-E0111)
关键词
高血压
社区卫生服务
综合防治
Hypertension
Community health services
Comprehensive intervention
