摘要
目的了解基层医院对高血压患者治疗的规范性和有效性。方法对北京市大兴区长子营镇中心卫生院于2013年1月~2015年12月间,604例高血压患者降压药物使用及血压控制情况进行回顾性分析。降压药物分三类:推荐制剂、传统制剂、中药制剂。推荐制剂即《中国高血压基层管理指南》推荐降压药:血管紧张素转换酶抑制剂(ACEI)、血管紧张素II受体拮抗剂(ARB)、β受体阻滞剂(βRB)、钙通道阻滞剂(CCB)和利尿剂(HCTZ);传统制剂:降压0号、复方利血平等;中药制剂:清肝降压胶囊、牛黄降压胶囊等。平均治疗时间为12.31±5.54 d,治疗后连续3 d血压≤140/90mm Hg为血压达标(1 mm Hg=0.133k Pa);达标率=达标患者数/治疗人数×100%。结果 604例患者年龄在40~96岁之间,平均(63.44±10.12)岁;其中男性259例,女性345例;平均高血压病程为8.5±8.2年;住院时限为10~20 d,治疗后血压不同程度降低,收缩压从入院时的151.9±15.6 mm Hg,到治疗后的128.5±8.0 mm Hg;舒张压从91.7±9.8 mm Hg降到79.6±4.9 mm Hg。总体达标率为98.5%,高血压1~3级患者达标率分别为100%,99.4%,97.82%。在药物的使用方面563例选择推荐制剂占93.2%,31例使用传统制剂+推荐制剂占5.1%,10例使用中药制剂+推荐制剂占1.6%。推荐制剂使用中,单种制剂、两种制剂和三种制剂分别为54.88%,40.6%和4.4%。单种推荐制剂使用中67.6.1%为CCB,两种制剂联合使用者86.4%为CCB+ACEI/ARB。三种制剂联合使用中68.0%为ACEI+ARB+βRB,4%为CCB+ACEI+ARB。结论基层医院住院患者高血压治疗总体规范,达标率高达98%以上;93%以上的患者使用了推荐制剂,单一和二联制剂使用规范,三种制剂的联合用药的选择上存在作用机制相同的药物重复使用,有一定局限性,可能是少数患者血压不达标的原因。
Objective To investigate the normative and effective treatment of patients with essential hypertension in primary hospitals. Methods A retrospective analysis was conducted on the use of antihypertensive drugs and blood pressure control in 604 hypertensive patients from January 2013 to December 2015.Antihypertensive drugs are divided into three categories: recommended preparations, traditional preparations,traditional Chinese medicine preparations. Recommended agents include angiotensin converting enzyme inhibitors (ACEI), angiotensin II receptor antagonists (ARB), beta blockers (βRB), calcium channel blockers (CCB) and diuretics (HCTZ); Traditional preparations include: antihypertensive 0, compound reserpine equality; traditional Chinese medicine preparations include: Qinggan Jiangya capsule, Niuhuang Jiangya capsules and so on. The average treatment time was 12.31±5.54 days, after treatment for three consecutive days blood pressure≤140/90 mmHg for blood pressure standards. The average treatment time was 12.31±5.54 days. The blood pressure was considered well controlled if the blood pressure≤140/90 mmHg for three consecutive days after treatment. Compliance rate =number of patients / number of treatment × 100%. Results 604 patients were aged between 40 and 96 years with average age (mean 63.44±10.12 years, including 259 males and 345 females. The mean duration of hypertension was 8.5±8.2 years and the hospitalization period was 10 to 20 days. The systolic blood pressure of the patients decreased from 151.9±15.6 mmHg to 128.5±8.0 mmHg, and the diastolic blood pressure decreased from 91.7 ± 9.8 mmHg to 79.6±4.9 mmHg after treatment. The overall compliance rate was 98.5% for all patients, and the compliance rates were 100%, 99.4%, 97.82% respectively in hypertension patients in level 1, 2 and 3. In the use of drugs, 563 patients (93.2%) selected recommended agents; 31 patients (5.1%) using traditional formulations +recommended preparations; 10 patients (1.6%) using traditional Chinese medicine preparat
作者
张彩红
鲍艳江
郭雪微
ZHANG Cai-hong;BAO Yan-jiang;GUO Xue-wei(Daxing Zhangziying Health Center,Beijing 102615, China)
出处
《中国循证心血管医学杂志》
2017年第3期335-338,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
高血压
药物治疗
达标率
基层医院
Hypertension
Drug therapy
Compliance rate
Primary hospital
