整体化慢性病管理理论对高血压患者血压及负面情绪等的影响

Impact of integrated chronic disease management theory on blood pressure and negative emotion etc.in hypertensive patients

目的:探讨高血压患者应用整体化慢性病管理理论(ICDMT)对其血压、负面情绪等的影响。方法:将本院2022年3月至2023年3月期间首诊为高血压的111例患者纳入研究,依据电脑数字表法分为整体组(n=55)和对照组(n=56),研究过程中整体组失访4例,对照组失访5例,最终共纳入102例患者,每组51例。对照组实施常规管理干预,整体组在对照组的基础上增加ICDMT干预,两组均干预6个月。分析两组干预前后血压水平、负面情绪、生化指标及生活质量,比较两组不良事件发生率。结果:与对照组比较,整体组干预后收缩压(SBP)[(143.88±5.70)mmHg比(133.29±5.55)mmHg]、舒张压(DBP)[(91.21±2.26)mmHg比(83.26±3.48)mmHg]、焦虑自评量表(SAS)[(55.31±2.17)分比(38.86±0.87)分]、抑郁自评量表(SDS)[(53.79±1.89)分比(38.90±0.85)分]评分、同型半胱氨酸(Hcy)[(14.50±0.83)μmol/L比(12.23±0.60)μmol/L]和氨基末端脑钠肽前体(NT-proBNP)[(387.42±54.50)ng/ml比(273.22±54.48)ng/ml]水平,明尼苏达心力衰竭生活质量问卷(MLHFQ)评分[(57.64±1.86)分比(51.17±1.62)分]显著降低(P均=0.001)。与对照组比较,整体组不良事件发生率(35.29%比13.73%)显著降低(χ^(2)=6.411,P=0.011)。结论:ICDMT可以显著控制高血压患者血压、生化指标水平,改善负面情绪及生活质量,具有较高安全性,值得临床推广。

Objective:To investigate the impact of integrated chronic disease management theory(ICDMT)on blood pressure and negative emotion etc.in hypertensive patients.Methods:A total of 111 patients with hypertension who were first diagnosed in our hospital from March 2022 to March 2023 were included in the study,and they were divided into ICDMT group(n=55)and control group(n=56)according to the digital table method.During the study,4 patients in ICDMT group and 5 patients in control group were lost,and a total of 102 patients were finally included,with 51 patients in each group.The control group received conventional management intervention,and the ICDMT group received additional ICDMT intervention based on control group,both groups were intervened for 6 months.Blood pressure levels,negative emotion,biochemical indexes and quality of life before and after intervention,and the incidence rate of adverse events was compared between two groups.Results:Compared with control group,there were significant reductions in systolic blood pressure(SBP)[(143.88±5.70)mmHg vs.(133.29±5.55)mmHg],diastolic blood pressure(DBP)[(91.21±2.26)mmHg vs.(83.26±3.48)mmHg],scores of self-rating anxiety scale(SAS)[(55.31±2.17)points vs.(38.86±0.87)points],self-rating depression scale(SDS)[(53.79±1.89)points vs.(38.90±0.85)points],levels of homocysteine(Hcy)[(14.50±0.83)μmol/L vs.(12.23±0.60)μmol/L]and N terminal pro brain natriuretic pepti de(NT-proBNP)[(387.42±54.50)ng/ml vs.(273.22±54.48)ng/ml],score of Minnesota Living with Heart Failure Questionnaire(MLHFQ)[(57.64±1.86)points vs.(51.17±1.62)points]in the ICDMT group after intervention(P=0.001 all).Compared with control group,there was significant reduction in incidence rate of adverse events(35.29%vs.13.73%)in ICDMT group(χ^(2)=6.411,P=0.011).Conclusion:ICDMT can significantly control blood pressure and biochemical indexes,improve negative emotions and quality of life in hypertensive patients with high safety,which is worthy of clinical promotion.