沈阳市社区高血压合并糖尿病患者的药物使用情况与影响因素分析

Analysis of antihypertensive drug use and influencing factors in community patients with hypertension combined with diabetes in Shenyang

目的分析沈阳市社区高血压合并糖尿病患者的药物使用情况与影响因素,为管理措施提供科学依据。方法选取2020年1月3~20日沈阳市社区的805例高血压合并糖尿病患者作为研究对象,统计其降压药物使用情况、联合用药情况,采用单因素及多因素logistic回归模型对药物使用情况的相关影响因素进行分析。结果2020年沈阳市社区高血压合并糖尿病患者占高血压群体的21.23%,其人群的血压控制率为4.84%。药物使用情况中,服用1种及2种以上降压药物的患者各占63.98%、7.20%;其中服用1种药物的种类包括钙通道阻滞剂(calcium channel blocker,CCB)、血管紧张素转化酶抑制剂(angiotensin converting enzyme inhibitor,ACEI)、血管紧张素Ⅱ受体阻滞剂(angiotensinⅡreceptor blocker,ARB)、β受体阻滞剂、利尿剂及其他药物,其中CCB的使用频次最多,占60.97%;其次为ARB占19.42%;多因素logistic回归分析结果显示:老年(OR=1.634,95%CI:1.149~2.324)、吸烟(OR=1.931,95%CI:1.260~2.959)、饮酒(OR=1.660,95%CI:1.084~2.542)是高血压合并糖尿病用药情况的影响因素。结论沈阳市社区高血压合并糖尿病的患病率占高血压群体的1/5,但其人群的血压控制率低,应积极探索其管理模式,改善用药情况,以获取更大的健康效益。

Objective To understand the drug use and influencing factors of patients with hypertension combined with diabetes in the community of Shenyang city,and to provide scientific basis for management measures.Methods 805 patients with hypertension combined with diabetes in the community of Shenyang city in 2020 were selected to describe their antihypertensive medication use and combination of medications,and the related influencing factors of medication use were analyzed by using unifactorial and multifactorial logistic regression models.Results In 2020,the prevalence of hypertension combined with diabetes in the Shenyang community was 21.23%,but its blood pressure control rate was 4.84%.In the use of antihypertensive medications,63.98%of patients were taking 1 antihypertensive drug and 7.20%were taking 2 or more in the Shenyang community.Among them,the types of one medication included calcium channel blocker(CCB),angiotensin-converting enzyme inhibitor(ACEI),angiotensinⅡreceptor blockers(ARB),β-blocker,diuretic and others.CCB was used most frequently at 60.97%,followed by ARB at 19.42%.The results of multifactorial logistic regression analysis showed that old age(OR=1.634,95%CI:1.149~2.324),smoking(OR=1.931,95%CI:1.260~2.959),and alcohol consumption(OR=1.660,95%CI:1.084~2.542)were the most important factors for hypertension medication using in combined diabetes.Conclusion The prevalence of hypertension combined with diabetes in the community of Shenyang accounted for about one-fifth of the hypertensive population,but the rate of blood pressure control in its population was low.And its management mode should be actively explored to improve the medication use to obtain greater health benefits.