急性缺血性脑血管病患者一级预防中高血压防治现状

The current status of the primary hypertension prevention in patients with acute ischemic cerebrovascular diseases.

目的调查分析急性缺血性脑血管病患者一级预防中高血压的防治状况。方法回顾性统计分析我院1年中急性脑梗死或短暂性脑缺血发作(transient ischemic attack,TIA)伴有高血压的住院患者入院前的高血压知晓率、治疗率及控制率。按文化程度分为小学,初中,高中,大学及以上4组,分别比较各组的治疗率和控制率。针对各组中高血压病进行分级统计,比较相同级别的不同文化程度患者人群之间的控制率是否有不同。结果以急性脑梗死或TIA入院的高血压患者518例中患者对高血压的知晓率、治疗率和控制率分别为51.9%、47.5%和25.2%。269例高血压知晓者中,按受教育层次分为小学、初中、高中和大学及以上4组,各组总体治疗率和控制率比较均P<0.05,差异有统计学意义,各组间控制率比较,小学和初中无统计学差异,P>0.05;初中和高中及高中与大学及以上组比较,均P<0.05,差异有统计学意义。各受教育组中,分别按高血压病分级法将患者分级,相同高血压分级患者,各组间总体的控制率有差异;在高血压病1级组中,各文化层次不同组产生的不同控制率之间的差异有统计学意义,与受教育程度呈正相关。结论针对急性缺血性脑血管病的一级预防,高血压的防治工作仍旧十分滞后。需要提高针对低文化层次的患者宣教监督管理,来提高血压病的治疗率与控制率。

Objective To investigate the status of prevention and treatment of hypertension in the primary prevention of acute ischemic stroke. Methods The status of prehospital medication and their awareness of hypertension were analyzed retrospectively in 518 patients with hypertension admitted to our hospital due to acute cerebral infarction or transient ischemic attack （TIA） during last year. The patients were divided into four groups based on their education levels into primary school, junior high school, high school, and university or above groups. The treatment and control rates were compared among these groups. Patents in each group were further divided into different subgroups based on the degree of hypertension and then treatment rate as well as the control rate were compared among subgroups. Results Hypertension awareness, treatment and control rates were 51.9%, 47.5% and 25.2% in 518 patients with hypertension, respectively. In 269 patients who were aware of high blood pressure, the differences in treatment and control rates were significant among elementary, middle and high schools and universities or above groups. Furthermore, the differences were also significant between middle and high schools or between high school and university or above but were not sig- nificant between the primary and junior high school groups. In patients with same degree of hypertension, treatment and control rates were different among patients with different education background. The control rate was significantly different among patients with different education background control rate was positively correlated with the levels of education. Conclusions Prevention and control of the hypertension for primary prevention of acute cerebral stroke in patients is very behind. Special attention should be paid to improving disease education in patients with low level education background to increase treatment and control rates of hypertension.