摘要
目的观察综合干预治疗对原发性高血压(高血压)患者疗效的影响。方法选择500例诊断为高血压且具有下列至少1项可干预的危险因素的患者:(1)血脂异常(总胆固醇≥5.7 mmol/L);(2)糖尿病[空腹血糖≥7.0 mmol/L或(和)餐后2 h血糖≥11.1 mmol/L];(3)肥胖(体质量指数≥28 kg/m2)。按随机平行对照临床试验,将入选患者分成综合干预组(n=220)及一般治疗组(n=280)。监测并比较两组血压、靶器官功能损害及并发症发生率。结果严格干预两年后,综合干预组的血压控制效果优于随意治疗组[收缩压(140.09±15.18)mm Hg vs.(145.90±16.8)mm Hg;舒张压(79.12±13.38)mm Hg vs.(81.90±13.63)mm Hg],差异有统计学意义(P<0.05);综合干预组靶器官功能损害指标(左心室射血分数、颈动脉内膜中层厚度、血清肌酐和尿蛋白浓度)均明显好于一般治疗组,差异有统计学意义(P均<0.05)。综合干预组心脑血管事件(急性心肌梗死、不稳定型心绞痛、脑出血、脑梗死、短暂性脑缺血发作)发生率均明显低于一般治疗组,差异有统计学意义(P均<0.05)。结论社区综合干预治疗高血压是延缓靶器官功能损害及预防脑出血、脑梗死、急性心肌梗死、脑卒中等心脑血管事件的有效手段。
Objectives To investigate the effect of community combination intervention treatment on hypertension. Methods Parallel randomized comparison clinical trial was used. 500 patients with hypertension who also had one or more of the following intervene risk factors were included in this study: (1) dyslipidemia (total cholesterol≥5.7 retool/L) ; ( 2 ) diabetes E fasting plasma glucose ≥ 7.0 mmol/L and (or) 2 -hour postprandial blood glucose ≥ 11.1 mmol/L ] ; (3) obesity (body mass index ≥ 28 kg/m2). The patients were divided into combination intervention treatment group (n= 220) and optional treatment group (n=280). Blood pressure, targeted organ damage and incidence of complications between the two groups were measured and compared. Results Blood pressure control of combination intervention treatment group significantly surpassed optional treatment group [systolic blood pressure (140.09±15.18)mm Hg vs. ( 145,90±16.81 )mm Hg, diastolic blood pressure ( 79.12 -± 13.38 )mm Hg vs. ( 81.90 ± 13.63 )mm Hg, P〈0.05 ]. Patients in combination intervention treatment group were with significantly lighter targeted organ damage,including left ventricular ejection fraction, carotid intimal-medial thickness, serum ereatinine, urinary albumin when compared with optional treatment group (P〈0.05). Incidences of cardiovascular and cerebrovascular events, including acute myocardial infarction, unstable angina, cerebral hemorrhage, cerebral infarction, transient isehemic attack in combination intervention treatment group were significantly lower than those in optional treatment group (P〈0.05). Conclusions It is important for community combination intervention treatment to control hypertension, which can prevent complications of hypertension, targeted organ damage, cardiovascular and cerebrovascular events.
出处
《岭南心血管病杂志》
2012年第5期521-524,共4页
South China Journal of Cardiovascular Diseases
基金
广州市番禺区科技局立项(项目编号:2009-Z-82-1)
关键词
高血压
干预治疗
危险因素
靶器官功能损害
心脑血管事件
hypertension
intervention treatment
risk factor
targeted organ damage
cardiovascular and cerebrovascular events