高血压患者强化管理与常规管理的比较研究

A Comparative Study Between Strengthening Management and Conventional Management in Patients With Hypertension

目的：探讨高血压患者强化管理（MUST模式）与常规管理的比较研究。方法：建立高血压患者MUST管理模式，并与传统的常规管理模式比较，分析提高患者药物治疗、生活方式、血压监测、防治知识四个方面的依从性。210例高血压患者按照随机数字法分为两组，进入MUST强化管理模式的为干预组（n=105），采用常规管理模式的为对照组（n=105），均进行为期12个月的监测。分析比较两组血压控制和依从性的改进情况。结果：对药物治疗、生活方式、血压监测、防治知识四个分项依从性的分析，干预组上述四项指标依从性均得到显著改善，并且均分别优于对照组。干预组与对照组比较，收缩压和舒张压下降更多；干预组体质指数、胆固醇、甘油三酯、低密度脂蛋白胆固醇监测后与对照组同期比较均降低，差异均有统计学意义（P均〈0．05）。监测后干预组患者第12个月时完全从医比例为75．8％；干预组与对照组的血压控制率比较，始终较高，差异有统计学意义（X2=15．87～20．15，P〈0．05）。干预组在第3、6、9、12个月四个监测点的从医比例均分别高于对照组；而完全不从医比例每个监测点均显著低于对照组，差异均有统计学意义（X2=12．32～18．45，P〈0．05）结论：MUST模式强调家属作为监督者的身份参与高血压教育的重要性，可显著提高患者血压控制率和依从性。

Objective： To compare the differences between strengthening management （MUST） and conventional management in patients with hypertension. Methods： A total of 210 hypertension patients were randomly divided into 2 groups, Intervention group, the patients received strengthening management, in which the family member was involved for the education, and Control group, the patients received conventional management, n=105 in each group. The 4 compliances as medication, life style, blood pressure monitoring and prevention knowledge were compared between 2 groups and followed-up for 1 year. Results： The above 4 compliances in Intervention group were respectively and obviously improved than those in Control group. Compared with Control group, the Intervention group presented decreased systolic and diastolic blood pressure, decreased BMI, TC, TG and LDL-C, all P〈O.05. At the end of 12 months follow-up period, Intervention group had 75.8% of patients kept clinical consulting, and it also had better control rate of blood pressure （X 2=15.87-20.15, P〈O.05） than those in Control group. Intervention group also had higher clinical consulting rate at 3, 6, 9 and 12 months of examination time respectively （ X 2=12.32-18.45, P〈O.05）. Conclusion： MUST model emphasizes the family member involved patient education, which may significantly improve the control rate of blood pressure and the related compliances in patients with hypertension.