全科医生综合干预对社区高血压患者血压管理效果评价

Effect of comprehensive intervention of general practitioner on patients with hypertension in community

目的 :评价在全科医生的综合干预下对社区高血压患者血压管理效果。方法 :在所辖区域内随机抽取2个居委的高血压患者673人,由社区全科医生依据《中国高血压防治指南(2010版)》制订个体化、综合性的干预治疗方案,干预1年后比较高血压知晓率、治疗率、控制率、吸烟、饮酒、糖耐量异常、血脂异常和食盐摄入等危险因素的变化情况。结果 :研究共入选高血压患者673人,完成研究658人;干预1年后知晓率、治疗率、控制率分别提高了35.2%、40.7%、29.5%;高血压患者收缩压自基线调查时的(158±17.9)mmHg降至(142±12.4)mmHg,舒张压自基线调查时的(93±12.1)mmHg降至(82.6±11.7)mmHg,差异具有统计学意义(P<0.01);具有每日食盐量超标、血脂异常、BMI超标、饮酒、缺少运动等危险因素的病例数也有明显降低。结论 :在全科医生的综合干预下,社区高血压患者的血压水平有明显下降,高血压的知晓率、治疗率、控制率有明显提高,危险因素可得到较好控制。

Objective： To evaluate the management effect of the comprehensive intervention of general practitioner on the control of blood pressure in patients with hypertension in community. Methods： Six hundred and seventy-three hypertension patients were randomly selected in the area of 2 residents committee, to whom a comprehensive individualized intervention therapy was formulated by general practitioner based on ＂Chinese Hypertension Prevention Guide＂. The indications such as the rates of the awareness, treatment and control of hypertension, abnormal glucose tolerance and dyslipidemia, and the changes of smoking, drinking, salt intake and other risk factors were compared before and after one year＇s intervention. Results： Six hundred and fifty-eight patients finally completed this study. The rates of awareness, treatment and control were increased by 35.2%, 40.7% and 29.5%, respectively, after one year＇s intervention. Systolic blood pressure in patients at baseline survey was declined from （ 158~17.9 ） mmHg to （ 142~12.4 ） mmHg and diastolic blood pressure from （ 93~12.1 ） mmHg to （ 82.6~11.7 ）mmHg. Both of the differences were statistically significant （P〈0.01）. The cases with the hyper intake of daily salt, dyslipidemia, hyper BMI, alcohol drinking, lack of exercise and other risk factors were also decreased. Conclusion： The above mentioned indications were remarkably improved and risk factors were better controlled.