社区原发性高血压综合干预——随访

Comprehensive Intervention on Primary Hypertension in Community

目的 :探讨原发性高血压综合干预模式及其疗效。方法 :对 1992年参加社区原发性高血压综合干预跟踪研究的 177名患者进行随访 ,被试者年龄范围 5 1-77岁 ,75 7%为退休人员。采用自编调查表、SCL -90和简短智力状态检查 (MMSE)量表对患者进行随访及现状调查 ,完成各种测查者共 15 2人。结果 :较好执行原治疗方案者占 44 1% (坚持度 >70 % ) ;目前治疗模式有三种 :(1)药物治疗 ,占 19 7% ,(2 )综合治疗 (除服药外包括低盐低脂饮食、戒烟酒、控制体重、增加活动和保持心理平衡 ) ,占 5 7 2 % ;(3 )药物 +运动 (运动量较大的体育活动 ) ,占 2 2 4% ;SCL -90测查结果显示 ,综合治疗和药物 +运动治疗的患者SCL -90总分、抑郁及焦虑因子分均低于单纯服药者 (P <0 0 5～ 0 0 1) ;认知功能明显受损者 (MMSE)占 0 7%。结论 :对原发性高血压患者采用综合干预措施可取得较好的远期效果 ,在药物治疗的基础上调整生活方式。

Objective:to study the effect of comprehensive intervention on primary hypertension in community Method:The authors did follow up study in 177 patients with primary hypertension,who were identified in 1992 Most of the patients were retired(75%),aged 51～77 At that time they were divided into two groups,control group with anti-hypertension drugs only and comprehensive group,with medication,low salt and low fat diet,weight control,stop drinking or smoking,increase of physical activity and keep mental Raalth In follow-up,we found 44% of patients could insist on the plan Actually,there are three groups:control group with anti-hypertension drugs only;comprehensive group with medication,low salt and low fat diet,weight control,stop drinking or smoking,and increase of physical activity;and the third group,with anti-hypertension drugs plus physical activity Apart from self-made inventory,SCL-90 and MMSE were used to assess the results of intervention By year 2001,152 patients completed the assessments Result:Assessed by SCL-90,the total score and subscores of anxiety and depression were lower in the latter two groups than in control group(P<0 05 or 0 01) Among all subjects,only one had obvious cognitive impairment(by MMSE) Conclusion:Comprehensive intervention on primary hypertension is helpful to patients