高血压高危评估量表的应用性研究

Study on the application of the Hypertension Risk Assessment Scale

目的利用“高血压高危评估量表”研究高血压高危评分在人群中的分布情况，以及“高血压高危评估量表”在筛查高血压高危人群中的灵敏度。方法根据高血压高危因素及其Logistic回归的相关数据制作“高血压高危评估量表”，并分成A和B两大类因素；从11家社区卫生服务中心随机抽取高血压病人1167人作为高血压组，以健康档案编号与之相邻、同性别、年龄相差3岁以下、非亲属、无高血压居民1167人作为非高血压组，采用评估量表进行评分，分别统计两组的评分情况。结果除因素B1（年龄≥40岁）和B6（吸烟）外，其他各单因素及所有因素组合在两组人群中的分布差异有统计学意义（P〈0．001）；两组平均评分及各分数段单因素分布差异均有统计学意义（P〈0．05），A＋B组合因素在各分数段分布除“20～”段差异无统计学意义（P〉0．05）外，其他差异均有统计学意义（P〈0．001）。以A因素15．0分、B因素10．0分和A＋B因素20．0分作为确定高危人群的筛查判断标准可以达到≥86．37％的准确概率。结论“高血压高危评估量表”对筛查高血压“高危人群”具有良好的灵敏度及特异性，而且简单、操作性强，值得在社区应用。

Objective To reveal the distribution of risk factors of hypertension in population by the Hypertension Risk Assess- ment Scale, and the sensitivity of the scale in screening the population at high risk of developing hypertension. Methods The Hypertension Risk Assessment Scale was formulated based on the hypertension high risk factors and their relevant Logistic regres- sion data. The risk factors of hypertension were classified into 2 categories, including factors A and B. 1,167 hypertension pa- tients were randomly selected from 11 community health service centers as the hypertension group, while 1,167 individuals with- out hypertension, with adjacent health- recorder numbers, the same gender and age gap less than 3 years as well as being non- relatives were assigned into the control group. The risk of hypertension among individuals in the two groups was scored using the Hypertension Risk Assessment Scale and the scores were statistically analyzed. Results The incidence of the risk factors for both the single factors, except B1 （the age of 40 years or above） and 136 （smoking）, and the combined factors （A ＋ B） was sta- tistically significant different between the two groups （P 〈 0. 001 ）. The average scores and the incidence of the single factors among individuals with various ranges of scores were statistically different between the two groups （P 〈 0.05）. There were sta- tistieally significant differences in the incidence of each score range of the combined factors A and B（P〈 0. 001 ） except in the score range of 20- （P〉0.05）. Having 15, 10, and 20.0 as the cutoff values for factors A, B and A ＋ B in screening high- risk population for hypertension, the accuracy of the judgment could reach 86.37% and above. Conclusions The Hyperten- sion Risk Assessment Scale has a good sensitivity and specificity in screening population at high risk for hypertension; moreover, it is simple, operable, and worthy of being applied in community health service centers.