中国老年高血压患者社区管理效果的Meta分析

Meta-analysis on general practitioners management for Chinese elderly patients with hypertension

目的针对中国老年高血压社区管理研究数据进行Meta分析,探讨合理有效的新型血压管理模式。方法纳入研究均为随机对照研究,入选对象为60岁以上高血压病患者,采用Meta分析软件Revman5.0研究老年高血压病患者全科医生管理的效果,并设立社区护士和联合医护人员管理亚组进行比较。结果干预组和对照组的舒张压、收缩压比较,差异均有统计学意义(均P<0.05),社区管理能够有效控制中国老年高血压患者的血压。不同干预者类型对中国老年高血压患者舒张压[社区护士:SMD为-1.12(-1.37^-0.86),I2=88.6%,社区医师:SMD为-1.28(-1.81^-0.76),I2=96.5%;社区医师和护士:SMD为-0.77(-1.28^-0.27),I2=89.8%]和收缩压[社区护士:SMD为-1.12(-1.37^-0.86),I2=88.6%;社区医师:SM D为-1.28(-1.81^-0.76),I2=96.5%;社区医师和护士:SMD为-0.58(-1.08^-0.07),I2=81.6%]的控制效果比较,差异均无统计学意义(均P>0.05)。结论社区管理可有效控制老年患者的血压,社区医护的多种模式均可采用。

Objective To study the data of general practitioners management for Chinese elderly hypertension by Meta-analysis, and to explore reasonable and effective blood pressure management pattern. Methods As randomized controlled study, hypertension patients with 60 years old or ahove were selected, and Meta-analysis software Revman 5.0 were used to research the effect of senile hypertension patient general practitioners management, and set up sub-group of nurse and united medical staff management. Results Diastolic and systolic blood pressure in intervention group and control group were significant difference（all P〈0.05）, general practitioners management can effectively control the blood pressure in elderly patients with hypertension. The effects of diastolic and systolic blood pressure of Chinese elderly hypertension in different types of intervenors [community nurses： SMD -1.12（-1.37--0.86）, F=88.6%;community doctors： SMD -1.28（-1.81--0.76）, I2=96.5%; community doctors and nurses： SMD -0.77（-1.28--0.27）,I2=89.8%] and systolic blood pressure [community nurses：SMD -1.12（-1.37--0.86）, I2=88.6%; community doctors： SMD -1.28（-1.81--0.76）, I2=96.5%; community doctors and nurses： SMD -0.58（-1.08--0.07）, I2=81.6%] were not significant difference（all P〉0.05）. Conclusions General practitioners management in Chinese elderly hypertension is effective, and mult-patterns can be adopted.