西藏林芝、拉萨、安多3个不同海拔区县高血压患者用药情况分析

Analysis of the antihypertensive drug usage and effectiveness in three counties with different altitudes in Tibet Autonomous Region in China

目的探讨西藏3个区县高血压患者的用药情况。方法 2014-2016年在西藏林芝县(海拔3000m)、拉萨市区(海拔3650m)、安多县(海拔4700m)每个区县随机抽取社区居民1000人进行心血管病患病率调查,对检出的有高血压史的患者的用药情况进行分析。结果 3个区县共检出有高血压史的患者490例(林芝县148例、拉萨市190例、安多县152例),2周内经常服用降压药者的比例均<40.0%,2周内经常服用降压药者的血压控制率均<50.0%。在高血压患者使用的药物中,藏药和中成药占有相当大的比重,占各类药物使用频次的36.84%。拉萨市区有72.55%的患者单用藏药进行降压治疗,该地区2周内经常服用降压药患者的血压控制率仅为15.7%。结论西藏地区高血压患者的药物治疗状况不容乐观,亟需对药物治疗现状进行进一步的深入分析并开展规范化的管理和治疗。

Objective To explore the usage and effectiveness of the antihypertensive drugs in three counties or districts in Tibet Autonomous Region in China. Methods Surveys on the prevalence of major cardiovascular disease were conducted in Linzhi county （altitude 3000 meters）, Chengguan district of Lasa city （altitude 3650 meters） and Anduo county （altitude 4700 meters） from 2014 to 2016. One thousand residents were randomly selected from each county （district） and the information on cardiovascular disease, related risk factors and drug usage data was collect- ed. The antihypertensive drug usage and effectiveness of the hypertensive patients were analyzed. Results A to- tal of 490 hypertensive patients were identified during the surveys, 148 were from Linzhi county, 190 from Cheng- guan district and 152 from Anduo county. For the three counties （district）, the proportions of the patients taking antihypertensive drugs regularly in the nearest two weeks were all below 40.0 % and the control rates of hypertension for these patients were all below 50.0%. The drugs used most frequently were Tibetan and Chinese herbs, which accounted for 36.84 % of all the drugs used. In Chengguan district, 72.55 % of the patients took only Tibetan herbs and the control rate of hypertension for the patients taking antihypertensive drugs in the nearest two weeks was 15.7%. Conclusion The situation is not ideal for the drug therapy of hypertension in Tibet. It is needed to carry out extensive research on the drug therapy and to promote the standardized treatment and management of hypertensive patients in Tibet.