老年高血压患者睡眠干预效果评价

Effect evaluation of sleep intervention on elderly patients with hypertension

目的评价睡眠干预对老年高血压患者的综合干预效果。方法纳入2016年上海市杨浦区延吉社区卫生服务中心登记管理的老年原发性高血压患者,分成干预组和对照组。对照组给予常规药物治疗和生活方式干预,干预组在此基础上实施以认知行为疗法为核心的睡眠干预;通过比较两组患者干预前后的匹兹堡睡眠质量指数(PSQI)、血压晨峰(MBPS)和心脑血管疾病发生率,评价综合干预效果。结果共纳入184例老年高血压患者,其中干预组102例,对照组82例。干预组患者干预前后PSQI得分分别为(14.17±3.68)和(11.36±2.15)分,对照组分别为(14.41±4.07)和(13.85±3.56)分,干预组PSQI得分下降幅度大于对照组(P<0.05);干预组患者干预前后MBPS值分别为(39.61±4.37)和(30.77±3.72)mm Hg,对照组分别为(40.17±4.25)和(39.12±4.26)mm Hg,干预组MBPS值下降幅度大于对照组(P<0.05);干预组心脑血管疾病发生率为2.94%,低于对照组的10.98%(P<0.05)。结论睡眠干预可提升社区老年高血压患者的睡眠质量,从而改善血压控制,预防心脑血管事件的发生。

Objective To explore the impact of sleep intervention on elderly patients with hypertension. Methods Elderly hypertensive patients were selected from Yanji Community Health Service during the year of 2016 and were divided into the intervention group and the control group. The control group was treated with the standardized drug treatment and traditional lifestyle intervention; the intervention group was in addition given sleep intervention based on cognitive behavioral therapy（CBT）. The Pittsburgh sleep quality index（PSQI）, morning blood pressure surge（MBPS） and the incidence rate of cardiovascular events were compared between the two groups after three months. Results A total of 184 elderly patients with hypertension were recruited,with 102 cases in the intervention group and 82 cases in the control group. In the intervention group,the PSQI before and after the treatment was（14.17 ±3.68） points and（11.36±2.15） points; the MBPS was（39.61 ±4.37） mm Hg and（30.77±3.72）mm Hg. In the control group,the PSQI before and after the treatment was（14.41±4.07）points and（13.85 ±3.56）points; the MBPS was（40.17 ±4.25）mm Hg and（39.12 ±4.26）mm Hg. The PSQI and MBPS in the intervention group were significantly reduced and remarkably lower than those in the control group（P0.05）. The incidence rate of cardiovascular events in the intervention group（2.94%） was significantly lower than that in the control group（10.98%）（P0.05）. Conclusion Sleep intervention based on CBT could significantly improve the sleep quality, thus promote the control of blood pressure and further prevent the cardiovascular events among elderly patients with hypertension.