家庭医生责任制对服药高血压患者血压控制达标率的影响

Effect of the family doctor responsibility system on blood pressure control compliance rate of hypertensive patients taking medication

目的 :分析实施社区家庭医生责任制对社区高血压患者降压药物使用与血压控制达标率的影响。方法 :分别选取实施家庭医生责任制前(2011年)和后(2016年)上海打浦桥街道4个居委会常住居民中已建立健康档案的服药高血压患者643例和694例,平均年龄分别为(75.82±11.01)岁和(69.11±9.10)岁。比较这两组患者的抗高血压药物使用和血压控制达标情况。结果 :2011年和2016年的血压达标率分别为71.70%和85.70%,差异有统计学意义(P <0.001)。与2011年相比,2016年患者使用钙拮抗剂(CCB)、血管紧张素II受体拮抗剂(ARB)、b受体阻滞剂和新型复方制剂的比例增加,使用传统复方制剂的比例降低(P均<0.001);使用"ACEI/ARB+"和"CCB+b受体阻滞剂"二联治疗方案的比例明显增高。结论 :在家庭医生制度下,提高了合理用药和联合用药治疗方案的比例,提高了高血压患者血压达标率。

Objective： To analyze the effect of the community family doctor responsibility system on the use ofantihypertensive drugs and blood pressure control compliance rate in community hypertensive patients. Methods： Beforethe implementation of the family doctor responsibility system（2011） and after the implementation of it（2016）, 643 and 694cases of hypertension who established health records and took antihypertensive drug were selected in permanent residents inthe 4 neighborhood committees of Dapuqiao Community, Shanghai, and their mean ages were （75.82±11.01） years old and（69.11±9.10） years old. Antihypertensive drug use and blood pressure control compliance was compared between the two groups.Results： The blood pressure compliance rates in 2011 and 2016 were 71.70% and 85.70%, respectively, and the difference wasstatistically significant（P〈0.001）. Compared with 2011, the proportion of patients using calcium antagonists（CCB）, angiotensin IIreceptor antagonists（ARB）, ？ receptor blocker and new compound preparation increased in 2016, and the proportion of traditionalcompound preparation decreased（P〈0.001）; the proportion of the two combination regimens using “ACEI/ARB＋” and “CCB＋？receptor blocker＂ increased significantly. Conclusion： Under the family doctor responsibility system, the proportion of rationaldrug use and combined medication regimen has been improved, and the blood pressure compliance rate of hypertensive patientshas been improved.