家庭医生工作室模式管理伴高同型半胱氨酸血症高血压患者的效果评价

Evaluation of the effect of family doctor’s studio mode in the management of hypertensive patients with hyperhomocysteinemia

目的:评价家庭医生工作室模式管理伴高同型半胱氨酸血症高血压患者的效果。方法:于2018年1—11月选取接受管理的伴高同型半胱氨酸血症高血压患者100例,随机分成干预组和对照组,每组各50例。对照组按高血压管理规范由工作室护理人员进行随访管理,干预组由家庭医生工作室模式下医生和护士共同进行随访管理,随访管理1年后,观察两组高血压控制率、脑血管事件发生率和同型半胱氨酸水平的变化。结果:干预后干预组患者的血压控制率高于对照组(70%比50%,P<0.05),心脑血管事件发生率明显低于对照组(4%比18%,P<0.05),血脂异常率明显低于对照组(40%比58%,P<0.05)。两组同型半胱氨酸水平差异无统计学意义(P>0.05)。结论:家庭医生工作室模式下管理伴高同型半胱氨酸血症高血压患者可提高血压控制率,降低血脂异常率和心脑血管发生率,但对血同型半胱氨酸水平无明显影响。

Objective:To evaluate the effect of the family doctor’s studio mode in the management of hypertensive patients with hyperhomocysteinemia.Methods:From January to November 2018,100 managed hypertensive patients with hyperhomocysteinemia were selected and randomly divided into an intervention group and a control group with 50 cases in each group.The control group was followed up and managed by the nurses in the studio according to the hypertension management standards,the intervention group was followed up by doctors and nurses under the family doctor studio mode,and after one year of follow-up and management,the control rate of hypertension,the incidence of cerebrovascular events and the changes and effects of homocysteine levels in the two groups were observed.Results:After the intervention,the blood pressure control rate of the intervention group was higher than that of the control group(70%vs.50%,P<0.05),the incidence of cardiovascular and cerebrovascular events of the intervention group was significantly lower than that of the control group(4%vs.18%,P<0.05),the dyslipidemia rate of the intervention group was significantly lower than that of the control group(40%vs.58%,P<0.05),and there was no statistically significant difference in the levels of homocysteine between the two groups(P>0.05).Conclusion:The management of hypertensive patients with hyperhomocysteinemia under the family doctor studio mode can improve blood pressure control rate,reduce the rate of abnormal blood lipids and the incidence of cardiovascular and cerebrovascular diseases,but it has no significant effect on the level of serum homocysteine.