钠钾比值干预法对高血压患者血压控制效果的研究

Study on the effect of sodium-potassium ratio intervention on blood pressure control in patients with hypertension

目的探讨钠钾比值干预法对高血压患者血压控制的效果,为制定减盐防控高血压政策提供科学依据。方法采取多阶段随机抽样法选取2017—2018年浙江省台州市天台县613例纳入社区健康管理的高血压患者为研究对象,随机分为干预组(305例)和对照组(308例),对照组接受《国家基本公共卫生服务规范(第四版)》要求的相关服务,干预组采用钠钾比值干预法进行干预,干预期为1年。评估干预前后两组研究对象减盐知识,态度与行为情况以及血压控制,尿钠、尿钾排泄,24 h盐摄入量等情况。采用SPSS 24.0软件进行t检验、χ^(2)检验。结果干预后,干预组平均收缩压、平均舒张压、尿钠排泄量、尿钠钾比值和估算24 h盐摄入量较本组干预前下降,且均低于对照组;尿钾排泄量较本组干预前上升,且高于对照组,差异均有统计学意义(P<0.05)。干预后,干预组知晓"吃盐过量有害健康"、乐意向家人宣传高盐膳食的风险、未来1个月有少吃盐的打算、目前采取减盐措施、使用定量盐勺、使用低钠盐的比例均高于干预前且高于对照组;知晓"少吃盐有助于降血压"的比例高于干预前,差异均有统计学意义(P<0.05)。结论钠钾比值干预法是高血压患者非药物治疗的重要组成部分,可在基层探索推广钠钾比检测等减盐适宜技术强化高血压患者降压效果。

Objectives To explore the effect of sodium-potassium ratio intervention on blood pressure control in patients with hypertension,and to provide the scientific basis for formulating policies of reducing salt to prevent and control hypertension.Methods The multi-stage stratified random sampling method was used to select 613 hypertension patients in community health management in Tiantai county of Taizhou city in Zhejiang Province from 2017 to 2018 as the subjects,which were divided into intervention group(305 cases) and control group(308 cases). The control group received the related services required by the National Basic Public Health Service Standards(Fourth Edition),the intervention group received the sodium-potassium ratio intervention for 1 year. The knowledge,attitude and behavior of salt reduction,blood pressure control,urinary sodium,urinary potassium excretion,and 24-hour salt intake were assessed before and after the intervention. SPSS 24.0 software was used for t test and χ^(2) test. Results The mean systolic pressure,mean diastolic pressure,urinary sodium excretion,sodium-potassium ratio and estimated 24 h salt intake in intervention group after intervention were significantly lower than those before intervention and those in control group,but the urinary potassium excretion in intervention group after intervention was higher than that before intervention or that in control group(P <0.05). After intervention,awareness rate of "excessive salt consumption is harmful to health",willing to publicize the risk of high-salt diets to family members,planning to eat less salt in the next month,adopting salt reduction measures,using a quantitative salt spoon,using low-sodium salt in intervention group were higher than those before intervention and those in control group,and awareness rate of "low salt is helpful to reducing blood pressure" after intervention was higher than that before intervention(P<0.05). Conclusion The sodium-potassium ratio intervention method is an important part of non-pharmacological treatment for hypertensive patients. Appropriate techniques for reducing salt,such as sodium-to-potassium ratio testing,can be explored and promoted in primary medical and health institutions to enhance the effect of reducing blood pressure in patients with hypertension.