2019年兰州铁路局402名高血压患者管理效果及影响因素分析

Analysis on management effect and influencing factors of 402 hypertension patients in Lanzhou Railway Bureau in 2019

目的 探讨兰州铁路局对“第三类人员”实施健康维护前后高血压患者血压管理效果及其影响因素,为铁路局高血压患者规范化管理和干预提供参考依据。方法 2019年3、6、9及12月分别对该铁路局“第三类人员”402例高血压患者进行健康检查、问卷调查及健康维护,采用趋势性χ^(2)检验评价高血压患者管理效果,logistic回归方法进行高血压分级的影响因素分析。结果 该铁路局“第三类人员”高血压患者血压控制率第4季度与第1季度相比整体上升12.94%;从第1季度到第4季度,高血压患者中血压控制在正常值及1级高血压人数呈现上升趋势,增幅分别为98.18%和38.07%。高血压患者行为因素中食盐、肉和糖中不喜欢和适中者、运动每周3~<6次及每周≥6次、不饮酒者及规范用药者均呈现正向增长趋势。多元有序logistic回归结果显示,运动、规范用药及睡眠时长是影响高血压严重程度的影响因素(均P<0.01),运动每周≥6次和每周3~<6次是高血压分级的保护因素(OR=0.644,95%CI:0.486~0.854;OR=0.543,95%CI:0.379~0.779),不规范用药是高血压分级的危险因素(OR=1.362,95%CI:1.081~1.718)。睡眠时长为6~8 h者较>8 h者高血压升高1个等级的概率减少(OR=0.460,95%CI:0.332~0.638)。结论 经过1年的健康维护,兰州铁路局“第三类人员”高血压患者的血压控制率有所提升,健康教育和行为生活方式的干预能降低高血压患者健康风险。

Objective To explore the blood pressure management effect and its influencing factors among"Third-type personnel"in Lanzhou Railway Bureau before and after health maintenance,provide reference for the standardization management and intervention of patients with hypertension in the railway bureau.Methods In March,June,September and December of 2019,physical examination,questionnaire survey and health maintenance were carried out on 402 hypertension patients of"Third-type personnel"in the railway bureau.The trendχ^(2)test was used to evaluate the management effect of hypertension patients,and logistic regression analysis was used to analyze the influencing factors of hypertension classification.Results The blood pressure control rate of hypertension patients of"Third-type personnel"in the railway bureau increased by 12.94%in the fourth quarter as compared with the first quarter.From the first quarter to the fourth quarter,the number of hypertension patients with normal blood pressure and grade 1 hypertension showed the rising trend,with an increase of 98.18%and 38.07%respectively.Among the behavioral factors of hypertension patients,those who don’t like salt,meat and sugar and modestly consumed,exercised 3-<6 times a week and≥6 times a week,as well as non drinkers and standardized drug users showed a forward growth trend.The multiple ordered logistic regression results showed exercise,normative medication and sleep duration were the factors affecting the severity of hypertension(all P<0.01),exercising 3-<6 times a week and≥6 times a week was a protective factor of hypertension classification(OR=0.644,95%CI:0.486-0.854;OR=0.543,95%CI:0.379-0.779),and normative medication was a risk factor for hypertension classification(OR=1.362,95%CI:1.081-1.718).The patients with 6-8 hours of sleep had the less probability of hypertension rising by 1 grade than those with sleep duration of>8 hour (OR=0.460,95%CI:0.332-0.638).Conclusion After one year of health maintenance,the blood pressure control rate in hypertension patients of"Third-type personnel"in Lanzhou railway bureau has improved,and the intervention of health education and behavioral lifestyle can reduce the health risk of hypertensive patients.