上海市某社区卫生服务中心抗高血压药物使用及控制情况分析

Analysis of the use and control of antihypertensive drugs in a community health service center in Shanghai

目的:调查上海市宝山区罗店镇社区卫生服务中心抗高血压药物使用及控制情况,为合理用药及后续优化血压管理提供参考。方法:选取上海市宝山区罗店镇社区卫生服务中心2021年10月前在管的高血压患者,通过随机抽样选取并集中开展基线调查,采集患者基本信息、既往史、高血压诊断、治疗、管理及相关行为等,于2021年11月集中完成921例基线调查。统计和分析抗高血压药物使用分布、用药方法(单药/联合)、具体用药方案治疗的分布情况、不同用药方法下的血压控制情况、不同病程组下的用药情况。结果:921例高血压患者中,降压药物使用率占97.72%(900/921),其中使用指南推荐药物者占98.00%(882/900)。高血压药物使用依次是血管紧张素Ⅱ受体拮抗剂(ARB)、钙通道阻滞剂(CCB)、复方制剂、利尿剂、β受体阻滞剂(β-RB)、血管紧张素转换酶抑制剂(ACEI),分别占60.26%(555/921)、59.07%(544/921)、29.32%(270/921)、27.69%(255/921)、12.16%(112/921)、3.91%(36/921)。上海某社区在管高血压患者抗高血压药用药方法中,单用抗高血压药物的患者占比最大,达46.33%(417/900)。二联、三联、四联中分别以ARB+CCB、ARB+利尿剂,ARB+CCB+利尿剂,ARB+CCB+利尿剂+β-RB为主。运用标准化测量方法测量血压显示,随机抽样人员不同用药方法下血压控制率为46.67%(420/900),不同用药方法下的血压控制率比较差异无统计学意义(P>0.05)。高血压病程在10年以下的患者不用降压药和使用单药的情况多于病程在10年以上的患者;高血压病程在10年以上的患者使用三联和四联降压药物明显多于10年以下患者,并且随着病程的增长而增加,在20年以上病程时,使用三联和四联降压药物的情况更多,差异均有统计学意义(P<0.05)。结论:ARB和CCB是临床常用的抗高血压药物。上海市宝山区罗店镇社区卫生服务中心抗高血压药物应用基本合理,符合抗高血压用药的用药原则,但不同用药方法下的血压控制率均较低。

Objective To investigate and analyze the use and control of antihypertensive drugs,and provide reference for reasonable medication and subsequent optimization of blood pressure management.Methods Patients from high blood pressure in the health-center management before October 2021 were selected and carried out baseline surveys through random sampling,collecting basic information,previous history,hypertension diagnosis,treatment,management and related behaviors,etc,and completed the 921 cases of base line surveys in November 2021,and included statistical and analysis of the distribution of antihypertensive drugs,medication methods(single medicine/combination),the distribution of specific medication schemes,blood pressure control conditions under different medication methods,and medication conditions under different disease groups.Results Among 921 cases surveyed by the center line of the center were 97.72%(900/921)among patients with hypertension,and drugs were recommended,accounting for 98.00%(882/900).The use of antihypertensive drugs was ARB,CCB,compound preparations,diuretics,β-blockers,and ACEI,accounting for 60.26%(555/921),59.07%(544/921),29.32%(270/921),27.69%(255/921),12.16%(112/921),3.91%(36/921).In a community in Shanghai,in patients with hypertension patients,patients with antihypertensive drugs accounted for the largest proportion of patients with antihypertensive drugs,reaching 46.33%(417/900).In the two coupons,triple,and four coupons,ARB+CCB,ARB+diuretics;ARB+CCB+diuretics;ARB+CCB+diuretic+β-blockers.The use of standardized measurement methods to measure blood pressure display random sampling personnel under different medication methods was 46.67%(420/900)under different medication methods,and there was no statistically significant difference in blood pressure control rate under different medication methods(P>0.05).Patients with hypertension with a course of more than 10 years used triple and quadruple antihypertensive drugs than patients with less than 10 years,and as the course of the disease increases,when the course of more than 20 years,the situation of the use of triple and quadruple antihypertensive drugs was more common,the differences was statistically significant(P<0.05).Conclusions ARB and CCB are commonly used antihypertensive drugs in clinical practice.The use of antihypertensive drugs in Luodian Community Health Service Center,Baoshan District,Shanghai is basically reasonable,which conforms to the medication principle of antihypertensive drugs,but the blood pressure control rate under different medication methods is low.