西南地区基于慢性病防控科技综合示范干预模式的血压管理研究

Blood pressure management based on technology comprehensive demonstration of chronic disease intervention model in southwest China

目的评估“慢性病防控科技综合示范干预模式”在西南地区项目点实施后的血压管理效果,为后续综合示范干预模式的推广提供依据。方法选取2018年12月—2019年3月西南地区4个慢性病科技示范基地(川藏、重庆、云南、贵州)的107067名管理对象为研究对象,依托西南地区慢性病适宜技术人群应用管理平台和慢性病管理信息平台,开展血压管理健康教育、生活方式管理和高血压药物治疗、定期随访的综合管理。评估管理对象干预中期和末期随访时的血压管理率、高血压治疗率和控制率的变化情况,采用SAS 9.4进行χ^(2)检验、Cochran-Armitage趋势检验。结果西南地区项目管理人群基线、中期和末期高血压患病率分别为57.5%、56.8%和56.9%。中期和末期随访血压管理率(均为99.9%)均比基线(80.5%)提升,血压管理率呈上升趋势(Z=176.9,P<0.01)。项目地区高血压人群在中期和末期随访时,高血压治疗率分别为77.9%和79.0%,与基线相比分别提高了6.3%和7.8%,高血压治疗率呈上升趋势(Z=23.8,P<0.01)。项目地区高血压人群在中期和末期随访时,高血压控制率分别为43.3%和46.7%,与基线相比分别提升24.1%和33.8%,高血压控制率呈上升趋势(Z=41.6,P<0.01)。结论西南地区项目构建的“慢性病防控科技综合示范干预模式”对血压管理效果显著,对西南地区重大慢性病的预防和早诊早治有很好示范效应。

Objective To evaluate the effects of the"technology comprehensive demonstration of chronic disease intervention model"on blood pressure management in southwest China,and provide the basis for popularizing the comprehensive demonstration intervention model in future.Methods Total 107067 managed subjects in four chronic disease science and technology demonstration bases(Sichuan-Tibet,Chongqing,Yunnan,Guizhou)in southwest China from December 2018 to March 2019 were selected as subjects.Relying on the chronic disease appropriate technology population application management platform and chronic disease management information platform,the investigation was performed with the health education of blood pressure management,life-style management or medication therapy of hypertension and regular follow-up comprehensive management.The rate of blood pressure management,therapy or control rates of hypertension were evaluated.The χ^(2) test and Cochran-Armitage trend test were used to anlyze the data.The used software was SAS 9.4.Results The morbidity rates of hypertension at baseline,middle and end stages were 57.5%,56.8% and 56.9%,respectively.The follow-up rates of blood pressure management in the middle and end stages(99.9%,99.9%)were significantly higher than that(80.5%)in the baseline,and the rate of blood pressure management showed an upward trend(Z=176.9,P<0.01).The medication treatment rates were 77.9% and 79.0%at the middle and end stage follow-up,respectively;which increased by 6.3% and 7.8% as compared with the baseline,respectively.The treatment rate of hypertension showed an increasing trend(Z=23.8,P<0.01).The control rates of hypertension were 43.3%and 46.7%at the middle and end stage follow-up,which increased by 24.1% and 33.8%,respectively,as compared with the baseline.The hypertension control rate showed an increasing trend(Z=41.6,P<0.01).Conclusion The"science and technology comprehensive demonstration of chronic disease intervention model"constructed in this project had a remarkable effect on blood pressure management,and had certain demonstration effects on the prevention or early diagnosis and treatment of major chronic diseases in southwest China.