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目的探讨团队式强化个体血压管理对原发性高血压患者踝-臂指数(ABI)与心脏-脚踝血管指数(CAVI)值的影响,通过对动脉硬化指标及血压监测,寻找血压管理的有效模式。方法以2014年1月至2015年6月在浙江医院保健门诊体检及就诊和部分住院的196例原发性高血压患者为研究对象,男性144例,女性52例,年龄45~79岁,平均(62.2±10.2)岁。将196例患者随机分为干预组(99例)和对照组(97例),两组在常规药物治疗基础上,干预组进行团队式强化个体血压管理12个月,对照组常规治疗,干预前后测定ABI和CAVI值,观察两组动脉弹性变化,同时对比两组患者血压、体质指数(BMI)、服药依从性、血压控制率等指标,用SPSS 18.0软件包进行独立样本t检验、配对样本t检验及χ2检验。结果干预组干预前ABI值为1.17±0.11,干预后为1.11±0.09,干预前CAVI为8.88±1.52,干预后为8.26±1.56,干预前后比较,差异均有统计学意义(P<0.01);两组干预前后ABI、CAVI差值比较,干预组明显低于对照组,差异均有统计学意义(P<0.01);干预组干预前收缩压(SBP)为(139.04±13.58)mm Hg,干预后为(133.78±10.74)mm Hg,干预前舒张压(DBP)为(81.90±7.31)mm Hg,干预后为(79.28±9.96)mm Hg,干预前后比较,差异均有统计学意义(P<0.01),两组干预前后差值比较,干预组明显低于对照组,差异均有统计学意义(P<0.05);同时干预组干预后BMI值、服药依从性、血压控制率与对照组比较,差异均有统计学意义(P<0.01)。结论团队式强化个体血压管理能有效延缓高血压患者动脉硬化的进展,同时有效控制血压、提高服药依从性、血压控制率及BMI值等。
Objective To explore the effect of team-based intensified blood pressure management on ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with essential hypertension. By means of arteriosclerosis index and blood pressure monitoring, find an effective mode of blood pressure management . Methods From January 2014 to June 2015, 196 patients with essential hypertension who were examined and treated in Zhejiang Health Care Clinic and some of them were enrolled in this study. There were 144 males and 52 females aged 45-79 years (62.2 ± 10.2) years old. A total of 196 patients were randomly divided into intervention group (n = 99) and control group (n = 97). The two groups were given routine medication for 12 months. In the control group, The ABI and CAVI were measured and the changes of arterial elasticity were observed. The blood pressure, body mass index (BMI), medication compliance and blood pressure control rate were compared between the two groups. SPSS 18.0 software package was used for independent sample t test and paired samples t Test and χ2 test. Results Before intervention, ABI was 1.17 ± 0.11, after intervention, it was 1.11 ± 0.09. Before intervention, CAVI was 8.88 ± 1.52, and after intervention was 8.26 ± 1.56. The difference was statistically significant before and after intervention (P <0.01). The differences of ABI and CAVI before and after the intervention in both groups were significantly lower than those in the control group (P <0.01). The SBP of the intervention group was (139.04 ± 13.58) mm Hg before intervention (133.78 ± 10.74) mm Hg after the intervention, and the mean diastolic blood pressure (DBP) was (81.90 ± 7.31) mm Hg before intervention and (79.28 ± 9.96) mm Hg after intervention, respectively, with significant differences before and after intervention (P < 0.01). The difference between the two groups before and after intervention was significantly lower in the intervention group than in the control group (P <0.05). The BMI, medication compliance and blood pressure control rate in the intervention group were significantly lower than those in the control group , The differences were statistically significant (P <0.01). Conclusion The team-based individual BP management can effectively delay the progression of atherosclerosis in hypertensive patients, meanwhile, it can effectively control the blood pressure, improve the medication compliance, the blood pressure control rate and BMI.