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目的探讨远程无线实时心电、血压和血糖同步监测及远程干预指导能否提高社区原发性高血压(EH)合并2型糖尿病(T2DM)患者的血压及血糖控制率。方法选择EH合并T2DM患者420例,分为远程监控组(n=200)和常规控制组(n=220),两组患者在常规治疗干预前及观察结束后行24h动态血压及空腹、餐后2h血糖测定,远程监控组在观察期同时行连续72h远程无线实时心电、血压及血糖同步监测或随时监测。对全部患者进行为期8周的血压、血糖干预治疗(包括监测心电、血压及血糖水平、指导生活方式、调整药物治疗等),比较两组血压、血糖控制达标情况。结果在8周治疗干预过程中,远程监控组接受远程信息指导达22.7次/例,平均每周2.8次/例。患者主动联系医生询问相关事宜的比例在远程监控组为84.5%,常规控制组为17.2%(χ2=189.42,P<0.01)。远程监控组24h平均收缩压(98.5%比39.1%)、舒张压(97.5%比43.6%)、清晨血压(97.0%比40.5%)及空腹血糖(84.0%比41.8%)、餐后2h血糖(98.0%比48.2%)的达标率明显高于常规控制组,且前者杓型血压比例(98.5%比41.8%)、24h平均收缩压下降幅度[(52.0±11.9)比(31.7±14.2)mm Hg]及舒张压下降幅度[(31.0±8.2)比(15.9±6.4)mm Hg]亦高于后者(均P<0.05)。结论在常规治疗基础上对EH合并T2DM者行远程无线实时多参数监测,通过实时信息给予及时指导,可提高患者对自身血压、血糖的关注度以及主动参与意识,有利于血压、血糖控制达标。
Objective To explore whether the simultaneous monitoring of long-range wireless real-time ECG, blood pressure and blood glucose and remote intervention can improve the blood pressure and blood glucose control rate in patients with essential hypertension (EH) and type 2 diabetes mellitus (T2DM). Methods A total of 420 patients with EH and T2DM were enrolled in this study. They were divided into two groups: long-term monitoring group (n = 200) and conventional control group (n = 220). Before and after routine treatment, 2h blood glucose measurement, remote monitoring group in the observation period at the same time continuous 72h remote wireless real-time ECG, blood pressure and blood glucose monitoring simultaneously or at any time monitoring. All patients were treated with blood pressure and blood sugar for 8 weeks (including monitoring ECG, blood pressure and blood glucose level, guiding lifestyle and adjusting medication). The blood pressure and blood sugar control were compared between the two groups. Results During the 8 weeks of treatment intervention, the remote monitoring group received 22.7 remote information instructions per case, with an average of 2.8 times per week. The proportion of patients who voluntarily contacted the doctor about the related issues was 84.5% in the remote monitoring group and 17.2% in the conventional control group (χ2 = 189.42, P <0.01). The mean systolic blood pressure (98.5% vs 39.1%), diastolic blood pressure (97.5% vs 43.6%), morning blood pressure (97.0% vs. 40.5%) and fasting blood glucose (84.0% vs. 41.8%) and 2 h postprandial blood glucose 98.0% vs 48.2%) was significantly higher than that of the control group, and the former dipper blood pressure ratio (98.5% vs 41.8%), 24h mean systolic blood pressure reduction rate (52.0 ± 11.9) vs (31.7 ± 14.2) mm Hg ] And diastolic blood pressure [(31.0 ± 8.2) vs (15.9 ± 6.4) mm Hg] were also higher than the latter (all P <0.05). Conclusion Based on routine treatment, long-range and wireless real-time multi-parameter monitoring of EH patients with T2DM can be timely and real-time guidance to improve their awareness of blood pressure and blood glucose as well as active participation awareness, which is good for blood pressure and blood glucose control.