高血壓患者門診藥物治療血壓達標的影響因素3
摘要:目的:研究高血壓門診患者藥物治療血壓控制達標的影響因素。
方法:對1012例醫(yī)療保險高血壓慢性病門診的患者進行調查,分別記錄患者的年齡、性別、患病年限、最高血壓、治療后血壓、用藥種類、隨診狀況等情況。并統計達標率,分析各種就診狀態(tài)患者的達標率;分析達標患者中各種藥物的使用比例及聯用情況;應用Logist回歸分析得出門診高血壓患者長期血壓控制達標的影響因素。
結果:患者平均年齡66.2±10.9歲,男357例,女655例,平均高血壓患病時間11.1±9.7年,總體達標率34.4%,達標患者主要集中在心血管?凭驮\,占71.2%;該人群中以鈣離子拮抗劑(CCB)的使用率最高,1、2、3級高血壓患者的使用率分別為62.1%、88.9%、80.8%;ß受體阻滯劑(ß-B)次之,分別為:37.9%、58.3%、60.3%。1級血壓達標患者51.7%單藥治療;隨著血壓水平升高,達標患者聯合治療比例增高:2、3級高血壓患者分別為76.4%、85.9%;在2種藥物組合中,最常被選用的聯合是CCB和 ß-B,占44.
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ith hypertension, the historic highest blood pressure, the sorts of blood pressure lowering agent, follow-up department, an so on. We calculated the controlling ratio of different pressure-level, the total patients and different follow-up situation of patients. We analyzed the proportion of various kinds of blood pressure lowering agent and the information of combination therapy in the controlled patients,then e*ported the impact factor of blood pressure controlling in long-term by Logist regression analysis.
Results:Of 66.2±10.9 mean age patients included 357 male and 655 female, its average duration with hypertension were11.1±9.7 years. It had 13.9%、38.4%、47.7% patients in 1 to 3 blood pressure level respectively. Total controlled ratio was 34.4%. The patent controlled ratio of cardiovascular department, endocrine, clinic of general medicine or community, oneself-treated and non-treated were 71.2%, 17.4%, 22.6%, 11.3%, 0 respectively. Calcium-channel blocker (CCB) was most used in blood pressure controlled patients, the second was ß blocker, and the third was angiotensin receptor antagonist (ARB). The results of logistic regression analysis showed that, the independent facilitative factor for the patients’ blood pressure controlling were followed-up in clinic of cardiovascular department, and treated by CCB and ß blocker (odd ratio and its P value were 1.73,0.000;1.81,0.031;1.60,0.054) ) .
Conclusion:Consistently follow up in cardiology outpatient-department, using CCB as a basis treatment or a basis of combination, and the combination of CCB and ß blocker are the value key to make Chinese Outpatients with essential hypertensive to reach the blood pressure goal in Long-term medic ……(未完,全文共6372字,當前僅顯示2237字,請閱讀下面提示信息。
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