摘要
目的探讨高血压病规范化分级健康管理成效。方法对2008年1月至2011年6月固定单位职工体检者中的高血压病患者，进行高血压危险评估，低危和中危者纳入2级管理、高危和极高危者纳入3级管理。包括建立健康管理信息档案、制定个性化健康管理方案、实施规范化分级健康管理。管理结束，从各年份中按50％比例分别随机抽取高血压病患者1441、1508、1533和1601例，年间比较采用多重Dunnett’s t检验和卡方检验来评估治疗性生活方式改变、血糖、血脂、血压达标率等指标的管理效果。结果2级和3级管理中，治疗性生活方式改善明显，摄盐过多、常吸烟、经常饮酒、很少运动人数出现不同比例下降，同干预前比较差异有统计学意义（X2分别为154，27和81．16、52．43和9．37、61．40和12．13、46．54和12．05，均P〈0．05）。除2级管理中血糖水平和3级管理中腰围干预前后无明显差异外，在两个管理级别中体重、血糖、血脂、血肌酐水平均有不同程度改善。2级和3级管理，干预后收缩压和舒张压水平明显下降（F值分别为13．12和56．86、56．86和239．89，均P〈0．05），血压达标率分别从2008年的28．8％和23．4％提升到2011年的37．9％和28．2％，差异有统计学意义（F值分别为12．78、22．93，均P〈0．05）。结论高血压病分级健康管理效果显著，通过管理能有效地控制血压，消除或降低高血压的可变危险因素，同时对指导其他慢性病管理亦具有深远意义。
Objective To evaluate the effect of graded management of health in hypertensive populations. Methods Hypertensive adults who were detected in health checkup between January 2008 and June 2011 and with no severe liver or kidney disease,chronic consumptive disease and cancer were enrolled in this investigation. Those with low or modest hypertensive risk received grade 2health management, and those with high or extreme high risk got grade 3heahh management. At the end of the intervention, 50% participants were randomly selected in each year（ 1441 in 2008,1508 in 2009,1533 in 2010, and 1601 in 2011 ） to compare lifestyle modification ,blood pressure ,blood glucose and blood lipid profiles by using multi- Dunnett＇s t test and X2 analyses. Results In both grade 2 and 3 health management groups,compared with baseline, high-salt diet, current cigarette smoking,alcohol consumption and insufficient physical activity were significantly improved after intervention （ X2 values were 154. 27 and 81.16,52.43 and 9.37,61.40 and 12. 13,46. 54 and 12. 05, respectively; all P 〈 0. 05 ）. Blood glucose in grade 2 health management group and waistline in grade 3 health management group showed no significant change. Body weight, blood glucose, blood lipid profiles and serum creatinine of grade 2 health management group were significantly declined after intervention. In both groups, systolic and diastolic blood pressure were significantly decreased（ F values were 13. 12 and 56.86,56. 86 and 239.89, respectively; all P 〈 0. 05 ） , and those with normal blood pressure were increased from 28.8% and 23.4% to 37.9% and 28.2% in grade 2 and 3 health management groups（ F values were 12. 78 and 22.93, respectively; all P 〈 0.05 ）. Conclusion These data suggest the beneficial effects of graded management of health on blood pressure control and reduced risks of cardiovascular disease.
出处
《中华健康管理学杂志》
CAS
2013年第2期86-90,共5页
Chinese Journal of Health Management
基金
湖南省卫生厅保健委员会重点资助项目（A2007-01）
关键词
高血压
干预性研究
分级健康管理
Hypertension
Intervention studies
Graded management of health
