醫(yī)學(xué)論文：高血壓患者門(mén)診藥物治療血壓達(dá)標(biāo)的影響因素

高血壓患者門(mén)診藥物治療血壓達(dá)標(biāo)的影響因素3

摘要：目的：研究高血壓門(mén)診患者藥物治療血壓控制達(dá)標(biāo)的影響因素。
方法：對(duì)1012例醫(yī)療保險(xiǎn)高血壓慢性病門(mén)診的患者進(jìn)行調(diào)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(lèi)、隨診狀況等情況。并統(tǒng)計(jì)達(dá)標(biāo)率，分析各種就診狀態(tài)患者的達(dá)標(biāo)率；分析達(dá)標(biāo)患者中各種藥物的使用比例及聯(lián)用情況；應(yīng)用Logist回歸分析得出門(mén)診高血壓患者長(zhǎng)期血壓控制達(dá)標(biāo)的影響因素。
結(jié)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(shí)間11.1±9.7年，總體達(dá)標(biāo)率34.4%，達(dá)標(biāo)患者主要集中在心血管專(zhuān)科就診，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(jí)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(jí)血壓達(dá)標(biāo)患者51.7%單藥治療；隨著血壓水平升高，達(dá)標(biāo)患者聯(lián)合治療比例增高：2、3級(jí)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(lián)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(dāng)前僅顯示2237字，請(qǐng)閱讀下面提示信息。收藏《醫(yī)學(xué)論文：高血壓患者門(mén)診藥物治療血壓達(dá)標(biāo)的影響因素》）