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目的了解沧州市农村高血压患者血压控制情况及其影响因素,为农村地区针对性地开展高血压控制工作提供依据。方法采用整群随机抽样方法,以纳入沧州市基本公共卫生服务项目规范管理满1年的1 470例高血压患者为调查对象,通过面对面问卷调查、现场体检,调查患者血压、服药依从性、生活方式等情况。用χ2检验和logistic回归分析血压控制的影响因素。结果共调查1 467例高血压患者,调查对象年龄35~95岁,平均(64.6±9.9)岁,纳入社区管理1年以上,血压控制率为23.1%。经单因素分析有统计学意义的因素进行多因素logistic回归分析结果显示,饮酒、高盐饮食、高脂饮食、合并糖尿病是影响血压控制的危险因素[OR值分别为0.67(95%CI:0.48~0.88)、0.42(95%CI:0.28~0.64)、0.58(95CI:0.41~0.78)和0.65(95%CI:0.48~0.85)],服药治疗为保护因素(OR=1.45,95%CI:1.21~1.67),差异均有统计学意义(P<0.01)。纳入管理时间不同,血压控制率的差异无统计学意义(P>0.05)。结论建议沧州市农村成立高血压患者个案健康管理服务团队,制定个性化综合干预措施,以提高沧州市农村高血压患者管理水平。
Objective To understand the blood pressure control and its influencing factors in rural hypertensive patients in Cangzhou City and provide evidence for the targeted control of hypertension in rural areas. Methods A total of 1 470 Hypertensive patients, who were included in CNAS of Cangzhou City for one year, were enrolled in this study. The questionnaires were used to investigate the prevalence of blood pressure, medication compliance, and life expectancy Way and so on. Factors influencing blood pressure control were analyzed by χ2 test and logistic regression. Results A total of 1 467 hypertensive patients were surveyed. The subjects were 35-95 years old (64.6 ± 9.9 years) on average, and were included in community management for more than 1 year. The blood pressure control rate was 23.1%. Multivariate logistic regression analysis of statistically significant factors by univariate analysis showed that alcohol consumption, high-salt diet, high-fat diet and diabetes mellitus were the risk factors influencing blood pressure control (OR = 0.67, 95% CI: 0.48 (OR = 1.45, 95% CI: 0.88 to 0.88), 0.42 (95% CI 0.28 to 0.64), 0.58 (95 CI 0.41 to 0.78) and 0.65 (95% CI 0.48 to 0.85) 1.21 ~ 1.67), the differences were statistically significant (P <0.01). The inclusion of management time, blood pressure control rate was no significant difference (P> 0.05). Conclusion It is suggested that a case management team should be set up in the rural areas of Cangzhou to develop personalized comprehensive interventions to improve the management of rural hypertensive patients in Cangzhou.