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目的评价山东省农村中老年高血压患者健康干预效果,为制定高血压预防策略提供参考依据。方法随机抽取2009年10月山东大学研究基地(平阴县、梁山县和莒南县)健康体检时检出的8个村548例和4个村285例55~75岁中老年高血压患者分别作为干预组和对照组,于2013年7月—2014年7月对干预村村医进行5次培训,提升村医高血压药物治疗水平及健康宣教技能。按照国家基本公共卫生服务要求,村医对干预组与对照组患者进行4次随访,比较2组高血压患者干预前后血压的变化情况。结果与干预前比较,干预后2组高血压患者收缩压和舒张压均低于干预前(均P<0.05),干预组患者收缩压和舒张压分别下降(11.79±21.85)和(7.24±11.40)mm Hg,均高于对照组的(10.72±25.39)和(6.44±12.36)mm Hg(均P<0.05);干预后干预组男性高血压患者收缩压和舒张压分别下降(13.06±22.88)和(8.64±11.70)mm Hg,均高于女性的(10.66±20.85)和(5.99±10.99)mm Hg(均P<0.05);干预后对照组男性高血压患者收缩压和舒张压分别下降(9.61±24.78)和(6.16±13.32)mm Hg,均低于女性的(11.81±26.00)和(6.71±11.37)mm Hg(均P<0.05);干预后干预组和对照组≤65岁高血压患者的收缩压分别下降(10.84±19.58)和(8.70±23.39)mm Hg,均低于>65岁的(12.49±23.78)和(12.03±26.92)mm Hg,舒张压分别下降(7.10±11.11)和(5.84±12.85)mm Hg,均低于>65岁的(7.41±11.56)和(6.88±12.13)mm Hg(均P<0.05)。结论以加强村医抗高血压药物治疗水平及健康宣教技能为主的健康干预可有效降低山东省农村中老年高血压患者的收缩压和舒张压。
Objective To evaluate the effect of health intervention on middle-aged and elderly hypertensive patients in rural areas of Shandong Province, and provide a reference for the development of hypertension prevention strategies. Methods 548 cases of 8 villages and 285 cases of 55 ~ 75 years old middle-aged and elderly patients with hypertension diagnosed at the physical examination of Shandong University (Pingyin, Liangshan and Taonan counties) in October 2009 were randomly selected. As an intervention group and a control group, five interventions were conducted in village medical doctors from July 2013 to July 2014 to improve the medical treatment and quality of village medical hypertensive drugs. In accordance with the requirements of the state’s basic public health services, the village doctors conducted 4 follow-up visits to the intervention group and the control group, and compared the changes of blood pressure before and after intervention in two groups of patients with hypertension. Results Compared with those before intervention, the systolic and diastolic blood pressures in the two groups were lower than those before intervention (both P <0.05), and the systolic and diastolic blood pressure in the intervention group decreased (11.79 ± 21.85) and (7.24 ± 11.40 (10.72 ± 25.39) and (6.44 ± 12.36) mm Hg in the control group (all P <0.05). After intervention, the systolic and diastolic blood pressure of the intervention group decreased (13.06 ± 22.88) And (8.64 ± 11.70) mm Hg, respectively, were higher than those of women (10.66 ± 20.85) and (5.99 ± 10.99) mm Hg respectively (all P <0.05); the systolic and diastolic blood pressure of the control group were decreased 9.61 ± 24.78 and 6.16 ± 13.32 mm Hg, respectively, which were lower than those of women (11.81 ± 26.00) and 6.71 ± 11.37 mm Hg (all P <0.05). After intervention, the intervention group and the control group were less than 65 years old with hypertension The systolic blood pressure decreased (10.84 ± 19.58) and (8.70 ± 23.39) mm Hg in patients, respectively, and were both lower than (12.49 ± 23.78) and (12.03 ± 26.92) mm Hg> 65 years old (7.10 ± 11.11) And (5.84 ± 12.85) mm Hg, both of which were lower than (7.41 ± 11.56) and (6.88 ± 12.13) mm Hg> 65 years old (all P <0.05). Conclusions The health intervention based on strengthening the medical treatment of antihypertensives and health education skills in village doctors can effectively reduce the systolic and diastolic blood pressure in middle-aged and elderly patients with hypertension in rural areas of Shandong Province.