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目的:本研究根据高血压患者的食盐摄入量及尿蛋白情况,对高血压患者采取个体化治疗,制定出适合基层医疗机构管理高血压患者的有效方法。方法:根据整群随机,在重庆市抽取9个社区(共757人),随机分为5个干预社区组(干预组,313人)和4个对照社区组(对照组,444人)。干预组根据食盐摄入量及尿白蛋白情况,给予个体化药物干预治疗;对照组根据医生经验进行常规治疗。随访3个月,观察降压幅度、血压达标情况及尿蛋白改善情况。结果:(1)干预组收缩压和舒张压下降幅度均明显高于对照组[15(8,24)mm Hg vs.10(2,21)mm Hg,8(2,14)mm Hg vs.4(-2,10)mm Hg,P=0.000]。(2)干预组血压控制达标率高于对照组(58.47%vs.47.07%,P=0.002)。(3)干预组尿蛋白阴转率高于对照组(35.09%vs.16.85%,P=0.012)。结论:基于高血压患者的食盐摄入量及尿蛋白情况给予个体化治疗,可有效控制血压、减少蛋白尿,适用于基层医院。
OBJECTIVE: In this study, according to the salt intake and urinary protein in patients with hypertension, individualized treatment of hypertension patients to develop suitable for primary care institutions to manage effective methods of hypertension. Methods: According to the cluster randomization, 9 communities (757 persons) were randomly selected from Chongqing, and randomly divided into 5 intervention community groups (intervention group, 313 persons) and 4 control community groups (control group, 444 persons). Intervention group according to salt intake and urinary albumin, given individualized drug intervention; control group according to the doctor’s experience for routine treatment. Followed up for 3 months, observed the range of blood pressure, blood pressure and urine protein to improve the situation. Results: (1) The decrease of systolic pressure and diastolic pressure in the intervention group were significantly higher than those in the control group [15 (8,24) mmHg vs.10 (2,21) mm Hg, 8 (2,14) mmHg vs. 4 (-2,10) mm Hg, P = 0.000]. (2) The compliance rate of blood pressure control in intervention group was higher than that in control group (58.47% vs.47.07%, P = 0.002). (3) The negative rate of urinary protein in the intervention group was higher than that in the control group (35.09% vs.16.85%, P = 0.012). Conclusion: Individualized treatment based on salt intake and urinary protein in patients with hypertension can effectively control blood pressure and reduce proteinuria, which is suitable for primary hospitals.