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目的评价辽宁省6县市基层医疗单位就诊的缺血性脑卒中患者原发性高血压防治现状。方法 2007年3月～2008年10月采用分层整群抽样方法选择辽宁省本溪县、西丰县、阜新县、庄河市、建平县、大洼县6个县市基层医院,对在上述医院就诊的1127例缺血性脑卒中患者进行问卷调查。结果 1127例缺血性脑卒中患者中原发性高血压患病率为65.7%。原发性高血压病患者的高血压病知晓率、治疗率和控制率分别是77.4%、62.3%和28.1%。原发性高血压病患病率随文化程度的升高呈先降低后增高趋势。伴有心脏病、糖尿病、血脂代谢异常、超重或肥胖的脑卒中患者的原发性高血压病患病率显著高于无上述危险因素脑卒中患者的患病率(P<0.05)。脑卒中发作2次及以上的患者,原发性高血压患病率显著高于发作1次的患者(67.5%vs58.9%,P<0.05)。527例接受药物治疗的患者中,48.6%(256例)使用复方类降压药;51.4%(271例)使用非复方类降压药;最常见的组合为钙拮抗剂和β受体阻滞剂、β受体阻滞剂和血管紧张素转换酶抑制剂。结论在辽宁省县市基层医院就诊的缺血性脑卒中患者原发性高血压的控制率较低,原发性高血压药物治疗还欠规范,高血压病与脑卒中的发病风险呈正相关,提高基层医院高血压病患者的控制率非常重要。
Objective To evaluate the status of prevention and treatment of essential hypertension in ischemic stroke patients from 6 primary medical units in Liaoning Province. Methods From March 2007 to October 2008, stratified cluster sampling was used to select six county-level hospitals in Benxi, Xifeng, Fuxin, Zhuanghe, Jianping and Dawa of Liaoning Province. A total of 1,127 ischemic stroke patients treated at the hospital were surveyed. Results The prevalence of essential hypertension in 1127 ischemic stroke patients was 65.7%. Hypertension awareness, treatment and control rates in patients with essential hypertension were 77.4%, 62.3% and 28.1%, respectively. The prevalence of essential hypertension with the increase of educational level was first decreased and then increased. The prevalence of essential hypertension in stroke patients with heart disease, diabetes mellitus, dyslipidemia, overweight or obesity was significantly higher than that in stroke patients without these risk factors (P <0.05). The prevalence of essential hypertension was significantly higher in patients with episodes of stroke 2 and above (67.5% vs 58.9%, P <0.05). Of the 527 patients who received medication, 48.6% (256) used a combination antihypertensive drug, 51.4% (271 patients) did not use a combination antihypertensive drug, and the most common combination was calcium antagonist and beta blocker Agents, beta blockers and angiotensin converting enzyme inhibitors. Conclusion The control rate of essential hypertension in ischemic stroke patients treated in primary and secondary hospitals in Liaoning Province is relatively low. The treatment of essential hypertension drugs is not standardized, and the incidence of hypertension is positively correlated with the risk of stroke. It is very important to improve the control rate of hypertensive patients in primary hospitals.