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目的评估2010-2011年长沙市城乡社区高血压综合干预效果。方法 2010年采用多阶段分层随机抽样方法,从9个区县中各抽取一个社区(乡镇),每一社区随机抽取3个居委会(村),每个居委会(村)随机抽取35~65岁常住居民30名,分成高血压患者组、高危人群组和健康人群组,每组各10名,社区干预1年后这些对象再次被调查。结果总计合格调查对象776名,其中女性387名,男性389名。高血压相关危险因素中“经常饮酒”、“不运动少运动”、“感到精神压力”的暴露率总体上比社区干预前下降(P<0.05或P<0.01);“不运动少运动”高危组和健康组下降显著(P<0.01);而“吸烟”率改变不明显,“盐摄入过量”患者组有所升高(P<0.05);空腹血糖受损(IFG)率平均为9.1%,糖尿病患病率平均为6.5%,年龄和性别差异有统计学意义(P<0.01或P<0.05);TC、TG异常率患者组、高危组均明显高于健康组。血压水平随年龄增长而显著升高(P<0.01);血压控制率城市社区由31.3%上升至50%(P<0.01),但干预后乡镇社区提高不明显。结论通过健康教育与良好生活方式指导,对于各组居民改变日常生活习惯的影响不一,生活方式干预对高危和健康人群获益更多;对于高血压患者的规范管理和血压控制效果城市社区仍明显好于乡镇社区。
Objective To evaluate the effect of community-based hypertension comprehensive intervention in urban and rural areas of Changsha City from 2010 to 2011. Methods In 2010, a multi-stage stratified random sampling method was used to select one community (township) from each of the 9 districts and counties. Three community committees (villages) were randomly selected from each community. Each neighborhood (village) randomly selected 35 to 65 years old 30 residents, divided into hypertension group, high-risk group and healthy group, each group of 10, one year after community intervention, these subjects were investigated again. Results A total of 776 qualified subjects were investigated, including 387 females and 389 males. The risk factors of hypertension were generally lower than those before community intervention (P <0.05 or P <0.01), and “less alcohol” and “no exercise less” and “mental stress” There was a significant decrease (P <0.01) in “no exercise less exercise” and high risk group and health group (P <0.01), while the “smoking” ; The average rate of impaired fasting glucose (IFG) was 9.1%, the average prevalence of diabetes was 6.5%, the difference was statistically significant between age and sex (P <0.01 or P <0.05) Group were significantly higher than the healthy group. The blood pressure level increased significantly with age (P <0.01). The blood pressure control rate increased from 31.3% to 50% in urban areas (P <0.01), but the township community did not increase significantly after intervention. Conclusion Through the guidance of health education and good lifestyle, residents in each group have different effects on changing daily habits, while lifestyle interventions have more benefits for high-risk and healthy people. Normative management and blood pressure control effect for hypertensive patients Obviously better than the township community.