远程血压监测对中青年高血压患者的影响

远程血压监测对中青年高血压患者的影响

聂颖,陈宝霞,夏蓉晖,邱文风,刘博,王伟

北京交通大学社区卫生服务中心,北京大学第三医院,北京交通大学社区卫生服务中心,北京交通大学社区卫生服务中心,北京交通大学社区卫生服务中心,北京交通大学社区卫生服务中心

收稿日期:2017-08-14 修回日期:2017-08-14 出版日期:2017-11-25
基金资助:
北京交通大学基本科研基金自由申报项目（项目编号：O14JB00120；项目名称：远程规范化管理对患高血压病的中青年教师血压达标率的影响）

Influence of Remote Blood Pressure Monitoring on Hypertension in Young and Middle-Aged Patients

NIE Ying,CHEN Baoxia,XIA Ronghui,QIU Wenfeng,LIU Bo and WANG Wei

Beijing Jiaotong University community Health Center,Department of Cardiology,Peking University Third Hospital,Beijing Jiaotong University community Health Center,Beijing Jiaotong University community Health Center,Beijing Jiaotong University community Health Center,Beijing Jiaotong University community Health Center

Received:2017-08-14 Revised:2017-08-14 Online:2017-11-25

摘要/Abstract

摘要： 目的：探讨远程血压监测指导治疗对中青年高血压患者血压的影响。方法：选择年龄35~60岁患高血压的在职教师59例，非随机分为对照组（25例）和远程组（34例）。对照组由门诊医师给予生活方式和/（或）药物治疗，并定期门诊随访；远程组在上述基础上同时给予远程血压监测，医生可根据血压情况随时短信指导治疗。随访12个月，比较两组生活方式、血压水平、血压达标率及诊疗情况等的变化。结果：远程组共传输血压4224次，平均（124.24±20.18）次/（人·年）及（2.34±0.38）次/（人·周），传输次数随时间呈下降趋势，血压达标所用时间中位数为12.5d。医生发出短信指导共452次，平均（13.29±0.87）次/（人·年）。随访12个月，远程组嗜盐者显著低于对照组（14.7% vs.40.0%，P<0.05），运动者显著高于对照组（67.6% vs. 44.0%，P<0.01）；两组收缩压及舒张压均较基线显著下降[对照组：（131.12±13.97）/（87.72±9.23）vs. （139.64±11.88）/（95.00±7.85）mmHg，P<0.05；远程组：（117.41±9.07）/（75.35±8.91） vs. （142.88±12.93）/（98.44±9.85）mmHg，P<0.01]（1 mmHg=0.133 kPa），远程组比对照组降低更明显（P<0.01）。12个月时，远程组MINICHAL评分较基线显著降低[（6.44±3.60） vs.（8.91±4.92）分，P<0.01]，明显优于对照组（P<0.01）。远程组血压达标率（97.1% vs.48.0%，P<0.01）及调整治疗次数[（1.12±0.23） vs.（0.52±0.14）次，P<0.01]明显高于对照组。结论：远程血压规范化管理可在12个月期间有效降低中青年高血压患者的血压，比常规治疗更好地改善患者生活方式和质量，提高高血压患者的治疗达标率。

Abstract: Objective：To explore the effect of home blood pressure(BP) telemonitoring on blood pressure control in middle aged hypertensive patients. Methods： Fifty-nine serve teachers （35y≤age＜60y） with hypertension were non-randomized divided into control group(25 cases) and telemonitoring group(34 cases). Patients in control group were treated with usual care including life-style change and medicine therapy. Intervention patients received home BP telemonitoring and transmitted BP data to doctors who adjusted therapy through short messages except above mentioned normal treatment. After 12 months follow-up， changes in life-mode， BP levels， control rates and treatment condition were compared between the two groups. Results： A total of 4 224 BP measurements were taken in the telemonitoring group corresponding to （124.24±20.18） readings per patient per year and （2.34±0.38） per patient per week. Frequency for measurement decreased with time. Mean time of BP control was 12.5 d. Messages contacts equaled to （13.29±0.87） per patient per year(452 in total). When compared with control group， rate of favorite salt（14.7% vs.40.0%，P<0.05） and exercise（67.6% vs.44.0%，P<0.01）in telemonitoring group were statistically improved at the end of 12 months. The mean BP values deceased in both groups when compared with baseline [control：（131.12±13.97）/（87.72±9.23） vs. （139.64±11.88）/（95.00±7.85）mmHg， P<0.05； telemonitoring：（117.41±9.07）/（75.35±8.91） vs. （142.88±12.93）/（98.44±9.85）mmHg， P<0.01]. Changes in telemonitoring group were significant more than the other（P<0.01）. Scores of MINICHAL questionnaire in telemonitoring group dramatically deceased [(6.44±3.60） vs. （8.91±4.92），P<0.01] and significantly better than those of control group（P<0.01）. The control rates of hypertension（97.1% vs.48.0%，P<0.01）and the frequency in drug changes were statistically increased [(1.12±0.23) vs. (0.52±0.14)，P<0.01] when compared with control group. Conclusion： Home blood pressure telemonitoring can effectively decrease BP in middle aged hypertensive patients and achieve better life mode， life quality， BP control rate during 12 months of intervention.

聂颖,陈宝霞,夏蓉晖,邱文风,刘博,王伟. 远程血压监测对中青年高血压患者的影响[J]. .

NIE Ying,CHEN Baoxia,XIA Ronghui,QIU Wenfeng,LIU Bo and WANG Wei. Influence of Remote Blood Pressure Monitoring on Hypertension in Young and Middle-Aged Patients[J]. .

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