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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2017年02期

页码:

122-126

栏目:

论著

出版日期:

2017-03-27

文章信息/Info

Title:

Investigation on relationship between the stroke recurrence and hypertension and its intervention treatment

作者:

王志敬¹; 周吴刚²; 张立娟³狄勇¹; 史楠³; 许东伟¹; 张蔚³; 金磊³

1. 上海市浦东新区周浦医院心内科，上海201318；2. 上海市第九人民医院急诊医学部，上海200011； 3. 上海市浦东新区周浦医院神经内科，上海201318

Author(s):

WANG Zhi-jing*;  ZHOU Wu-gang;  ZHANG Li-juan;  DI Yong;  SHI Nan;  XU Dong-wei;  ZHANG Wei;  JIN Lei

*Department of Emergency, Shanghai Pudong New Area Zhoupu Hospital, Shanghai 201318, China Corresponding author: ZHOU Wu-gang, E-mail: zhouwugang2002@163.com

关键词:

脑卒中; 复发; 高血压; 流行病学调查

Keywords:

Stroke;  Recurrence;  Hypertension;  Epidemiological investigation

分类号:

R544.1

DOI:

-

摘要:

目的调查和分析上海市城乡结合部脑卒中再发与高血压关系以及干预现状。方法于2012年1—12 月以上海市浦东新区城乡结合部的社区居民作为调查对象，共纳入符合标准的脑卒中患者722 例，其中421 例有 脑卒中再发史（再发组），301 例无再发史（对照组）。采用横断面问卷调查和面对面访视方法，收集脑卒中患者 的一般情况、血压水平、降压药物应用等基本资料。结果再发组平均年龄（74.00 ± 9.12） 岁和对照组 （71.00±11.23） 岁比较，差异有统计学意义（P＜0.01），两组的年龄分布差异有统计学意义（P＜0.01）。多因素 回归分析发现，高血压是脑卒中再发的独立危险因素（OR=2.782，95% CI：1.812~4.271）。70~79岁年龄段再 发组的舒张压（DBP） 水平显著高于对照组（P＜0.01）。脑卒中再发组中高血压患病率87.7%显著高于对照组 73.1% （P＜0.05）；再发组收缩压（SBP） 控制≤140 mm Hg 的比率43.5%和DBP 控制在＜90 mm Hg 的比率 74.1%均显著低于对照组的65.8%和94.4% （P＜0.01）。再发组间断服用降压药物者58 例（13.78%） 较对照组13 例（4.32%） 显著增高，而未服用降压药物者147 例（34.92%） 显著低于对照组137 例（45.51%）（P 均＜0.01）。 结论加强血压控制、提高用药的依从性可显著降低脑卒中再发，对于城市社区特别是城乡结合部脑卒中高血 压的控制具有较好的指导价值。

Abstract:

Objectives To investigated relationship between the stroke recurrence and hypertension and blood pressure control in the population of the suburb of Shanghai. Methods A total of 722 stroke patients eligible for criteria were recruited in the suburb of Pudong New Distric from January 2012 to December 2012, which included 421 recurrent patients （recurrence group） and 301 non- recurrent patients （first- episode group）. Moreover, baseline characteristics, blood pressure and anti- hypertensive drugs were evaluated by the cross- sectional survey and face- to- face interview. Results Recurrence group of average age （74.00±9.12） compared with the first-episode group, the difference was statistically significant （P<0.01）, the age distribution of the two groups was statistically significant difference （P< 0.01）. Multivariate logistic regression analysis showed that hypertension was an independent risk factor for stroke recurrence （OR=2.782, 95% CI：1.812-4.271）. Between 70-79 years old,the diastolic blood pressure level of the recurrence group was significantly higher than that of the first-episode group （P<0.01）. The ratio of patients with hypertension in the recurrent group was more than that in the first-episode group （87.7% vs. 73.1% , P＜0.05）, while those with systolic blood pressure ≤140 mmHg and diastolic blood pressure＜90 mm Hg in the recurrent group were less than that in the first- episode group （43.5% and 74.1% vs. 65.8% and 94.4% , P＜0.01）. Patients who took drugs intermittently 58 cases （13.78%） in the recurrence group were significantly more than those 13 cases （4.32%） in the first-episode group （P＜0.01）, whereas patients who did not take anti-hypertensive medicines 147 cases （34.92% ） were less than 137 cases（45.51% ） in the first- episode group （P＜0.01）. Conclusions Taking anti-hypertensive medicine regularly and raising treatment compliance played a crucial role in the blood pressure control and the prevention from the stroke recurrence.

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备注/Memo

备注/Memo:

基金项目：上海市卫生局科研计划课题（20114343） 作者简介：王志敬，本科，副主任医师，研究方向：心血管疾病 通信作者：周吴刚，E-mail:zhouwugang2002@163.com

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更新日期/Last Update: 2017-02-18