摘要
目的 :通过对一般人群、高危人群和高血压患者进行以社区为基础的综合干预 ,降低高血压和心脑血管疾病的发病率和死亡率 ;对综合干预的结果进行系统性的评价 ;提出适合中国国情的以社区为基础的高血压综合防治模式。方法 :分别选择上海黄浦区和北京房山区作为城市和农村社区 ,对一般人群进行健康促进 ,对高血压的高危人群进行强化干预 ,对高血压患者进行系统管理。结果 :通过对一般人群和高危人群进行综合干预使得人群血压分布曲线下移 ;脑卒中的发病率和死亡率呈现下降趋势 ;心电图和超声心动显示对高血压患者进行系统治疗可以改善患者的心功能。生命质量研究显示 ,系统治疗可以提高高血压患者的生活质量 ;成本效益分析表明每投入 1元进行社区综合干预可以节约心血管疾病的治疗费用 8.5 9元。病因学研究显示 ,同型半胱氨酸 (Hcy)水平随年龄增加而增加 ,并且在各年龄段男性均高于女性 ;亚甲基四氢叶酸还原酶 (MTHFR)基因突变与同型半胱氨酸水平有关 ;同型半胱氨酸水平随叶酸浓度的增加而下降。结论 :本研究提出了一套适合中国国情的以社区为基础的高血压综合防治的方案 。
Objective: Through the comprehensive interventions f or the general and t he high-risk population and hypertensive patients, reducing the incidence/morta lity rates of hypertension and cardiovascular diseases and systematically analyzing and es timating the effects of the comprehensive intervention measures,to providing the pattern of community-based comprehensive prevention and control for hypertension, which was suitable for the situation in China. Methods:Having select ed the Huangpu District i n Shanghai as a city community and Fangshan District in Beijing as a country com munity, We carried out health promotion in general population, gave an intensi fied int ervention to the high risk population and established a system managing and tr eating hypertension cases. Results: Through the comprehensi ve in terventions for th e general and the high-risk population, the distribution curves of blood pressu r e in the population of the intervention communities shifted down. The incidence and the mortality rate of stroke decreased. The long-term follow-up of cardiog ra m and ultrasound cardiogram indicates that the systematic therapy for hypertensi ve patients could improve the cardiac function of the patients. The research of qu ality of life showed that the systematic treatment could improve the quality of li fe of the hypertensive patients and cost-benefit analysis found that $1 R MB cos t of comprehensive interventions in the communities could save $8.59 RMB which wo uld have to be paid for the treatment of cardiovascular diseases. The etiologic research in the program indicates that the homocysteine (Hcy) level increased wi th age and the concentrations of Hcy was higher in males than in females in e very age group. MTHFR mutation was related to elevated Hcy level. The Hcy level was inversely related to concentration of folate. Conclusion: Our project has pr ovided the pattern of community-based comprehensive prevention and control for h ypertension, which was suitable for the situation in China. The experiences were also important for formulating health policy on prevention and control of non- communicable diseases all over the country.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2002年第5期519-524,共6页
Journal of Peking University:Health Sciences
基金
国家"九五"科技攻关项目 ( 96 90 6 0 2 0 5 )
