2型糖尿病合并高血压患者社区干预研究

目的评估2型糖尿病（T2DM）合并高血压患者短期干预效果。方法对上海市杨浦区402名2型糖尿病合并高血压确诊患者，随机分为干预组（n=200）和对照组（n=202），给予为期1年对照强化干预。结果干预组空腹血糖（FPG）、2hPG、HbAlc较干预前分别下降7．57％、10.55％、9．16％，差异有统计学意义（P〈0，05）。对照组糖负荷2小时血糖（2hPG）、舒张压（DBP）分别较干预前下降10．27％、4．92％，糖化血红蛋白（HbAlC）较干预前升高10．85％。两组间比较，干预后收缩压（SBP）、DBP、FPG、2hPG、HbAIc差异有统计学意义（t值分别为3．966，-2．932，9．784，4．942，2．539，P〈0．05）。干预组高血压知识认知水平明显高于对照纽。结论①血压、血糖与血脂相比，在短期干预中有更显著改善。②与血压、血脂相比，血糖水平可能是短期强化干预的先行效果评价指标。③在糖尿病患者中开展高血压健康教育是必要并有效的。

Study on Community Intervention for Patients with Type 2 Diabetes and Hypertension

Objective To evaluate the short-term intervention results in patients with type two diabetes mellitus （T2DM） and hypertension. Methods Four hundred and two patients from Shanghai Yangpu District diagnosed with type 2 diabetic and hypertension were randomly divided into intervention group （ n = 200 ） and control group （ n = 202 ）. The intervention period was one year. Results In the intervention group, fasting plasma glucose （ FPG）, 2hPG, HbA1 c were decreased by 7.57%, 10.55 % and 9.16%, respectively （P 〈 0. 05 ）. In the control group, the 2 hours glucose load blood glucose（2hPG） decreased hy 10.27% ;the diastolic blood pressure（DBP） decreased by 4.92% ; the glycosylated hemoglobin （ HbAl c） was increased by 10. 85%, and the difference was statistically significant （ P 〈 0.05 ）. After the intervention, the difference of systolic blood pressure （ SBP）, DBP, FPG,2hPG, HbA1 c between the two groups was significantly （ t values were 3. 966,-2. 932,9. 784,4. 942,2. 539, respectively, P 〈 0.05 ）. The cognitive level of hypertension was significantly higher in the intervention group as compared to the control group. Conclusion （1）The short-term intervention can significantly improve the blood pressure and blood glucose level as compared to the blood lipid. （2）Compared with the blood pressure and blood lipids, the blood glucose level may be the first indicator in shortterm intervention evaluation. （3）Heahh education carried out in diabetic patients with hypertension is necessary and effective.