专科医联体模式对高血压患者血压控制和自我管理能力的影响

目的　 评价高血压专科医联体模式对高血压患者血压控制和自我管理能力的影响。方法　 按高血压等级、年龄组分层抽样社区高血压患者，以性别配对，随机分为实验组和对照组，每组110例。实验组采用“医院-社区-家庭”三级高血压专科医联体模式进行干预，对照组采用我院高血压管理团队进行干预。干预6个月后，比较两组患者血压控制达标率、相关生理指标改善和自我管理能力评分变化。结果 干预6个月后，两组患者血压控制达标率都取得较好效果，两组无明显差异（χ2 = 0.174，P = 0.676）。干预后，实验组体质指数显著改善，且明显好于对照组（t值 = 3.225，P = 0.001）；实验组血清胆固醇值和甘油三酯值均显著下降（t值 = 2.522，P = 0.010；t值 = 3.893，P＜0.001），实验组血清甘油三酯值明显低于对照组（t值 = 4.384，P＜0.001）。干预后，实验组患者自我管理能力评分显著提高，且明显高于对照组（t值 = -18.448，P＜0.001）。结论 高血压专科医联体模式对高血压患者血压控制，生理指标改善和自我管理能力提升有积极作用。

Effect of medical specialist joint on regulation of blood pressure and improvement of self-management ability in patients with hypertension

The aim of this study was to investigate the management effect of medical specialist joint on regulation ofblood pressure and improvement of self-management ability in patients with hypertension. Methods The community patients withhypertension were taken with the hierarchical sampling method based on severity of hypertension and age, matched by gender,then randomly assigned to the experimental group and the control group. The experimental group received medical specialist jointmanagement of "Hospital -Community -Family", while the control group received our hospital medical management. Thehypertension control rates, physiological indexes, and score of self -management behaviors were analyzed respectively in twogroups after 6 months. Results After 6 months’ intervention, blood pressure compliance rates in both groups were improved, andthere was no significant difference between two groups (χ2=0.174, P=0.676). After intervention, the body mass indexes in theexperimental group were improved significantly, which were significantly better than those in the control group (t=3.225, P=0.001).After intervention, the serum levels of cholesterol and triglyceride in the experimental group showed a greater reduction (t=2.522,P=0.010; t=3.893, P<0.001). Compared with the control group, the serum levels of triglyceride in the experimental group were lower(t=4.384, P<0.001). After intervention, the experimental group showed significantly higher score of self-management behaviors,and significant difference from the control group (t=-18.448, P<0.001). Conclusion It is helpful for improving blood pressurecontrol, physiological indexes, and self-management ability in hypertension patients under medical specialist joint.