心血管脑卒中高危人群预防危险评估及分层治疗效果比较

目的 探讨社康中心进行心血管疾病首次危险评估的可行性,分析社康中心与三甲医院对心血管脑卒中高危人群分层干预的效果.方法 选择2012年6月～2013年6月梅林一村800例心血管疾病患者为研究对象,采用氟明翰卒中风险评估量表（Frarningham）进行首次危险分层,然后将患者送交三甲医院进行二级评估,并将三甲医院二级评估高危患者随机分为社康中心干预组和三甲医院干预组,比较危险评估及分层干预效果.结果 800例心血管疾病患者中,社康中心筛查出低危患者202例,中危患者160例,高危患者438例.三甲医院筛查出低危患者198例,中危患者152例,高危患者450例,社康中心与三甲医院筛查出低危、中危、高危患者比较差异无统计学意义（P＞0.05）.社康中心高危人群治疗率90.87％（398/438）,血压控制率69.61％（142/204）,三甲医院高危人群治疗率96.89％（436/450）,血压控制率75.71％（159/210）,两者比较差异均无统计学意义（P＞0.05）;社康中心与三甲医院治疗率均与患者是否享受医保、是否并发高血压显著相关,血压控制均与是否享受医保、是否定期给予健康教育、首次是否接受降血压药物治疗、是否使用固定复方制剂降血压药物或联合用药密切相关.结论 社康中心进行心血管疾病危险评估可信度较高,对高危患者实行分层治疗效果较好.

Cardiovascular stroke high risk prevent assessment and layered treatment effect comparison

Objective To explore the feasibility of Community Rehabilitation Centre for cardiovascular the first time the risk assessment, to analyze Community Rehabilitation Centre and third-grade class-A hospital for cardiovascular high- risk groups stratified intervention effect of cerebral apoplexy. Methods 800 cases patients with cardiovascular diseases using fluorine framingham risk assessment scale for stroke risk stratification for the first time, and then high-risk groups send third-grade class-A hospital to evaluate secondary, high-risk patients were randomly divided into Com- munity Rehabilitation Centre intervention group and third-grade class-A hospital intervention group, risk assessment and stratified intervention effect were compared. Results 2000 patients with cardiovascular disease, Community Re- habilitation Centre screening out low-risk patients 202 cases, 160 patients with moderate,438 cases of high-risk pa- tients;third-grade class-A hospital screening out low-risk patients 198 cases, 152 patients with moderate, 450 cases high risk patients, social health center and 3 armour hospital screening out low-risk, dangerous, comparing differ- ences between high-risk patients had no statistical significance （P 〈 0.05）; Community Rehabilitation Centre high-risk groups therapy was 90.87%（398/438）, blood pressure control rates was 69.61% （142/201）, 3 armour hospital high- risk groups therapy was 96.89% （436/450）, blood pressure control rates 75.71% （159/210）, there were no statistical significances between Community Rehabilitation Centre and 3 armour hospital;Community Rehabilitation Centre and 3 armour hospital treatment with with the patient whether enjoy medical insurance, whether concurrent with high blood pressure was significantly associated, blood pressure control and whether enjoy medical insurance, the first time whether to use antihypertensive drugs, whether concurrent with high blood pressure was were closely related. Conclu- sion Community Rehabilitation Centre for cardiovascular