Article(id=1241023929872085405, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410379, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729353600000, receivedDateStr=2024-10-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773812761991, onlineDateStr=2026-03-18, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773812761991, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773812761991, creator=13701087609, updateTime=1773812761991, updator=13701087609, issue=Issue{id=1241023927812682133, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773812761500, creator=13701087609, updateTime=1773812858867, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241024336258200259, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241024336258200260, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241023927812682133, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=508, endPage=512, ext={EN=ArticleExt(id=1241023931096822187, articleId=1241023929872085405, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the relationship between follow-up management and blood pressure control in hypertensive patients in Sichuan Province, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective To explore the impact of follow-up management on blood pressure control in hypertensive patients in Sichuan Province, so as to improve the blood pressure control rate in the population.
Methods Based on the data of the Seventh National Health Service Survey in Sichuan province, 3 587 hypertensive patients were included. Descriptive statistical analysis was used to analyze the follow-up management situation, demographic characteristics, lifestyle behaviors and health status of patients. Combined with the multivariate logistic regression model, the follow-up management factors affecting blood pressure control were explored.
Results The blood pressure control rate was 68.9%. Among the effectively controlled patients, the rate of taking medications regularly as prescribed was 84.6%, the proportion of those with a follow-up frequency of ≥4 was 71.4%, and the rate of family doctor-signed home visits was 48.1%. Among the patients not effectively controlled, the rate of taking medications regularly as prescribed was 73.4%, the proportion of those with a follow-up frequency of ≥4 was 67.6%, and the rate of family doctor-signed home visits was 45.2%. Multivariate Logistic regression analysis showed that not taking medications regularly as prescribed (OR=1.742, 95%CI:1.453-2.089), a follow-up frequency of <4 (OR=1.287, 95%CI: 1.057-1.567) and other follow-up methods (OR=1.286, 95%CI:1.092-1.516) had significant negative impacts on the blood pressure control effect of patients.
Conclusion Follow-up management of hypertension is beneficial to blood pressure control. The follow-up frequency should be optimized, drug compliance should be improved, and the interaction between the signed doctor and the patient should be enhanced.
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目的 旨在探讨四川省高血压患者随访管理对血压控制的影响,以提高人群血压控制率。
方法 基于四川省第七次国家卫生服务调查数据,纳入3 587名高血压患者。采用描述性统计分析患者的随访管理情况、人口学特征、生活行为及健康状况,结合多因素logistic回归模型探讨影响血压控制的随访管理因素。
结果 血压控制率为68.9%。在有效控制的患者中,按医嘱规律服药率为84.6%,随访频率≥4占比71.4%,签约家庭医生入户随访率为48.1%;未有效控制的患者中,按医嘱规律服药率为73.4%,随访频率≥4占比67.6%,签约家庭医生入户随访率为45.2%。多因素logistic回归分析显示,未按医嘱规律服药(OR=1.742,95%CI:1.453~2.089)、随访频率<4 (OR=1.287,95%CI:1.057~1.567)和其他随访方式(OR=1.286,95%CI:1.092~1.516)对患者血压控制效果有显著的负面影响。
结论 对高血压的随访管理有利于血压控制,应该优化随访频率、提高药物依从性和增强签约医生与患者的互动。
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=cCWM+MUSW3pImvKcqpXaIw==, magXml=ZJTptv3ejjELKELXJKnvzg==, pdfUrl=null, pdf=r0R0GvVC4RngDx32BmUnEA==, pdfFileSize=485381, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=cwSYSTPAZYB7vZec0JgcAQ==, mapNumber=null, authorCompany=null, fund=null, authors=
喻瑞(1994—),男,硕士,科研助理,研究方向:统计方法在流行病学中的应用
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1.四川大学华西公共卫生学院/华西第四医院,四川 成都610041)]), AuthorCompany(id=1241023931696607692, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023929872085405, xref=2., ext=[AuthorCompanyExt(id=1241023931704996301, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023929872085405, companyId=1241023931696607692, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=
2.四川省卫生健康信息中心/四川省医疗大数据中心)])], figs=[ArticleFig(id=1241023935450509912, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023929872085405, language=EN, label=Table 1, caption=
Comparison of basic characteristics between hypertension controlled group and uncontrolled group [n(%)]
, figureFileSmall=null, figureFileBig=null, tableContent=
| 项目 | 全部患者 (n=3 587) | 控制组 (n=2 470) | 未有效控制组 (n=1 117) | χ2值 | P值 |
|---|
| 年龄(岁) | | | | 0.878 | 0.349 |
| ≥65 | 2 433(67.8) | 1 688(68.3) | 745(66.7) | | |
| <65 | 1 154(32.2) | 782(31.7) | 372(33.3) | | |
| 性别 | | | | 2.101 | 0.147 |
| 男性 | 1 729(48.2) | 1 170(47.4) | 559(50.0) | | |
| 女性 | 1 858(51.8) | 1 300(52.6) | 558(50.0) | | |
| 城乡 | | | | 70.903 | <0.001 |
| 城市 | 1 828(51.0) | 1 376(55.7) | 452(40.5) | | |
| 农村 | 1 759(49.0) | 1 094(44.3) | 665(59.5) | | |
| 受教育程度 | | | | 30.408 | <0.001 |
| 没上过学 | 811(22.6) | 520(21.1) | 291(26.1) | | |
| 小学或初中 | 2 428(67.7) | 1 671(67.7) | 757(67.8) | | |
| 高中或技校 | 257(7.2) | 202(8.2) | 55(4.9) | | |
| 大专或本科及以上 | 91(2.5) | 77(3.1) | 14(1.3) | | |
| 家庭人均收入(元/年) | | | | 52.560 | <0.001 |
| >14 400 | 1 792(50.0) | 1 335(54.0) | 457(40.9) | | |
| ≤14 400 | 1 795(50.0) | 1 135(46.0) | 660(59.1) | | |
| 体育锻炼 | | | | 30.427 | <0.001 |
| 锻炼 | 1 980(55.2) | 1 440(58.3) | 540(48.3) | | |
| 几乎不锻炼 | 1 607(44.8) | 1 030(41.7) | 577(51.7) | | |
| BMI | | | | 0.528 | 0.768 |
| 正常 | 2087(58.2) | 1428(57.8) | 659(59.0) | | |
| 偏瘦 | 209(5.8) | 147(6.0) | 62(5.6) | | |
| 超重或肥胖 | 1291(36.0) | 895(36.2) | 396(35.5) | | |
| 吸烟状况 | | | | 9.088 | 0.003 |
| 从未吸烟 | 2773(77.3) | 1945(78.7) | 828(74.1) | | |
| 吸烟 | 814(22.7) | 525(21.3) | 289(25.9) | | |
| 饮酒状况 | | | | 9.398 | 0.002 |
| 从未饮酒 | 2553(71.2) | 1797(72.8) | 756(67.7) | | |
| 饮酒 | 1034(28.8) | 673(27.2) | 361(32.3) | | |
| 糖尿病 | | | | 0.845 | 0.358 |
| 无 | 2933(81.8) | 2030(82.2) | 903(80.8) | | |
| 有 | 654(18.2) | 440(17.8) | 214(19.2) | | |
| 抑郁、焦虑情绪 | | | | 43.909 | <0.001 |
| 无 | 2822(78.7) | 2019(81.7) | 803(71.9) | | |
| 有 | 765(21.3) | 451(18.3) | 314(28.1) | | |
| 失眠问题 | | | | 38.161 | <0.001 |
| 无 | 1549(43.2) | 1152(46.6) | 397(35.5) | | |
| 有 | 2038(56.8) | 1318(53.4) | 720(64.5) | | |
| 服药状况 | | | | 62.334 | <0.001 |
| 按医嘱规律服用 | 2910(81.1) | 2090(84.6) | 820(73.4) | | |
| 未按医嘱规律服用 | 677(18.9) | 380(15.4) | 297(26.6) | | |
| 随访频率(次/年) | | | | 5.201 | 0.023 |
| ≥4 | 2519(70.2) | 1764(71.4) | 755(67.6) | | |
| <4 | 1068(29.8) | 706(28.6) | 362(32.4) | | |
| 随访形式 | | | | 2.528 | 0.232 |
| 签约家庭医生入户随访 | 1694(47.2) | 1189(48.1) | 505(45.2) | | |
| 未随访 | 447(12.5) | 298(12.1) | 149(13.3) | | |
| 其他随访 | 1446(40.3) | 983(39.8) | 463(41.5) | | |
), ArticleFig(id=1241023935588921949, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023929872085405, language=CN, label=表1, caption=
高血压患者控制组与未有效控制组基本情况比较[n(%)]
, figureFileSmall=null, figureFileBig=null, tableContent=
| 项目 | 全部患者 (n=3 587) | 控制组 (n=2 470) | 未有效控制组 (n=1 117) | χ2值 | P值 |
|---|
| 年龄(岁) | | | | 0.878 | 0.349 |
| ≥65 | 2 433(67.8) | 1 688(68.3) | 745(66.7) | | |
| <65 | 1 154(32.2) | 782(31.7) | 372(33.3) | | |
| 性别 | | | | 2.101 | 0.147 |
| 男性 | 1 729(48.2) | 1 170(47.4) | 559(50.0) | | |
| 女性 | 1 858(51.8) | 1 300(52.6) | 558(50.0) | | |
| 城乡 | | | | 70.903 | <0.001 |
| 城市 | 1 828(51.0) | 1 376(55.7) | 452(40.5) | | |
| 农村 | 1 759(49.0) | 1 094(44.3) | 665(59.5) | | |
| 受教育程度 | | | | 30.408 | <0.001 |
| 没上过学 | 811(22.6) | 520(21.1) | 291(26.1) | | |
| 小学或初中 | 2 428(67.7) | 1 671(67.7) | 757(67.8) | | |
| 高中或技校 | 257(7.2) | 202(8.2) | 55(4.9) | | |
| 大专或本科及以上 | 91(2.5) | 77(3.1) | 14(1.3) | | |
| 家庭人均收入(元/年) | | | | 52.560 | <0.001 |
| >14 400 | 1 792(50.0) | 1 335(54.0) | 457(40.9) | | |
| ≤14 400 | 1 795(50.0) | 1 135(46.0) | 660(59.1) | | |
| 体育锻炼 | | | | 30.427 | <0.001 |
| 锻炼 | 1 980(55.2) | 1 440(58.3) | 540(48.3) | | |
| 几乎不锻炼 | 1 607(44.8) | 1 030(41.7) | 577(51.7) | | |
| BMI | | | | 0.528 | 0.768 |
| 正常 | 2087(58.2) | 1428(57.8) | 659(59.0) | | |
| 偏瘦 | 209(5.8) | 147(6.0) | 62(5.6) | | |
| 超重或肥胖 | 1291(36.0) | 895(36.2) | 396(35.5) | | |
| 吸烟状况 | | | | 9.088 | 0.003 |
| 从未吸烟 | 2773(77.3) | 1945(78.7) | 828(74.1) | | |
| 吸烟 | 814(22.7) | 525(21.3) | 289(25.9) | | |
| 饮酒状况 | | | | 9.398 | 0.002 |
| 从未饮酒 | 2553(71.2) | 1797(72.8) | 756(67.7) | | |
| 饮酒 | 1034(28.8) | 673(27.2) | 361(32.3) | | |
| 糖尿病 | | | | 0.845 | 0.358 |
| 无 | 2933(81.8) | 2030(82.2) | 903(80.8) | | |
| 有 | 654(18.2) | 440(17.8) | 214(19.2) | | |
| 抑郁、焦虑情绪 | | | | 43.909 | <0.001 |
| 无 | 2822(78.7) | 2019(81.7) | 803(71.9) | | |
| 有 | 765(21.3) | 451(18.3) | 314(28.1) | | |
| 失眠问题 | | | | 38.161 | <0.001 |
| 无 | 1549(43.2) | 1152(46.6) | 397(35.5) | | |
| 有 | 2038(56.8) | 1318(53.4) | 720(64.5) | | |
| 服药状况 | | | | 62.334 | <0.001 |
| 按医嘱规律服用 | 2910(81.1) | 2090(84.6) | 820(73.4) | | |
| 未按医嘱规律服用 | 677(18.9) | 380(15.4) | 297(26.6) | | |
| 随访频率(次/年) | | | | 5.201 | 0.023 |
| ≥4 | 2519(70.2) | 1764(71.4) | 755(67.6) | | |
| <4 | 1068(29.8) | 706(28.6) | 362(32.4) | | |
| 随访形式 | | | | 2.528 | 0.232 |
| 签约家庭医生入户随访 | 1694(47.2) | 1189(48.1) | 505(45.2) | | |
| 未随访 | 447(12.5) | 298(12.1) | 149(13.3) | | |
| 其他随访 | 1446(40.3) | 983(39.8) | 463(41.5) | | |
), ArticleFig(id=1241023935710556772, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023929872085405, language=EN, label=Table 2, caption=
Logistic regression analysis of factors affecting blood pressure control in Sichuan Province
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| 变量 | | OR值(95%CI) | P 值 |
|---|
| 年龄(岁) | ≥65 | | |
| <65 | 1.164(0.985~1.375) | 0.075 |
| 性别 | 男性 | | |
| 女性 | 0.923(0.763~1.116) | 0.407 |
| 城乡 | 城市 | | |
| 农村 | 1.702(1.450~1.997) | <0.001 |
| 受教育程度 | 没上过学 | | |
| 小学或初中 | 0.856(0.707~1.035) | 0.108 |
| 高中或技校 | 0.636(0.440~0.919) | 0.016 |
| 大专或本科及以上 | 0.458(0.245~0.859) | 0.015 |
| 家庭人均收入(元/年) | >14400 | | |
| ≤14400 | 1.343(1.145~1.574) | <0.001 |
| 体育锻炼 | 锻炼 | | |
| 几乎不锻炼 | 1.192(1.022~1.39) | 0.025 |
| BMI | 正常 | | |
| 偏瘦 | 0.708(0.511~0.98) | 0.038 |
| 超重或肥胖 | 1.017(0.868~1.192) | 0.832 |
| 吸烟状况 | 从未吸烟 | | |
| 现在或曾经吸烟 | 1.216(0.987~1.498) | 0.067 |
| 饮酒状况 | 从未饮酒 | | |
| 饮酒 | 1.208(1.009~1.447) | 0.040 |
| 糖尿病 | 无 | | |
| 有 | 1.379(1.137~1.673) | 0.001 |
| 抑郁、焦虑情绪 | 无 | | |
| 有 | 1.535(1.284~1.836) | <0.001 |
| 失眠问题 | 无 | | |
| 有 | 1.402(1.196~1.643) | <0.001 |
| 服药状况 | 按医嘱规律服用 | | |
| 未按医嘱规律服用 | 1.742(1.453~2.089) | <0.001 |
| 随访频率(次/年) | ≥4 | | |
| <4 | 1.287(1.057~1.567) | 0.012 |
| 随访形式 | 签约家庭医生入户随访 | | |
| 未随访 | 1.058(0.794~1.409) | 0.702 |
| 其他随访 | 1.286(1.092~1.516) | 0.003 |
), ArticleFig(id=1241023935815414377, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241023929872085405, language=CN, label=表2, caption=
四川省城乡居民高血压患者血压控制情况随访管理因素logistic回归分析结果
, figureFileSmall=null, figureFileBig=null, tableContent=
| 变量 | | OR值(95%CI) | P 值 |
|---|
| 年龄(岁) | ≥65 | | |
| <65 | 1.164(0.985~1.375) | 0.075 |
| 性别 | 男性 | | |
| 女性 | 0.923(0.763~1.116) | 0.407 |
| 城乡 | 城市 | | |
| 农村 | 1.702(1.450~1.997) | <0.001 |
| 受教育程度 | 没上过学 | | |
| 小学或初中 | 0.856(0.707~1.035) | 0.108 |
| 高中或技校 | 0.636(0.440~0.919) | 0.016 |
| 大专或本科及以上 | 0.458(0.245~0.859) | 0.015 |
| 家庭人均收入(元/年) | >14400 | | |
| ≤14400 | 1.343(1.145~1.574) | <0.001 |
| 体育锻炼 | 锻炼 | | |
| 几乎不锻炼 | 1.192(1.022~1.39) | 0.025 |
| BMI | 正常 | | |
| 偏瘦 | 0.708(0.511~0.98) | 0.038 |
| 超重或肥胖 | 1.017(0.868~1.192) | 0.832 |
| 吸烟状况 | 从未吸烟 | | |
| 现在或曾经吸烟 | 1.216(0.987~1.498) | 0.067 |
| 饮酒状况 | 从未饮酒 | | |
| 饮酒 | 1.208(1.009~1.447) | 0.040 |
| 糖尿病 | 无 | | |
| 有 | 1.379(1.137~1.673) | 0.001 |
| 抑郁、焦虑情绪 | 无 | | |
| 有 | 1.535(1.284~1.836) | <0.001 |
| 失眠问题 | 无 | | |
| 有 | 1.402(1.196~1.643) | <0.001 |
| 服药状况 | 按医嘱规律服用 | | |
| 未按医嘱规律服用 | 1.742(1.453~2.089) | <0.001 |
| 随访频率(次/年) | ≥4 | | |
| <4 | 1.287(1.057~1.567) | 0.012 |
| 随访形式 | 签约家庭医生入户随访 | | |
| 未随访 | 1.058(0.794~1.409) | 0.702 |
| 其他随访 | 1.286(1.092~1.516) | 0.003 |
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