吴小琼 马春来 沈育华 程红梅 邵明凤 黎衍云

摘要：【目的】评价上海市社区高血压高危人群综合干预实施效果，为在社区推广、开展干预提供依据。【方法】于2015年10至2017年2月，对上海市青浦区徐泾社区招募200名高血压高危人群实施综合干预。对干预前后高血压健康知识、不良生活行为进行问卷调查，进行体检和实验室检测。【结果】经过15个月干预，高血压高危人群对高血压知识知晓状况明显提高，血压、血糖、血脂、血尿素氮以及血肌酐水平明显改善，体质指数（BMI）均值及肥胖、每日食盐摄入量、高盐膳食以及缺乏有氧运动的比例均明显下降，降幅分别为0.45、5.5%、0.45 g、10.5%和22.0%（P<0.05）；吸烟、过量饮酒干预前后无明显变化；超重比例干预后较干预前上升5.5%（P<0.05）。【结论】综合干预可以提高高危人群高血压知识的知晓率，改善健康水平，控制高血压行为危险因素。

关键词：高血压；高危人群；综合干预；效果

中图分类号：R544.1 文献标志码：ADOI：10.19428/j.cnki.sjpm.2018.18488

文章編号：1004-9231（2018）04-0316-04

Abstract： [Objective] To evaluate the effects of comprehensive intervention among high-risk population of hypertension in Xujing community，Shanghai，and to provide evidence for promoting intervention in communities. [Methods] A total of 200 volunteers with high-risk of hypertension from Xujing Community in Shanghai were included in a comprehensive intervention program for high-risk population of hypertension.Hypertension knowledge awareness，healthy behaviors and health status in the participants before and after the comprehensive intervention were investigated by using structured questionnaires，physical examination，at the same time. [Results] After 15 months′ intervention，the high-risk population had a wealth of knowledge of hypertension，and the average fast blood glucose，blood pressure，blood lipid，urea nitrogen and blood creatinine were obviously improved.After the intervention the proportions of high-salt consumption decreased，as well as the rates of obesity and lack of aerobic exercise decreased by 5.5%，10.5% and 22.0% respectively，the average value of BMI and daily salt intake decreased by 0.45 and 0.45 g （all P<0.05），and the proportion of overweight increased by 5.5% （P<0.05）. [Conclusion] Community-based comprehensive intervention for hypertension is beneficial to development of healthy life habits.

Keywords：hypertension；high risk population；comprehensive intervention；effect

高血压是目前公认的心脑血管疾病的重要危险因素，疾病负担较高。随着我国经济的快速发展和生活方式的改变，高血压患病率呈快速上升趋势[1]，已经成为一个严重的公共卫生问题。因此，如何有效的预防高血压，降低其发病率具有重要的现实意义。本研究在上海市徐泾社区开展高血压高危人群综合干预，观察其促进高血压高危人群形成正确生活方式的效果，旨在实现预防关口前移。

1 对象与方法

1.1 研究对象

于2015年9月份，在上海市青浦区徐泾社区进行社区宣传和动员，由社区医生对符合条件且自愿参加研究的高血压高危人群进行登记建档。高血压高危人群标准：① 收缩压介于130～139 mmHg之间或舒张压介于85～90 mmHg之间；② 超重或肥胖[体质指数（BMI）≥24 kg/m2）；……