黄扬　　贾海波　　闻慧娟　　陈灏璟　　王璇　　朱琪

[關键词] 老年病;高血压;互联网;并发症

[中图分类号] R2-03;R241          [文献标识码] A          [文章编号] 1673-9701（2021）14-0020-03

Preliminary study on the construction of the diagnosis and treatment database of senile hypertension and the establishment of the management mode of doctors interconnect

HUANG Yang   JIA Haibo   WEN Huijuan   CHEN Haojing   WANG Xuan   ZHU Qi

Department of Geriatrics，Nanjing First Hospital，Nanjing Medical University，Nanjing   210000，China

[Abstract] Objective To investigate the effect of the construction of the diagnosis and treatment database and the establishment of an interconnected management model of doctors on improving the blood pressure and complications of elderly hypertensive patients. Methods A total of 80 elderly hypertensive patients diagnosed and treated in our hospital from January to December 2019 were randomly divided into the observation group and the control group，with 40 cases in each group. The control group adopted conventional health education mode，and the observation group received the Daoqunyun medical APP based on the mode in the control grou. All patients were treated for 12 weeks. The blood pressure levels and complications of the two groups were compared before and after the intervention. Results Before the intervention，there was no significant difference in the systolic and diastolic blood pressures between the two groups（P>0.05）. After the intervention，the systolic and diastolic blood pressures of the two groups were significantly reduced. The blood pressure values in the observation group were significantly lower than that in the control group， and the difference was statistically significant （P<0.05）. After the follow-up period， the total incidence of complications such as cardiovascular disease， cerebral infarction， renal insufficiency， retinopathy in the observation group was significantly lower than that in the control group， and the differences between the two groups were statistically significant （P<0.05）. Conclusion The construction of the diagnosis and treatment database of senile hypertension and the construction of the management model of interconnected doctors can reduce the blood pressure level and the incidence of complications in patients with senile hypertension. It is expected to be further promoted and applied in clinical work.

[Key words] Geriatric disease; Hypertension; Internet; Complications

老年性高血压是指年龄大于65岁，血压值持续或非同日3次以上超过标准血压诊断标准[1-2]。由于老年人心血管系统呈退行性变化，动脉硬化明显，因此，该病特点为脉压差较大，且以收缩压升高为主[3]。究其原因，老年人因味觉减退喜食含钠量高的食物，同时，由于老年人腹部脂肪堆积、向心性肥胖、交感神经活动度高及胰岛素抵抗均为老年性高血压病的常见原因[4]。老年性高血压临床症状多样，主要体现在血压波动大，易产生体位性低血压;并发症与合并症众多，并发症包括冠心病、糖尿病等，合并症包括心绞痛、脑卒中等。目前，老年人高血压患病率约为40%，其发病率呈逐年上升趋势[5]。老年性高血压的治疗主要在于预防心力衰竭及脑血管意外的发生[6]。因此，本研究拟考察基于数据库建设及医家互联管理模式对老年性高血压防治方面的改善效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2019年1—12月我院诊治的80例老年性高血压患者，其中男51例，女29例，年龄68～90岁，平均（81.73±10.91）岁。将纳入患者随机分为观察组和对照组，每组各40例。纳入标准[7]：①老年性高血压病的诊断标准参照中华医学会心血管学分会制定的《中国高血压防治指南》;②患者或家属拥有智能手机，且会使用智能手机;③经我院医学伦理委员会审批通过;④患者及其家属知情并同意。排除标准[8]：①肝肾功能严重异常者;②恶性肿瘤者;③精神疾病者;④脑血管疾病者;⑤不能正常沟通者;⑥合并高血压并发症者。