【摘要】 目的探讨远程医疗管理联合药物治疗老年高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病人的降压效果。方法 128例高血压合并OSAHS的老年病人,根据干预方法的不同分为云平台远程医疗管理联合药物治疗组(云平台管理组)和单纯药物治疗组(非云平台管理组),每组各64例。非云平台管理组根据病人家中自测血压,每月门诊随诊调整降压药物用量;云平台管理组在常规单纯药物治疗的基础上使用云平台远程医疗管理系统,实时监测病人24 h内血压变化情况,医生随时根据血压变化情况调整药物治疗及生活方式。比较治疗后2组降压效果的差异。结果治疗前,2组病人的24 h平均血压及清晨血压比较,差异无统计学意义(P>005);治疗1个月后,2组病人的血压均较治疗前有所改善,差异有统计学意义(P<005),且云平台管理组的24 h平均血压和清晨血压达标率均较非云平台管理组高,差异有统计学意义(P<005)。治疗6个月后,2组病人的血压均较治疗前有明显改善,差异有统计学意义(P<001),但2组间24 h平均血压和清晨血压的达标率差异无统计学意义(P<005)。结论应用远程医疗联合药物管理老年高血压合并OSAHS病人的清晨血压和24 h平均血压比单纯药物管理更易获得早期控制。更多还原

【Abstract】 Objective To investigate the antihypertensive effect of telemedicine managementcombined with drugs in the treatment of elderly hypertensive patients complicated with obstructive sleepapnea hypopnea syndrome( OSAHS). Methods A total of 128 elderly patients with hypertensioncomplicated with OSAHS were divided into cloud platform telemedicine management combined drugtherapy group( cloud platform management group) and pure drug therapy group( non-cloud platformmanagement group) according to different intervention methods, with 64 cases in each group. The non-cloud platform management group adjusted antihypertensive drug treatment according to the self-measuredblood pressure in patients’ home and monthly outpatient follow-up. The cloud platform management group uses the cloud platform telemedicine management system on the basis of conventional drug therapy tomonitor the changes of the blood pressure within 24 h in real time, and adjusted drug treatment andlifestyle improvement schemes were conducted according to the blood pressure changes at any time.Finally, the difference of antihypertensive efficacy between the two groups was compared. Results Before treatment, there were no significant differences in 24 h mean blood pressure and morning bloodpressure between the two groups(P>0. 05). After one month of treatment, the blood pressures of bothgroups was improved significantly(P<0. 05), and the control rates of 24 h mean blood pressure andmorning blood pressure in cloud platform management group were more significant than those in non-cloudplatform management group(P<0. 05). After 6 months of treatment, the blood pressures of both groupswere significantly improved compared with those before treatment(P< 0. 01), but there were nodifferences in the control rates of 24 h mean blood pressure and morning blood pressure between the twogroups. Conclusions Telemedicine combined with drug management for morning blood pressure and24 h mean blood pressure in the elderly hypertensive patients complicated with OSAHS is easier to obtainearly control than drug management alone.更多还原