【摘要】 目的 探讨互联网院外家庭血压监测管理模式对患者血压控制率的影响。方法 选择等级医院1家（北京市海淀医院）、社区医疗机构2家（双榆树社区卫生服务中心和清毛社区卫生服务站），2021年4～8月，医师对符合纳入标准的425例高血压患者开具3个月的长处方。患者采用可上传家庭血压设备规范地进行家庭血压测量，自动上传血压数据；医师通过手机APP了解患者血压，借助第三方健康管理服务机构通过互联网血压管理系统，采用提示、报警、督促的血压测量形式，进行院外血压管理，时间为3个月，观察患者家庭血压。结果 最后完成全程血压监测且基线血压未控制的高血压患者385例。三组患者的性别、体质量指数、入组家庭基线收缩压及心率比较，差异均无统计学意义（P>0.05）；等级医院患者年龄显著低于社区医院，舒张压显著高于社区医院。院外血压管理后第1个月控制率为32.99%、第2个月为51.43%、第3个月末时血压控制率上升至57.40%，与院外血压管理前相比，各时间段达标率差异均有统计学意义（P<0.05）。总体人群家庭血压从基线至管理后第3个月：收缩压（systolic blood pressure,SBP）/舒张压（diastolic blood pressure, DBP）由（147.79±14.97）/（89.17±12.47）mm Hg(1mmHg=0.133kPa)下降到（130.08±9.86）/（78.79±9.18）mm Hg，平均SBP降低17.71mmHg,DBP降低10.38mmHg，等级医院的血压降低幅度高于社区医院。通过院外管理平台干预3个月后，有337例患者家庭血压降低5mmHg以上，占比达87.53%。结论 互联网院外家庭血压监测管理模式可提高血压控制率，对高血压患者血压管理具有较好的效果。更多还原

【Abstract】 Objective To explore the influence of internet out–of–hospital blood pressure monitoring and management mode on the blood pressure control rate of patients. Methods One graded hospital(Beijing Haidian Hospital)and two community medical institutions(Shuangyushu Community Health Service Center, Qingmao Community Health Service Station) were selected. From April to August 2021, 425 patients with hypertension who met the inclusion criteria were prescribed an advantage prescription for 3 months. The patients used the home blood pressure device which can upload blood pressure to measure the home blood pressure in a standardized manner, and the blood pressure data was automatically uploaded. Doctors can know the patient’s blood pressure through the mobile APP.With the third–party health management service agency and through the Internet blood pressure management system,in the form of prompts, alarms, and supervision to measure the blood pressure, doctors conducted out–of–hospital blood pressure management for 3 months, observe the patient’s home blood pressure. Results There were 385 hypertensive patients who did not meet the standard blood pressure at baseline and completed the whole blood pressure monitoring. There were no significant differences in gender, body mass index, baseline systolic blood pressure of enrolled families, and heart rate in the three groups(P>0.05). The age of patients in grade hospitals was significantly lower than that in community hospitals, and the diastolic pressure was significantly higher than that in community hospitals. After out–of–hospital blood pressure management, the control rate of blood pressure was 32.99% in the first month, 51.43% in the second month, and increased to 57.40% at the end of the third month. Compared with that before out–of–hospital blood pressure management, the compliance rate in each time period was significantly different(P<0.05). From baseline to the third month after management, home blood pressure measurements in the general population, systolic blood pressure(SBP)/diastolic blood pressure(DBP) decreased from(147.79±14.97)/(89.17±12.47)mmHg(1mmHg=0.133kPa) to(130.08±9.86)/(78.79±9.18)mmHg, the average SBP decreased by 17.71mmHg and DBP decreased by 10.38mmHg. The reduction of blood pressure in graded hospital was higher than that in community hospitals. After 3 months of intervention by the out–of–hospital management platform, 337 patients had reduced their family blood pressure by more than 5mmHg, accounting for 87.53%. Conclusion Internet home blood pressure monitoring management modelimproves the blood pressure control rate, It has a good effect on blood pressure management of hypertensive patients.更多还原