【作者】 王志忠；

【导师】 张波； 张毓洪； 郭忠琴； 刘兰；

【作者基本信息】 宁夏医学院 ， Cardiovascular Epidemiology， 2005， 硕士

【摘要】 目的:了解我区农村地区原发性高血压的流行现况和防治基础,观察北京降压0号和寿比山治疗农村原发性高血压患者的长期疗效,了解血管紧张素转换酶基因插入/缺失(ACE I/D)多态性在我区农村回汉人群中的分布情况,探讨在农村地区开展社区综合防治措施结合药物防治原发性高血压的模式。方法:以村队为单位整群抽样调查我区部分农村地区30岁以上人口的高血压流行现况,开展社区诊断,评价农村社区原发性高血压防治基础和条件。采用前瞻性的社区前后对照实验研究,通过对研究社区给予适当的干预措施(包括:建立防治网络,对农村基层卫生人员进行培训、卫生宣传、高血压筛检、对高血压患者开展集中管理并建立随访档案,免费提供降压药物等)随访1年后,观察研究社区人群原发性高血压患者的知晓率、治疗率和控制率的变化,评价综合干预措施的效果,探讨开展农村社区综合防治的方式方法。同时在筛检出的高血压患者中选择符合研究要求的患者240人,以村为单位整群分为两组各120人,分别给予寿比山和北京降压0号治疗一年,综合社区干预措施集中管理,观察药物长期疗效及患者血压控制情况。采集筛检人群中外周静脉血,提取基因组DNA,利用PCR技术对37例农村地区回族高血压患者,42例回族正常人,81例同一地区的汉族高血压患者以及34例汉族正常人进行ACE I/D多态性的分析比较。研究该基因多态性在农村社区回、汉族原发性高血压人群和正常回、汉族人群中的分布情况,探讨其在少数民族地区高血压防治中的意义。结果:抽样调查总人数2276人、男性为1102人,年龄(54.77±12.49),女性为1174人,年龄(53.37±11.94),30岁以上人群原发性高血压的总患病率为25.5%,男性患病率为24.6%,女性患病率为26.2%。高血压患者的知晓率为15.2%,治疗率为13.3%,控制率为0.6%。采取综合干预措施一年后抽样调查高血压患者的知晓率、治疗率和控制率分别为, 55.4%、51.6%、30.6%,与干预前比较均有明显提高。药物治疗高血压患者更多还原

【Abstract】 Objective : To understand the prevalence of the essential hypertension in the cluster above 30 in parts of the rural areas in Ning Xia Hui Autonomous regions . Provide the data to prevent the essential hypertension in the rural area. Assess the long term antihypertensive effect of Beijing Hypotensive No.0 and Indepamide in patients with essential hypertension in rural area. And observe the distribution of polymorphism of AngiotensinI-converting enzyme gene in the rural area population in Ning xia and to analysis the relationship between the polymorphism and the Muslim essential hypertension .To study the model of health education and drug therapy preventing essential hypertension in rural area .Method : A sample survey managed in the residents among 6 towns in the rural area of Ningxia above 30 years old ,and a questionnaire study was done in the patients of hypertension , through the community diagnosis to assess the basis and advantages in prevention . To observe the effects of community intervention trial respectively . The intervention including institution web foundation , health education , screening ,mass deal management of patients ,making follow up files and supply drugs free fee and so on. After a year assess the awareness rate、the treatment rate and the control rate in groups. At the same time 240 patients selected and separate two group by Administrative area .One group treated with Beijing Hypotensive No.0 1-2 tablets per day and remains treated with Indepamide 2.5-5mg per day ,then follow up for one year and the antihypertensive effect were observed . To collect the blood sample during the screening and survey ,An insertion/deletion polymorphism(ACE I/D polymorphism) in angiotensinI-converting enzyme gene was detected by PCR in 37 Muslim EH patients、42 normal muslins、34 Han nationalities and 81更多还原