【摘要】：目的探討藥物強(qiáng)化治療對脈壓的影響以及降低脈壓是否會減少腦卒中的發(fā)生。方法對遼寧省阜新市農(nóng)村常住居民采用集中方式進(jìn)行問卷調(diào)查。按照整群隨機(jī)的方法分為非強(qiáng)化治療組和強(qiáng)化治療組,非強(qiáng)化治療組給予生活方式干預(yù),強(qiáng)化治療組在生活方式干預(yù)的基礎(chǔ)上按預(yù)定方案給予雙氫克尿噻、尼群地平、卡托普利治療,調(diào)查其腦卒中發(fā)生情況。結(jié)果基線調(diào)查共完成41 242人。腦卒中患病率校正了收縮壓后與40~49 mm Hg組相比僅在60~69 mm Hg組有統(tǒng)計學(xué)意義(P0.05)。強(qiáng)化治療組治療后脈壓平均下降8.18 mm Hg;非強(qiáng)化治療組治療后脈壓平均升高1.11 mm Hg。強(qiáng)化治療組脈壓≥60 mm Hg患者脈壓下降更明顯,與非強(qiáng)化治療組差異有統(tǒng)計學(xué)意義(P0.05);非強(qiáng)化治療組脈壓60 mm Hg患者治療后脈壓上升更明顯,與強(qiáng)化治療組差異有統(tǒng)計學(xué)意義(P0.05)。強(qiáng)化治療組發(fā)生腦卒中26例,非強(qiáng)化治療組53例,兩組差異有統(tǒng)計學(xué)意義(P0.05)。強(qiáng)化治療組脈壓≥60 mm Hg患者發(fā)生腦卒中20例,非強(qiáng)化治療組38例,兩組差異有統(tǒng)計學(xué)意義(P0.05)。強(qiáng)化治療組脈壓60 mm Hg患者發(fā)生腦卒中6例,非強(qiáng)化治療組15例,兩組差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論脈壓在60~69 mm Hg腦卒中的患病率顯著增高。氫氯噻嗪、尼群地平和卡托普利聯(lián)合降壓治療方案可有效降低脈壓。對于低脈壓人群不論治療與否,脈壓均有隨著年齡增加的趨勢,而氫氯噻嗪、尼群地平和卡托普利聯(lián)合降壓治療可使這種趨勢下降。氫氯噻嗪、尼群地平和卡托普利聯(lián)合降壓可減少腦卒中的發(fā)生,高脈壓人群從上述治療中獲益更大。
[Abstract]:Objective to investigate the effect of intensive drug therapy on pulse pressure and whether decreasing pulse pressure can reduce the occurrence of stroke. Methods A questionnaire survey was conducted among rural residents in Fuxin, Liaoning Province. They were randomly divided into non-intensive treatment group and intensive treatment group. The non-intensive treatment group was given lifestyle intervention, and the intensive treatment group was given dihydroclopidine and nitrendipine on the basis of lifestyle intervention. Captopril was treated to investigate the incidence of stroke. Results the baseline survey was completed in 41,242 persons. The incidence rate of stroke adjusted after systolic blood pressure was only significantly higher than that of 40 ~ 49 mm Hg group (P0.05) in 60 ~ 69 mm Hg group (P0.05). Pulse pressure decreased 8.18 mm Hg; after treatment in intensive treatment group and increased 1.11 mm Hg. after treatment in non-intensive treatment group The pulse pressure of the intensive treatment group 鈮，

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