降压治疗对脉压的影响及其与脑卒中的关系

发布时间：2019-01-22 20:24

【摘要】：目的探讨药物强化治疗对脉压的影响以及降低脉压是否会减少脑卒中的发生。方法对辽宁省阜新市农村常住居民采用集中方式进行问卷调查。按照整群随机的方法分为非强化治疗组和强化治疗组,非强化治疗组给予生活方式干预,强化治疗组在生活方式干预的基础上按预定方案给予双氢克尿噻、尼群地平、卡托普利治疗,调查其脑卒中发生情况。结果基线调查共完成41 242人。脑卒中患病率校正了收缩压后与40~49 mm Hg组相比仅在60~69 mm Hg组有统计学意义(P0.05)。强化治疗组治疗后脉压平均下降8.18 mm Hg;非强化治疗组治疗后脉压平均升高1.11 mm Hg。强化治疗组脉压≥60 mm Hg患者脉压下降更明显,与非强化治疗组差异有统计学意义(P0.05);非强化治疗组脉压60 mm Hg患者治疗后脉压上升更明显,与强化治疗组差异有统计学意义(P0.05)。强化治疗组发生脑卒中26例,非强化治疗组53例,两组差异有统计学意义(P0.05)。强化治疗组脉压≥60 mm Hg患者发生脑卒中20例,非强化治疗组38例,两组差异有统计学意义(P0.05)。强化治疗组脉压60 mm Hg患者发生脑卒中6例,非强化治疗组15例,两组差异无统计学意义(P0.05)。结论脉压在60~69 mm Hg脑卒中的患病率显著增高。氢氯噻嗪、尼群地平和卡托普利联合降压治疗方案可有效降低脉压。对于低脉压人群不论治疗与否,脉压均有随着年龄增加的趋势,而氢氯噻嗪、尼群地平和卡托普利联合降压治疗可使这种趋势下降。氢氯噻嗪、尼群地平和卡托普利联合降压可减少脑卒中的发生,高脉压人群从上述治疗中获益更大。
[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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