上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2022 , Vol. 42 >Issue 6: 797 - 804

DOI: https://doi.org/10.3969/j.issn.1674-8115.2022.06.015

论著 · 公共卫生

基于“互联网+”的心脑血管疾病“协防共管”健康管理模式对社区重点监测人群血压改善的效果评价

  • 李国栋 ,
  • 颜少华 ,
  • 张秋霞 ,
  • 雷力 ,
  • 张新禄 ,
  • 梁鸿彬 ,
  • 卢俊颜 ,
  • 肖敏 ,
  • 罗玮 ,
  • 卜军 ,
  • 修建成
展开
  • 1.南方医科大学南方医院心血管内科，广州 510515
    2.南方医科大学南方医院增城分院心血管内科，广州 511340
    3.上海交通大学医学院附属仁济医院心内科，上海 200127
李国栋（1981—），男，主治医师，硕士生；电子信箱：48379807@qq.com
李国栋（1981—），男，主治医师，硕士生；电子信箱：48379807@qq.com第一联系人：（李国栋、颜少华并列第一作者）
修建成，电子信箱：xiujch@163.com。

收稿日期: 2022-01-27

  录用日期: 2022-06-20

  网络出版日期: 2022-08-19

基金资助

国家重点研发计划(2018YFC1312803);国家自然科学基金(81974266)

收起

Evaluation of the application effect of “Internet+”-based “co-prevention and co-management” health management model for cardio-cerebrovascular diseases on the improvement of blood pressure in target surveillance population in community

  • Guodong LI ,
  • Shaohua YAN ,
  • Qiuxia ZHANG ,
  • Li LEI ,
  • Xinlu ZHANG ,
  • Hongbin LIANG ,
  • Junyan LU ,
  • Min XIAO ,
  • Wei LUO ,
  • Jun PU ,
  • Jiancheng XIU
Expand
  • 1.Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
    2.Department of Cardiology, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou 511340, China
    3.Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
XIU Jiancheng, E-mail: xiujch@163.com.

Received date: 2022-01-27

  Accepted date: 2022-06-20

  Online published: 2022-08-19

Supported by

National Key R&D Program of China(2018YFC1312803);National Natural Science Foundation of China(81974266)

Fold

摘要

目的·探讨基于“互联网+”的心脑血管疾病“协防共管”健康管理模式对社区重点监测人群的血压改善效果。方法·选取2020年1月—2021年7月在广州市增城区新塘镇参与国家基本公共卫生服务项目年度体检至少2次的社区重点监测人群，按照是否接受“互联网+”心脑血管疾病“协防共管”健康管理模式将其分为常规治疗组（n=2 987）和“协防共管”模式组（n=2 876）。常规治疗组接受常规模式管理，即每年1次的常规体检；“协防共管”模式组除常规治疗外，还需接受“互联网+”健康教育，其所在村落被投放可穿戴心电监测设备。对2组受试者的基线水平（干预前）进行比较，观察2组受试者于干预前后的血压变化差值情况。采用协方差分析不同干预措施对血压的影响是否受其基线血压水平的影响，并运用多因素线性回归模型探讨基于“互联网+”的心脑血管疾病“协防共管”健康管理模式与血压及其他心血管疾病危险因素控制情况的相关性。结果·与常规治疗组相比，“协防共管”模式组受试者的基线收缩压、舒张压均较高（均P=0.000）。在中位干预时间227 d后，“协防共管”模式组受试者的收缩压、舒张压在干预前后的变化分别为-0.28 mmHg（95% CI -0.94~0.37，P=0.398）、-0.68 mmHg（95% CI -1.09~-0.27，P=0.001）；常规治疗组受试者的变化分别为2.92 mmHg（95% CI 2.29~3.54，P=0.000）、-0.12 mmHg（95% CI -0.51~0.28，P=0.554）；干预前后收缩压、舒张压变化差值的2组间差异分别为3.20 mmHg（95% CI 2.29~4.11，P=0.000）、0.56 mmHg（95% CI -0.01~1.13，P=0.055）。协方差分析显示，在校正了干预前的收缩压后，与常规治疗组相比，“协防共管”模式组受试者干预后的收缩压降低了2.06 mmHg（P=0.000）。在多因素线性回归模型中，校正混杂因素后，基于“互联网+”的心脑血管疾病“协防共管”健康管理模式与收缩压下降相关（P=0.000）。结论·基于“互联网+”的心脑血管疾病“协防共管”健康管理模式有助于改善社区重点监测人群的收缩压控制。

关键词： 心脑血管疾病; 互联网+; 协防共管; 社区重点监测人群; 血压

本文引用格式

李国栋 , 颜少华 , 张秋霞 , 雷力 , 张新禄 , 梁鸿彬 , 卢俊颜 , 肖敏 , 罗玮 , 卜军 , 修建成 . 基于“互联网+”的心脑血管疾病“协防共管”健康管理模式对社区重点监测人群血压改善的效果评价[J]. 上海交通大学学报（医学版）, 2022 , 42(6) : 797 -804 . DOI: 10.3969/j.issn.1674-8115.2022.06.015

Abstract

Objective

·To evaluate the effect of “Internet+”-based “co-prevention and co-management” health management model for cardio-cerebrovascular diseases on the improvement of blood pressure in target surveillance population in community.

Methods

·Target surveillance population in community who participated in the annual physical examination provided by the National Basic Public Health Service project at least twice in Xintang Town, Zengcheng District, Guangzhou from January 2020 and July 2021 were enrolled, and divided into regular management group (n=2 987) and “co-prevention and co-management” model group (n=2 876) based on whether they had received “Internet+”-based “co-prevention and co-management” health management model for cardio-cerebrovascular diseases or not. The regular management group received the regular management mode which included an annual physical examination. In addition to regular treatment, the “co-prevention and co-management” model group received “Internet+ health education”, and their villages were provided with wearable electrocardiogram monitoring equipment. The baseline levels (before the intervention) of the two groups were compared, and the differences of blood pressure changes between the two groups before and after the interventions were observed. Covariance analysis was used to analyze whether the effect of different intervention measures on blood pressure was affected by its baseline blood pressure level. Multi-variable linear regression model was used to explore the association between the “Internet+”-based “co-prevention and co-management” health management model for cardio-cerebrovascular diseases and the control of blood pressure and other cardio-cerebrovascular disease risk factors.

Results

·Compared with the regular management group, the baseline levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the “co-prevention and co-management” model group were higher (both P=0.000). After the median intervention time of 227 days, the changes of SBP and DBP in the “co-prevention and co-management” model group before and after the interventions were -0.28 mmHg (95% CI -0.94?0.37, P=0.398) and -0.68 mmHg (95% CI -1.09?-0.27, P=0.001), respectively; the changes in the regular treatment group were 2.92 mmHg (95% CI 2.29?3.54, P=0.000) and -0.12 mmHg (95% CI -0.51?0.28, P=0.554), respectively; the differences of SBP and DBP before and after the intervention between the two groups were 3.20 mmHg (95% CI 2.29?4.11, P=0.000) and 0.56 mmHg (95% CI -0.01?1.13, P=0.055), respectively. Covariance analysis showed that after adjusting for SBP before the intervention, compared with the regular treatment group, the SBP in the “co-prevention and co-management” model group was reduced by 2.06 mmHg (P=0.000). In the multi-variable linear regression model, after adjusting the confounding factors, the “Internet+”-based “co-prevention and co-management” health management model for cardio-cerebrovascular diseases was associated with lower SBP (P=0.000).

Conclusion

·The application of “Internet+”-based “co-prevention and co-management” health management model for cardio-cerebrovascular diseases among target surveillance population in community can help improving the control of systolic blood pressure.

Key words： cardio-cerebrovascular disease; Internet+; co-prevention and co-management; target surveillance population in community; blood pressure

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