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中国基层高血压管理模式的网状Meta分析

A Network Meta-analysis of Primary Hypertension Management Patterns in China

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背景 高血压作为危险因素能够显著增加城乡居民心脑血管疾病的发病率与死亡率,有效控制高血压是防治心脑血管疾病的重中之重.目的 全面收集我国不同高血压管理模式效果评价方面的文献,评价不同模式的管理效果,为进一步优化高血压管理模式提供参考依据.方法 使用统计软件StataSE-64,以血压控制率为评价指标,对纳入的 18 篇高血压管理模式文献涉及医院-社区联合管理、常规社区管理、常规医院治疗管理、一般管理、"互联网+"管理五种模式进行网状Meta分析.结果 相对于作为空白对照的一般管理模式,医院-社区联合管理、常规社区管理、常规医院管理、"互联网+"管理四种模式对高血压控制都具有一定效果.总体效果排序为医院-社区联合管理≈"互联网+"管理>常规医院治疗管理>常规社区管理>空白对照.其中医院-社区联合管理模式对高血压控制效果显著;医院-社区联合管理模式与"互联网+"管理模式效果相近;常规医院管理比常规社区管理效果好.结论 为完善基层高血压管理模式,应推进基层医疗卫生机构医院-社区-家庭管理模式建设,引导慢性病管理模式与"互联网+医疗"模式结合,加强慢性病全生命全周期管理.
Background Hypertension as a risk factor can significantly increase the morbidity and mortality of cardiovascular and cerebrovascular diseases,and effective control of hypertension is the key to prevent and treat cardiovascular diseases.Objective Collect literature on the evaluation of the effectiveness of hypertension management models in China.Evaluate the management effects of different models and provide a reference for further optimization of hypertension management models.Methods Using StataSE-64,a network Meta-analysis of the 18 included hypertension management model papers was performed using blood pressure control rates as an evaluation metric.The models included five models:joint hospital-community management,community management,hospital treatment management,general management,and combined Internet management.Results Joint hospital-community management,community management,hospital management,and combined Internet management are all effective for hypertension control.The order is joint hospital-community management ≈ combined Internet management>hospital treatment management>community management>blank control.Among them,the joint hospital-community management model has significant effect on hypertension control;the joint hospital-community management model and combined Internet management has similar effect;and hospital management has better effect than community management.Conclusion In order to improve the hypertension management model,the construction of hospital-community-family management model in primary health care institutions should be promoted,and the combination of chronic disease management model and combined Internet model should be guided to strengthen the whole-life,whole-cycle management of chronic disease patients.

HypertensionHypertension management modelPrimary health careNetwork meta-analysis

谷明宇、秦廷廷、乔昆、白欣苑、王尧、杨宇彤、李星明

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100069 北京市,首都医科大学公共卫生学院

高血压 高血压管理模式 基层 网状Meta分析

2025

中国全科医学
中国医院协会

中国全科医学

北大核心
影响因子:2.04
ISSN:1007-9572
年,卷(期):2025.28(10)