文章摘要
吕筠,李立明,何平平,曹卫华,詹思延,胡永华.苯那普利抗高血压治疗患者血压长期变化趋势分析[J].中华流行病学杂志,2004,25(6):537-540
苯那普利抗高血压治疗患者血压长期变化趋势分析
Analysis on the trend of long-term change of blood pressure in hypertensive patients treated with benazepril
收稿日期:2003-08-21  出版日期:2014-09-17
DOI:
中文关键词: 药物监测;血管紧张素转换酶抑制剂;纵向研究;混合线性模型
英文关键词: Product surveillance;Angiotensin-converting enzyme inhibitors;Longitudinal studies;Mixed linear model
基金项目:国家“九五”科技攻关课题资助项目(96-906-02-05)
作者单位
吕筠 北京大学医学部流行病与卫生统计学系 100083 
李立明 中国疾病预防控制中心 
何平平 北京大学医学部流行病与卫生统计学系 100083 
曹卫华 北京大学医学部流行病与卫生统计学系 100083 
詹思延 北京大学医学部流行病与卫生统计学系 100083 
胡永华 北京大学医学部流行病与卫生统计学系 100083 
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中文摘要:
      目的 介绍混合线性模型方法在降压治疗中对血压长期变化趋势分析的应用。方法利用在上海市南市区开展的一项以社区为基础的苯那普利上市后3年流行病学监测数据,分析不同年龄、性别的原发性高血压患者用药3年中血压水平的变化趋势。用作拟合的是患者每3个月1次的血压重复测量值。结果 对收缩压和舒张压拟合的较适模型为曲线线性模型。而对脉压进行了分段拟合,即用药后前9个月为曲线线性模型,9个月后为线性模型。服用苯那普利期间,患者的血压水平表现出长期稳定的降压效果。不同年龄和性别的患者在血压水平、降压速度和加速度方面存在一定的变异。患者年龄越大,表现出收缩压越高、舒张压越低、脉压越大。抗高血压治疗表现出最初的血压水平越高,降压速度越快,降压幅度越大。结论 混合线性模型方法在应用于纵向数据的分析时,尤其是在处理缺失数据方面,具有很大的灵活性,能更充分地利用可得信息。
英文摘要:
      Objective To introduce the application of mixed linear model in the anaysis of secular trend of blood pressure under antihypertensive treatment.Methods A community-based postmarketing survillance of benazepril was conducted in 1831 essetial hypertensive patients (age range from 35 to 88 years) in Shanghi.Deta of blood pressure was analyzed every 3 months with mixed linear model to describe the secular trend of blood pressure and changes of age-specific and gender-specific.Results The changing trends of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were found to fit the curvilinear models.A piecewise model was fit for pulse pressure (PP),i.e.,curvilinear model in the first 9 months and linear model after 9 months of taking medication. Both blood pressure and its velocity gradually slowed down.There were significant variation for the curve parameters of intercept,slope,and acceleration.Blood pressure in patients with higher initial levels wa persistently declining in the 3-year-treatment.However blood pressures of patients with relatively low initial levels remained low when dropped down to some degree.Elderly patients showed high SBP but low DBP,so as with higher PP.The velocity and sizes of blood pressure reductions increased with the initial level of blood pressure.Conclusion Mixed linear model is flexible and robust when applied to the analysis of longitudinal data but with missing values and can also make the maximum use of available information.
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