中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
47期
139-142
,共4页
潘仰中%蔡运昌%郑流波%柳桂娥%张彪%谢春凤%刘宏珍%邓小林%夏旻
潘仰中%蔡運昌%鄭流波%柳桂娥%張彪%謝春鳳%劉宏珍%鄧小林%夏旻
반앙중%채운창%정류파%류계아%장표%사춘봉%류굉진%산소림%하민
高血压/预防和控制%贵州%女性
高血壓/預防和控製%貴州%女性
고혈압/예방화공제%귀주%녀성
背景:女性高血压患者有其自身流行病学特点,其主要于预措施也有所不同.目的:调查贵州省心脑血管病社区综合防治示范点女性人群高血压危险因素并观察康复预防干预效果.设计:采用整群随机设计,13个行政村每个村根据总人口数随机抽取一定比例样本量.单位:贵州省心血管病研究所,贵阳市云岩区人民医院,贵州省临床检验中心.对象:1996年以来,在贵州省心脑血管病社区开展心脑血管病社区综合防治的一系列工作,社区内有13个行政村,112个村民组,主要为在城郊结合部村民26 604人,多数村民的社会自然条件、生活行为方式等可以反映贵州省城乡人民的一般状况.调查范围为本社区15岁以上人群3 934人,均对调查项目知情同意.对数据不完整的样本剔除.方法:①于2001-04-01/05-15按照中国科学院预防医学研究所设计对示范点基线调查的要求对15岁以上人群进行调查(基线调查).②对纳人人群进行健康教育,并开展健康促进活动.③2002-07/2003-06按照中国科学院预防医学研究所设计的监测项目对女性人群进行调查(干预后监测调查).④以体质量指数18.5～23.9 kg/m2为正常,体质量指数24～27.9 kg/m2为超重,体质量指数≥28 kg/m为肥胖.⑤对两次调查结果作体质量指数、腰臀围比、平均血压、高血压患病率、知晓率、治疗率、高盐高脂饮食率对比分析.⑥两样本均数比较采用t检验,率的比较采用x2检验.主要观察指标:①贵州省社区基线调查不同年龄女性高血压患病率、知晓率、治疗率、控制率比较.②不同年龄社区基线调查女性人群体质量指数、腰臀比、血压比较.③不同体质量指数基线调查女性人群高血压患病率比较.④基线调查与干预后调查女性人群体质量指数、腰臀比、血压、吸烟、饮酒、高盐高脂饮食率、患病率、知晓率、治疗率、控制率比较.结果:基线调查获填写准确、完整的表格6 361份,合格率为99.84%.其中女性3 934人;干预后获合格资料1 141份.社区基线调查显示:①社区女性人群高血压患病率、知晓率、治疗率均随年龄增加而增加(P＜0.05);而控制率随年龄增加而降低(P＜0.05).②社区基线调查女性人群的体质量指数、腰臀围比、收缩压、舒张压及脉压均随年龄增加而显著增高(P＜0.01).女性人群体质量指数随年龄增加而升高,但在≥60岁下降.③体质量正常、超重、肥胖人群的高血压患病率分别为15.05%,23.87%,39.37%.即随体质量指数增加,高血压患病率显著增加(两两比较,P＜0.05).干预后结果与基线调查比较:①基线调查与干预后结果比较,同年龄者的体质量指数、腰臀比、血压均值多数有所降低,大部分显示差异明显(P＜0.05).②干预后女性吸烟率显著增高,高盐高脂率有所降低(P＜0.05).③本社区女性人群健康干预后患病率显著低于干预前(P＜0.05),知晓率、治疗率、控制率有显著增高(P＜0.05).结论:①贵州省社区女性人群高血压患病率、知晓率、治疗率、控制率存在年龄差异.②随着年龄增长,贵州省社区女性人群高血压危险因素严重程度也增高.③体质量的增加是影响高血压患病率的重要因素.④健康教育可降低高血压危险因素程度、提高知晓率、治疗率、控制率.
揹景:女性高血壓患者有其自身流行病學特點,其主要于預措施也有所不同.目的:調查貴州省心腦血管病社區綜閤防治示範點女性人群高血壓危險因素併觀察康複預防榦預效果.設計:採用整群隨機設計,13箇行政村每箇村根據總人口數隨機抽取一定比例樣本量.單位:貴州省心血管病研究所,貴暘市雲巖區人民醫院,貴州省臨床檢驗中心.對象:1996年以來,在貴州省心腦血管病社區開展心腦血管病社區綜閤防治的一繫列工作,社區內有13箇行政村,112箇村民組,主要為在城郊結閤部村民26 604人,多數村民的社會自然條件、生活行為方式等可以反映貴州省城鄉人民的一般狀況.調查範圍為本社區15歲以上人群3 934人,均對調查項目知情同意.對數據不完整的樣本剔除.方法:①于2001-04-01/05-15按照中國科學院預防醫學研究所設計對示範點基線調查的要求對15歲以上人群進行調查(基線調查).②對納人人群進行健康教育,併開展健康促進活動.③2002-07/2003-06按照中國科學院預防醫學研究所設計的鑑測項目對女性人群進行調查(榦預後鑑測調查).④以體質量指數18.5～23.9 kg/m2為正常,體質量指數24～27.9 kg/m2為超重,體質量指數≥28 kg/m為肥胖.⑤對兩次調查結果作體質量指數、腰臀圍比、平均血壓、高血壓患病率、知曉率、治療率、高鹽高脂飲食率對比分析.⑥兩樣本均數比較採用t檢驗,率的比較採用x2檢驗.主要觀察指標:①貴州省社區基線調查不同年齡女性高血壓患病率、知曉率、治療率、控製率比較.②不同年齡社區基線調查女性人群體質量指數、腰臀比、血壓比較.③不同體質量指數基線調查女性人群高血壓患病率比較.④基線調查與榦預後調查女性人群體質量指數、腰臀比、血壓、吸煙、飲酒、高鹽高脂飲食率、患病率、知曉率、治療率、控製率比較.結果:基線調查穫填寫準確、完整的錶格6 361份,閤格率為99.84%.其中女性3 934人;榦預後穫閤格資料1 141份.社區基線調查顯示:①社區女性人群高血壓患病率、知曉率、治療率均隨年齡增加而增加(P＜0.05);而控製率隨年齡增加而降低(P＜0.05).②社區基線調查女性人群的體質量指數、腰臀圍比、收縮壓、舒張壓及脈壓均隨年齡增加而顯著增高(P＜0.01).女性人群體質量指數隨年齡增加而升高,但在≥60歲下降.③體質量正常、超重、肥胖人群的高血壓患病率分彆為15.05%,23.87%,39.37%.即隨體質量指數增加,高血壓患病率顯著增加(兩兩比較,P＜0.05).榦預後結果與基線調查比較:①基線調查與榦預後結果比較,同年齡者的體質量指數、腰臀比、血壓均值多數有所降低,大部分顯示差異明顯(P＜0.05).②榦預後女性吸煙率顯著增高,高鹽高脂率有所降低(P＜0.05).③本社區女性人群健康榦預後患病率顯著低于榦預前(P＜0.05),知曉率、治療率、控製率有顯著增高(P＜0.05).結論:①貴州省社區女性人群高血壓患病率、知曉率、治療率、控製率存在年齡差異.②隨著年齡增長,貴州省社區女性人群高血壓危險因素嚴重程度也增高.③體質量的增加是影響高血壓患病率的重要因素.④健康教育可降低高血壓危險因素程度、提高知曉率、治療率、控製率.
배경:녀성고혈압환자유기자신류행병학특점,기주요우예조시야유소불동.목적:조사귀주성심뇌혈관병사구종합방치시범점녀성인군고혈압위험인소병관찰강복예방간예효과.설계:채용정군수궤설계,13개행정촌매개촌근거총인구수수궤추취일정비례양본량.단위:귀주성심혈관병연구소,귀양시운암구인민의원,귀주성림상검험중심.대상:1996년이래,재귀주성심뇌혈관병사구개전심뇌혈관병사구종합방치적일계렬공작,사구내유13개행정촌,112개촌민조,주요위재성교결합부촌민26 604인,다수촌민적사회자연조건、생활행위방식등가이반영귀주성성향인민적일반상황.조사범위위본사구15세이상인군3 934인,균대조사항목지정동의.대수거불완정적양본척제.방법:①우2001-04-01/05-15안조중국과학원예방의학연구소설계대시범점기선조사적요구대15세이상인군진행조사(기선조사).②대납인인군진행건강교육,병개전건강촉진활동.③2002-07/2003-06안조중국과학원예방의학연구소설계적감측항목대녀성인군진행조사(간예후감측조사).④이체질량지수18.5～23.9 kg/m2위정상,체질량지수24～27.9 kg/m2위초중,체질량지수≥28 kg/m위비반.⑤대량차조사결과작체질량지수、요둔위비、평균혈압、고혈압환병솔、지효솔、치료솔、고염고지음식솔대비분석.⑥량양본균수비교채용t검험,솔적비교채용x2검험.주요관찰지표:①귀주성사구기선조사불동년령녀성고혈압환병솔、지효솔、치료솔、공제솔비교.②불동년령사구기선조사녀성인군체질량지수、요둔비、혈압비교.③불동체질량지수기선조사녀성인군고혈압환병솔비교.④기선조사여간예후조사녀성인군체질량지수、요둔비、혈압、흡연、음주、고염고지음식솔、환병솔、지효솔、치료솔、공제솔비교.결과:기선조사획전사준학、완정적표격6 361빈,합격솔위99.84%.기중녀성3 934인;간예후획합격자료1 141빈.사구기선조사현시:①사구녀성인군고혈압환병솔、지효솔、치료솔균수년령증가이증가(P＜0.05);이공제솔수년령증가이강저(P＜0.05).②사구기선조사녀성인군적체질량지수、요둔위비、수축압、서장압급맥압균수년령증가이현저증고(P＜0.01).녀성인군체질량지수수년령증가이승고,단재≥60세하강.③체질량정상、초중、비반인군적고혈압환병솔분별위15.05%,23.87%,39.37%.즉수체질량지수증가,고혈압환병솔현저증가(량량비교,P＜0.05).간예후결과여기선조사비교:①기선조사여간예후결과비교,동년령자적체질량지수、요둔비、혈압균치다수유소강저,대부분현시차이명현(P＜0.05).②간예후녀성흡연솔현저증고,고염고지솔유소강저(P＜0.05).③본사구녀성인군건강간예후환병솔현저저우간예전(P＜0.05),지효솔、치료솔、공제솔유현저증고(P＜0.05).결론:①귀주성사구녀성인군고혈압환병솔、지효솔、치료솔、공제솔존재년령차이.②수착년령증장,귀주성사구녀성인군고혈압위험인소엄중정도야증고.③체질량적증가시영향고혈압환병솔적중요인소.④건강교육가강저고혈압위험인소정도、제고지효솔、치료솔、공제솔.
BACKGROUND: Female hypertension has its own epidemicologic character and the chief interventions on it are various.OBJECTIVE: To investigate the risk factors of female hypertension and observe the effects on rehabilitative and preventive intervention in demonstrative community for comprehensive prevention and treatment of cardiac cerebral vascular disease in Guizhou.DESIGN: Group randomization was designed. The samples of certain percentage were randomized according to total population from each village of 13 administrative areas.SETTING: Guizhou Institute of Cardiovascular Disease, Renmin Hospital of Yunyan District in Guiyang, Guizhou Clinical Examination Center.PARTICIPANTS: Since 1996, a series of comprehensive prevention and treatment had been carried in the communities for cardiac cerebral vascular disease in Guizhou, involved 13 administrative areas and 112 villagecitizen groups, in which, 26 604 people were employed, living in the regions between town and country. Social natural condition and life behavior of majority citizen reflected the common state of people in town and country. Totally 3 934 people aged over 15 years were investigated in the communities, and were all in the known of investigation. The samples without complete data were excluded.METHODS: ① Base-line investigation was carried on for the groups over 15 years old according to the requirement for administrative region designed by Institute of Preventive Medicine of China Academy of Sciences from April 1st 2001 to May 15th . ② Health education and health promotion activity were carried on for the included groups. ③ Survey after intervention was given for females according to the survey items designed by Institute of Preventive Medicine of China Academy of Sciences from July 2002to June 2003. ④ Normal body-mass index (BMI) was 18.5-23.9 kg/m2,overweight was indicated if BMI was 24-27.9 kg/m2 and obesity was diagnosed if BMI ≥28 kg/m2. ⑤ Analysis was applied on comparison of BMI,waist to hip ratio (WHR), average blood pressure, the rates of incidence,awareness and treatment of hypertension and rate of high-salty and lipid diet. ⑥ t test was adopted for comparison of means between two samples and x2 test was used for rate comparison.MAIN OUTCOME MEASURES: ① Comparison of the rates of incidence, awareness, treatment and control of hypertension for females of different ages in community base-line investigation in Guizhou. ② Comparison of BMI, WHR and BP of females of various ages in baseline investigation.③ Comparison of incident rate of hypertension for females with various BMI in baseline investigation. ④ Comparison of BMI, WHR, BP, smoke, alcohol, rate of high-salty and lipid diet, the rates of incidence, awareness,treatment and control of hypertension for females between baseline investigation and post-intervention survey.RESULTS: In baseline investigation, 6 361 correct and complete forms were collected, with 99.84% qualified rate, of which, there were 3 934females. 1 141 data were qualified after intervention. It was indicated in community baseline investigation: ① Rates of incidence, awareness and treatment of hypertension for females were improved with increased age (P ＜ 0.05), and the control rate was decreased with increased age (P ＜ 0.05). ② BMI, WHR, SBP (systolic blood pressure) and DBP (diastolic blood pressure) and PP (pulse pressure) were improved significantly with in creased age (P ＜ 0.01). BMI for females was increased with ages, but was declined with age ≥60 years. ③ The incident rates of hypertension for groups of normal body mass, overweight and obesity were 15.05%, 23.87% and 39.37% successively, indicating that the hypertension inci dent rate was increased significantly with improved BMI (paired compari son, P ＜ 0.05). Comparison between post-intervention survey and base-line investigation: ① In the comparison, the results of BMI, WHR and BP means were reduced for most cases at same age and significant difference was displayed in majority (P ＜ 0.05). ② After intervention, smoke rate of females was increased significantly and rate of high-salty and lipid diet was decreased (P ＜ 0.05). ③ Incident rate after health intervention was decreased significantly compared with that before intervention (P ＜ 0.05),and the rates of awareness, treatment and control of hypertension were enhanced significantly (P ＜ 0.05).CONCLUSION: ① The rates of incidence, awareness, treatment and control of female hypertension are different in ages in community of Guizhou. ② The severity of risk factor of female hypertension is enhanced with increased age in community of Guizhou. ③ The increased body mass is the important factor of incident rate of hypertension. ④ Health education probably decreases the severity of risk factor of hypertension and increases the rates of awareness, treatment and control.
