辽宁省大中城市及郊区老年人支气管哮喘患病率调查

目的　调查辽宁省大、中城市及其郊区老年人支气管哮喘 (哮喘 )的患病情况 ,为老年人哮喘的防治提供依据。　方法　以分层整群不等比随机抽样对照方法 ,抽取全省人口的 2 5‰以上人口共 1162 76人 ,对其中≥ 60岁的 12 73 5名老年人哮喘患病情况进行分析。　结果　确诊老年哮喘患者 52 2例 ,患病率为 4 0 9% ,显著高于我省同期现患病率的 1 2 5% ,其中男 2 0 7例、女 3 15例 ,女性显著高于男性 (P <0 0 1)。农村老年人哮喘患病率显著高于城市 (患病率分别为 5 2 4%和3 0 1% ,P <0 0 1)。城市工业区老年人哮喘患病率高于文化区 (患病率分别为 3 85%和 2 44% ,P<0 0 5) ,起病年龄在 60岁以上者 50例 ,占 9 58%。本次调查确诊为哮喘者 2 13例 ,漏诊率为40 80 %。　结论　哮喘是老年人的常见疾病 ,加强其防治极为重要     

上海市30岁以上人群阻塞性睡眠呼吸暂停低通气综合征流行病学调查

目的 调查阻塞性睡眠呼吸暂停低通气综合征(0SAHS)的人群患病率，为制定该病的防治策略提供依据。方法 采用整群抽样的方法对上海市卢湾区、徐汇区、杨浦区、浦东新区4区6个街道常住30岁以上居民9600人，进行问卷调查；根据打鼾程度，从中、重度组随机抽样150例，行整夜便携式多导睡眠检测仪监测，保守估计人群0SAHS的患病率。结果 实际调查人数8081人(应答率为84．18％)，其中有效问卷6826份(有效率为84．47％)。其中打鼾占57．11％，中、重度打鼾占23．73％。且随着年龄的增加，打鼾比例逐渐增加，70岁后呈下降趋势。男性高于女性，尤见于中、重度。吸烟和饮酒与打鼾程度相关。绝经和月经不规律打鼾的发生率及程度均较规律为高。不同程度打鼾患，日间的嗜唾评分有明显差异。按睡眠呼吸暂停低通气指数(AHI)≥5次h为标准，人群0SAHS的发生率为20．39％。结合日间Epworth嗜唾量表(ESS)评分≥9分为标准，保守估计人群0SAHS的患病率为3．62％。结论 我国大陆30岁以上人群0SAHS患病率保守估计为3．62％，是影响公众健康的重要问题之一，应当引起足够的重视。     

睡眠呼吸暂停综合征和慢性阻塞性肺疾病

睡眠呼吸暂停综合征 (sleep apnea- hypopnea syndrome,SAHS)和慢性阻塞性肺疾病 (chronic obstructive pulmonarydisease,COPD)均为 4 0岁以上男性的常见疾病。据统计成人SAHS的发病率为 2 %～ 4 % ,男性高于女性 ,女性更年期以后发病率增高。 COPD的发病率为 3.17% ,两种疾病     

老年人睡眠质量及其影响因素的调查分析

睡眠质量是影响老年人生活质量的重要组分之一 〔1 ,2〕。我们在杭州市开展老年人睡眠质量及其影响因素的调查 ,以便掌握老年人睡眠障碍的发生率和影响老年睡眠质量的因素 ,为提高老年人睡眠质量的干预措施提供一线资料。1　材料与方法1.1　 研究对象　在杭州市 5个城区各抽取 12 0名 6 5岁以上的居民 ,总计 6 0 0名。实际收回有效调查问卷 5 81份 ,回收率为96 .8%。其中男性 4 8.7% (2 83人 ) ,女性 5 1.3% (2 98人 ) ,平均年龄 70 .12± 7.2 6岁。1.2 　 研究工具　 (1)老年人一般情况调查表 ,包括人口统计学资料、家庭关系、身体状况等 ;…     

汉族和维吾尔族人群睡眠呼吸暂停低通气综合征与高血压的相关性研究

目的 调查两个民族睡眠呼吸暂停低通气综合征(SAHS)患者中高血压的患病率,探讨SAHS及夜间低氧与高血压的关系.方法 采用流行病调查的方法对克拉玛依市区3个社区1121例35岁以上常住居民进行入户睡眠鼾症问卷及高血压病史调查,其中汉族582例,维吾尔族539例,并对所有人群进行夜间血氧及呼吸监测.结果 年龄、性别相匹配的汉族与维吾尔族组间的体重指数、颈围、腹围、氧减指数、夜间平均氧饱和度、呼吸紊乱指数、收缩压、舒张压等方面比较差异有统计学意义(P均＜0.01).夜间低氧组与无低氧组间高血压患病率比较差异有统计学意义(P均＜0.05).SAHS组与非SAHS 组间高血压患病率比较差异有统计学意义(P＜0.05).结论 克拉玛依市区35岁以上汉族SAHS患者中高血压患病率为42.6％,维吾尔族为29.9％,高血压与SAHS分级相关,睡眠呼吸暂停和夜间低氧可引起血压增高,应引起重视.     

2000年与1990年儿童支气管哮喘患病率的调查比较

目的　调查儿童哮喘患病率 10年前、后的变化。方法　采用整群抽样调查方法 ,调查2 7个城市 (分为中南、西南、华东、东北、西北、华北六片 ) 0～ 14岁儿童哮喘患病率情况。结果　 2 0 0 0年共调查 2 8732 9名儿童中有 4 30 1例 (1 5 0 % )诊断为哮喘 ,其中 35 4 0例 (82 31% )为儿童哮喘 ,76 1例 (17 6 9% )为婴幼儿哮喘 ;1990年调查 399193名儿童中有 36 2 5例 (0 91% )诊断为哮喘 ,其中 2 6 91例 (74 2 3% )为儿童哮喘 ,934例 (2 5 77% )为婴幼儿哮喘。两次调查性别比均为男性占优势 [2 0 0 0年男 (14 796 9例 )、女 (13936 0例 )患病数分别为 2 733例 (1 85 % )、15 6 8例 (1 13% ) ,其比值为 1 74∶1.0 0 ;1990年男 (2 10 137例 )、女 (1890 5 6例 )患病数分别为 2 2 6 5例 (1 0 8% )、136 0例 (0 72 % ) ,比值为1 6 7∶1.0 0 ],并且 90 %左右 [2 0 0 0年为 90 .30 % (3884 /430 1) ;1990年为 95 .2 6 % (345 3/36 2 5 ) ]在 6岁前发病。 10年前、后患病率上升了 6 4 84 % ;各城市儿童哮喘患病率不同 ,2 0 0 0年上海 (483/14 4 6 8)和重庆 (374 /112 0 0 )最高 ,均为 3 34% ,拉萨 (35 /6 6 76 )最低 ,为 0 5 2 % ;1990年重庆 (199/76 5 1)最高 ,为2 6 0 % ,拉萨 (14 /15 36 0 )最低 ,为 0     

深圳城区成年人峰值骨密度和骨质疏松患病率的调查

目的　调查深圳城区健康人群峰值骨密度 (PBM )和骨质疏松患病率 ,以期为深圳地区骨质疏松症防治工作提供理论依据。方法　三年调查期间体检的健康成年人 747名 ,年龄 2 0～70岁 ,每 5岁一个年龄段分为 10组 ;用双能X光骨密度仪测量骨密度并得到峰值骨密度 (PBM )值。结果　男性各部位PBM值出现在 2 5～ 2 9岁 ,女性除Ward’s部位PBM值出现在 3 0～ 3 4岁外 ,其余部位PBM值均出现在 3 5～ 3 9岁。骨质疏松患病率 :女性 5 0岁为 2 3 % ,60～ 70岁为 67% ;男性 60～70岁为 5 4%。深圳城区女性髋部PBM高于南宁 (P <0 .0 1)和广州 (P <0 .0 5 )而与北京相近 ,腰部PBM低于北京、南京 (P <0 .0 5 )而高于南宁 (P <0 .0 1)。男性PBM腰部和髋部低于北京 (P <0 .0 5 ,P <0 .0 1) ,高于南宁 (P <0 .0 1) ,与广州、南京相似。结论　 1.女性骨质疏松症于绝经后五年出现高峰 ;老年时期骨质疏松症又达一个高峰 ,且老年女性骨质疏松患病率明显高于老年男性。2 .骨质疏松的预防应从青少年时期提高PBM开始     

上海市杨浦区痛风的流行病学调查

目的　调查上海市杨浦区原发性痛风的流行情况。方法　按照统一制定的表格 ,对上海市杨浦区 65 84名自然人群 (≥ 16岁 )进行问卷调查 ,对回答阳性者进行体检、X线检查和血尿酸检验。结果　共发现原发性痛风患者 2 2例 (男性 2 0例、女性 2例 ) ,患病粗率为 0 .3 3 % (男性0 .63 %、女性 0 .0 6% ) ,标化患病率为 0 .2 2 % (男性 0 .44 %、女性 0 .0 3 % )。男女性标化患病率之比约为 15∶1。结论　痛风在上海地区的患病率为 0 .2 2 % ,且主要发生于男性     

上海市6～18岁少儿肥胖患病率调查

目的　研究上海市 6～ 18岁年龄组的儿童青少年肥胖和超重患病率情况。　方法　采用整群系统抽样的方法随机抽取上海市区、郊区各一个区 ,普查区内所有中小学学生共 6 5 0 0 6名 (郊区 4 0 310名 ,市区 2 4 6 96名 )的身高、体重。以体质指数 (BMI)评价调查对象的肥胖患病率 ,并比较标化患病率的差异。　结果　 (1)调查对象肥胖粗患病率为 3 5 8% ,超重标化患病率为 3 30 % ;超重粗患病率达 13 2 5 % ,标化患病率为 12 95 %。 (2 )总体上肥胖和超重的标化患病率市区显著高于郊区 (肥胖 :P <0 0 0 1,超重 :P <0 0 0 1) ;女性的发病率显著低于男性 (肥胖 :P <0 0 0 1,超重 :P <0 0 0 1)。 (3)肥胖和超重患病率随年龄增加显著减低 (P <0 0 0 1)。　结论　本组的肥胖患病率稍高于我国 1996年全国性调查的 0～ 7岁组儿童肥胖患病率 ,远低于美国上世纪 90年代末期的水平 ;各年龄组肥胖患病率随年龄增加而逐渐减低 ,与西方发达国家青少年肥胖患病率随年龄增加而增高的趋势有显著的不同。     

太原地区健康体检人群甲状腺功能紊乱患病情况调查

目的　调查太原地区人群中甲状腺功能紊乱的患病率。方法　测定太原地区 812 5名体检人群的TSH ,然后再测定FT3、FT4 和甲状腺抗体。结果　在此体检人群中 ,甲状腺功能亢进(甲亢 )患病率为 1.2 0 % ,亚临床甲亢患病率为 0 .87% ,甲状腺功能减退 (甲减 )患病率为 1.0 3 % ,亚临床甲减患病率为 0 .95 %。各种甲状腺功能紊乱的患病率女性均高于男性 (P <0 .0 5～ <0 .0 1)。结论　报道太原地区人群中甲状腺功能紊乱的患病率 ,无论是甲亢和亚临床甲亢或甲减和亚临床甲减 ,女性的患病率均高于男性     

Situation in Spain of the diagnostic resources and of the treatment with continuous positive pressure respiration in sleep obstructive apnea-hypopnea syndrome

Sleep apnea-hypopnea syndrome (SAHS) is a major health problem whose estimated prevalence is 2 to 4% of the population. The Respiratory Insufficiency and Sleep Disorders Task Force estimated in 1995 that over one million people suffer SAHS with clinical repercussions in Spain while the number of patients receiving treatment was 8,000; diagnostic resources were not widely available. The aim of this study was to analyze the current situation in Spain. A survey carried out nation-wide in the period from 1995 to 1997 revealed that approximately 28,000 individuals were receiving nighttime support ventilation, signifying a prevalence of 72 per 100,000 inhabitants for this type of treatment. This situation has come about in a context of insufficient availability of diagnostic tools, with nocturnal oxygen levels having been established for some 37% of patients. We conclude that a broad plan to diagnose and treat patients with SAHS is required. The plan should include: a) greater availability of diagnostic tools; b) protocols for coordination; c) programs for continuous training and updating of knowledge of this disease, and d) revision of systems for financing support ventilation.     

承德市区居民睡眠呼吸暂停低通气综合征患病率入户调查

目的 了解承德市区30岁以上居民唾眠呼吸暂停低通气综合征(SAHS)的患病率，为该病的防治提供依据。方法 按照随机整群抽样法，对承德市双桥区部分30岁以上居民进行入户调查，对部分2级及2级以上打鼾进行整夜唾眠呼吸监测。结果 在调查的1168人中打鼾为53．76％，≥2级打鼾为28．25％。≥2级打鼾男性(39．27％)高于女性(17．65％)，统计学上差异有非常显性意义(P＝0．000)。随着年龄增加，打鼾率明显增加。≥2级打鼾在不同职业比较差异均有显性(P＝0．000)，司机组最高(42．00％)。≥2级打鼾中吸烟(41．23％)和饮酒(40．50％)均高于非吸烟(21．36％)和非饮酒(19．73％)。被调查中55．82％认为打鼾不是病，不需要治疗。按唾眠呼吸暂停低通气指数(AHU)≥5次/h为标准，OSAHS患病率为22．64％，按AHI≥5次/h加Epworth嗜唾量表(ESS)评分≥9分为标准判断，人群患病率为4．63％。结论 承德市30岁以上人群中SAHS患病率为4．63％，打鼾及SAHS是严重危害广大人民群众健康的疾病之一，但未引起人们重视．因此需要进一步搞好宣传教育工作。     

Prevalence of obstructive sleep apnea syndrome in patients with sick sinus syndrome

INTRODUCTION AND OBJECTIVES: Sleep apnea-hypopnea syndrome (SAHS) has been associated with different cardiovascular diseases. It may even be implicated in the pathophysiology of sick sinus syndrome (SSS). However, the precise relationship between the two syndromes is still unknown. We investigated the prevalence of SAHS in patients diagnosed with SSS. PATIENTS AND METHOD: Between June 2002 and December 2004, 38 consecutive patients who were diagnosed with SSS by 24-hour Holter monitoring were studied prospectively in our institution. All patients were asked about symptoms of SAHS, and underwent polysomnography out of hospital using a validated monitor. RESULTS: The patients' mean age was 67 (10) years, 68% were male, and 58% were hypertensive. Holter monitoring demonstrated a maximum heart rate of 87 (6) beats/min, a minimum of 35 (3) beats/min, and a mean of 48 (3) beats/min. Some 24 (63%) patients required pacemaker implantation because of symptomatic SSS. Overall, 39% of patients had symptoms suggestive of SAHS (i.e., an Epworth index or EI>9). Polysomnography showed that only 13% of patients had a normal apnea-hypopnea index (AHI) and that 31.6% (95% CI, 16.8%-46.4%) had SAHS (i.e., AIH>10 and EI>9). CONCLUSIONS: Given that the prevalence of SAHS in the general population is around 3%, our results indicate that it is ten-fold higher in patients with SSS than in the general population. This observation indicates that there may be a relationship between the two syndromes.     

宁夏地区睡眠呼吸暂停低通气综合征的流行问卷调查

目的了解宁夏地区睡眠呼吸暂停低通气综合征(SAHS)的患病情况,为进一步制定该病的防控措施提供基线资料。方法采取多级整群分层抽样方法,2007年6月至2008年12月对宁夏地区银川市、石嘴山市、吴忠和泾源城乡20岁以上常住居民10 000人进行调查问卷,内容包括打鼾情况、日间嗜睡程度(ESS嗜睡量表),测量身高、体重、颈围、腹围等数据,初步得出宁夏地区SAHS的患病情况。结果有效问卷7804份(有效率91.64%),回族3914人(50.15%),汉族3890人(49.85%)。依据中、重度打鼾结合日间嗜睡(ESS≥9)为标准,初步保守估计宁夏地区20岁以上常住居民SAHS的患病率为3.31%,其中汉族SAHS的患病率为2.93%,回族为3.68%,两民族之间的患病率差异无统计学意义。城镇人群SAHS的患病率为4.23%,农村为2.80%,城镇和农村患病率差异有统计学意义,且随着体重指数的增加SAHS患病率明显增加。结论宁夏地区汉族SAHS的患病率为2.93%,回族SAHS的患病率为3.68%,且存在地区差异,表现为城镇人群SAHS的患病率明显高于农村。     

Apnea del sueño en individuos de edad avanzada. Actividad asistencial (2002–2008) en España

Introduction and objective

There is a significant lack of scientific evidence on the role of SAHS in the elderly despite the increasing ageing of the population. The objective of the present study is to analyse the current healthcare situation in Spain on the diagnosis and treatment of sleep apnea in the population ≥65 years and its progress over the last few years.

Material and method

Cross-sectional study. Healthcare information was collected on the diagnosis and treatment of patients of both sexes and ≥65 years suspected with having SAHS and referred to sleep units (SU) between 2002 and 2008.

Results

There were 51,229 sleep studies performed in 16 SU. Of these, 24.3% were performed on subjects ≥ 65 years (64.9% males), of which 71.5% had an AHI (apnoea-hypopnoea index) >10 (68.6% treated with CPAP). There were no differences over time as regards mean age, mean AHI or percentage of studies done. A significant decrease was observed in the number of CPAP prescribed to males ≥65 years from 2002 to 2005 (p=0.01) which subsequently increased up to 2008 (p=0.01). This phenomenon was not observed in women ≥65 years.

Conclusion

Despite the lack of evidence on the subject, healthcare activity due to suspected SAHS in the elderly population is intense, therefore it should be a priority to start clinical studies that may be able to answer key questions on the diagnosis and treatment of SAHS in this age group.     

椎基底动脉供血不足支架植入对改善睡眠呼吸暂停低通气综合征的初步观察

目的 观察椎基底动脉缺血发作与睡眠呼吸暂停低通气综合征(SAHS)之间的关系,以及椎动脉内支架植入治疗对SAHS的作用.方法 对20例椎动脉血管内支架成形术患者在治疗前后进行多导睡眠图监测,同时记录患者的一般资料和临床表现,填写Epworth嗜睡程度量表.按照成人SAHS的诊断标准进行诊断、分型,判断其严重程度及缺氧变化.治疗前后的比较采用配对t检验和秩和检验,偏态分布的计量资料以中位数和四分位间距表示.结果 20例椎基底动脉缺血性狭窄患者合并SAHS者17例,其中轻度10例、中度3例、重度4例,临床类型符合阻塞性睡眠呼吸暂停低通气综合征(OSAHS).治疗后患者的呼吸暂停低通气指数[5.0(1.6～12.7)次/h]、最长呼吸暂停时间[(19.5±12.4)s]、呼吸暂停低通气时间占总睡眠时间百分比[2.3(0.6～9.8)%]、每小时动脉血氧饱和度下降4%的次数[5.8(2.7～17.0)次/h]明显低于治疗前[11.3(6.3～23.6)次/h、(31.5±18.6)s、6.9(2.6～14.3)%、10.1(5.3～29.0)次/h],治疗后患者的夜间最低动脉血氧饱和度[(86.1±3.3)%]明显高于治疗前[(83.6±7.1)%].结论 椎基底动脉缺血患者的睡眠结构紊乱,睡眠效率降低.患者具有较高的SAHS患病率,主要造成阻塞性睡眠呼吸暂停.椎动脉血管内支架成形术治疗可改善缺血性脑血管病患者的睡眠呼吸紊乱及缺氧状况.     

Status and management of hypertension in Greece: role of the adoption of a Mediterranean diet: the Attica study

OBJECTIVE: To evaluate the prevalence, awareness, treatment, and control of hypertension, in a random sample of adults free of cardiovascular disease, in Greece. A secondary goal was to evaluate the association between hypertension status and adoption of the Mediterranean diet. DESIGN: Cross-sectional survey. PARTICIPANTS: On the basis of multistage sampling, 1,128 men and 1,154 women older than 18 years were enrolled. MAIN OUTCOME MEASURES: The survey included a detailed interview and, among other clinical measurements, status and management of blood pressure were recorded. Adoption of the Mediterranean diet was assessed through a special questionnaire. RESULTS: The prevalence of hypertension was 38.2% in men and 23.9% in women (P < 0.05). The majority of men (65%) and women (40%) were untreated, and of those who were treated, only 109 of 319 (34%) had their blood pressure adequately controlled. Thus only 15% of the hypertensive population had their blood pressure well controlled. Multivariate logistic regression analysis revealed that consumption of a Mediterranean diet was associated with a 26% (odds ratio = 0.74, P = 0.008) lower risk of being hypertensive, and with a 36% (odds ratio = 1.36, P = 0.021) greater probability of having the blood pressure controlled. CONCLUSIONS: A considerable proportion of the general population remain unaware of having hypertension or do not have their blood pressure well controlled. However, consumption of a Mediterranean type of diet seems to reduce rates of hypertension in the population, and may contribute to the control of hypertension at the population level.     

Hepatitis C in the general adult population of Oslo: prevalence and clinical spectrum

BACKGROUND: The prevalence of hepatitis C (HCV) in Northern Europe has not been well described. This study aimed to estimate the prevalence and spectrum of hepatitis C infection in the general adult population of Oslo, Norway. METHODS: The study was part of the Oslo Health Study 2000-2001 and included a random selection of individuals older than 30 years living in Oslo County. Sera from 11,456 participants were screened for anti-HCV (EIA-3), positive samples were confirmed (RIBA-3) and examined for HCV RNA (PCR). All anti-HCV positive patients were offered clinical evaluation. Routine biochemical liver tests were performed. Candidates for HCV treatment were asked to undergo a percutanous liver biopsy. RESULTS: Among 11,456 participants HCV RNA was detected in 62 (0.5%) and HCV RNA with raised serum alanine aminotransferase (ALT) in 46 (0.4%). Anti-HCV was detected in 78 (0.7%) with a peak prevalence of 1.5% among subjects 40 and 45 years old. Being anti-HCV positive was associated with being unmarried, unemployed and having low education. Anti-HCV prevalence was higher among subjects with alcohol-related problems compared to those without (4.4% versus 0.6%, P < 0.001). It was also higher among smokers compared to non-smokers (2.0% versus 0.2%, P < 0.001). In 33 liver biopsies, bridging fibrosis was seen in 8 (24%) and cirrhosis in 1 (3%). The route of transmission was injecting drug use in 67%, transfusion in 6% and unknown in 27%. CONCLUSION: In this population-based survey the prevalence of chronic hepatitis C was 0.5% and ALT was raised in 80% of those with chronic infection.     

睡眠呼吸暂停低通气综合征6年临床趋势分析

目的 探讨睡眠呼吸暂停低通气综合征(sleep apnea-hyperpnoea syndrome,SAHS)患者的临床流行病学特征,以及危险因素和合并症,进一步提高临床诊治水平.方法 回顾性分析宁夏医学院附属医院从2002年1月至2007年12月住院诊断为SAHS的466例患者的临床资料及睡眠监测指标.结果 2002年住院人数56例,后逐年递增至2007年91例.在住院患者中,男、女比例为6:1,高发的年龄段在40～49岁.SAHS合并高血压占39.0%,合并高脂血症占24.6%,合并糖尿病占17.6%,合并冠状动脉粥样硬化性心脏病占14.0%,合并脑卒中占4.9%.SAHS患者出现心脑血管等合并症占总数的80.7%.结论 SAHS住院患者人数呈逐年上升的趋势.肥胖、性别是SAHS的危险因素.SAHS患者易出现心脑系统合并症.     

A study of IgM rheumatoid factors in a middle-aged population of Northern Norway

Summary A random selection of 8807 blood samples was analysed for the presence of IgM rheumatoid factor (RF). The sera were obtained from an epidemiological survey of rheumatoid arthritis in a middle-aged population of Northern-Norway. The prevalence of IgM-RF was 1.36% for the total population, but a prevalence of IgM RF in healthy individuals between 0.48–0.49 % was found with no significant difference between males and females. The majority of RF positive sera were low titred. Only 11.4 % of the persons possessing serum IgM RF suffered from classical or definite rheumatoid arthritis. Eighty-one per cent of the IgM RF positive individuals converted to seronegativity in the course of 3.5 years.