河南省老年人能力状况对跌倒的影响

目的 了解河南省老年人跌倒发生情况,并探讨老年人能力状况与跌倒之间的关系。方法 采用分阶段抽样的方法,对河南省60岁及以上的老年人进行问卷调查。采用二元logistic回归模型分析日常生活能力、精神状态能力、感知觉与沟通能力、社会参与能力对老年人跌倒的影响。结果 共调查5 570例老年人,其中496例老年人发生了跌倒,发生率为8.9%。Logistic回归分析表明,全人群中日常生活能力受损（OR = 3.060,95%CI = 2.418～3.872）、感知觉与沟通能力受损（OR = 1.449,95%CI = 1.128～1.861）、社会参与能力受损（OR = 1.438,95%CI = 1.100～1.880）是河南省老年人跌倒的危险因素。根据性别进行分层后无论对于男性（OR = 3.542,95%CI = 2.445～5.130）还是女性（OR = 2.826,95%CI = 2.075～3.848）,跌倒都受日常生活能力受损的影响。除此之外,感知觉与沟通能力受损（OR = 1.543,95%CI = 1.118～2.130）和社会参与能力受损（OR = 1.480,95%CI = 1.045～2.096）也是女性老年人跌倒的危险因素。结论 能力状况受损是老年人跌倒的危险因素,其中男性跌倒主要受日常生活能力的影响,女性跌倒受日常生活能力、感知觉与沟通能力、社会参与能力的影响。     

湖北省抽样点老年人跌倒风险状况及其影响因素研究

目的研究湖北省抽样点老年人群跌倒风险情况及其相关影响因素,为采取针对性的预防措施提供理论依据。方法于2018年1-12月采取多阶段分层整群随机抽样的方法,在湖北省抽取1个区和1个县作为研究点。将符合纳入标准的2970名年龄≥60岁老年人作为研究对象,以标准化问卷进行调查,并进行身体测量和跌倒风险评估。用SPSS22.0统计软件进行χ²检验,采用多因素logistic回归模型分析老年人跌倒风险的影响因素。结果2970名老年人中存在跌倒风险的人数为1703人(57.34%),1年内摔倒1、2和3次及以上的比例分别为5.42%,0.88%和0.40%。多因素logistic回归分析结果显示,女性(OR=1.681,95%CI:1.431~1.975),高龄(70~74岁OR=1.925,95%CI:1.338~2.669,75~79岁OR=2.698,95%CI:1.883~3.886,≥80岁OR=5.014,95%CI:3.327~7.556),无配偶(OR=1.305,95%CI:1.054~1.615),跌倒相关药物服药史(OR=1.440,95%CI:1.215~1.707),日常生活活动能力受损(OR=3.238,95%CI:2.104~4.984)及患有眼疾(OR=2.844,95%CI:1.711~4.729)的湖北省抽样点老年人群跌倒风险较高,居住在农村(OR=0.515,95%CI:0.429~0.620)、每天进行体育锻炼(OR=0.715,95%CI:0.555~0.921)的湖北省抽样点老年人群跌倒风险较低。结论湖北省抽样点老年人群跌倒风险较高,且呈现影响因素多样化,个体跌倒影响因素叠加等现象,应重点关注女性、高龄独居和日常生活活动能力受损的老年人,通过社会、家庭和个体3个维度的综合性干预措施来降低老年跌倒风险。     

中国农村中老年人社会隔离的影响因素分析

目的 调查我国农村中老年人社会隔离的影响因素。方法 采用2015年中国健康与养老追踪数据,筛选出符合研究纳入标准的农村中老年人样本7 427例,根据Berkman社会网络指数判断是否存在社会隔离,采用多因素logistic逐步回归分析,对社会隔离的影响因素进行探讨。结果 中国农村中老年人社会隔离发生率为28.84%,其主要影响因素有:性别(OR = 1.55,95%CI:1.38～1.73)、年龄(OR = 1.69,95%CI:1.58～1.80)、地域(OR = 1.21,95%CI:1.13～1.29)、教育水平(OR = 0.83,95%CI:0.74～0.94)、金融机构存款金额(OR = 0.86,95%CI:0.80～0.93)、出入阶梯数(OR = 1.06,95%CI:1.01～1.13)、听力(OR = 1.25, 95%CI:1.11～1.41)、认知情况(OR = 0.91,95%CI:0.89～0.93)、生活满意度(OR = 1.07, 95%CI:1.01～1.15)、抑郁(OR = 1.17,95%CI:1.04～1.31)。结论 我国农村中老年人社会隔离发生率较高,应结合农村中老年人群体的特殊性,加强农村基础设施建设,重视中老年人身心健康管理,增加其社会网络和社会参与,以减少社会隔离的发生。     

重庆市老年人多次跌倒发生率及相关因素分析

目的 了解重庆市65岁及以上老年人过去1年多次跌倒发生率及相关因素,为开展干预工作提供建议.方法 在4个区县采用多阶段分层整群随机抽样抽取65岁及以上老年人进行问卷调查.多次跌倒发生率的比较采用x2检验,多次跌倒发生的相关因素采用多因素logistic回归分析.结果 共计调查1607人,平均年龄(72.36±6.27)...     

中国中老年人群和高个成年人中心型肥胖的腰围界值点验证

目的 探讨中国中老年人群和高个成年人的适宜腰围界值点及其对糖尿病患病危险的预测价值.方法 利用2002年中国居民营养与健康状况调查数据,分析≥45岁人群和身高在全人群第85百分位数(P85)以上成年人的腰围分布特征,分析不同的腰同界值点与体重指数(BMI:kg/m2)≥24的诊断一致性,采用多元logistic回归分析不同腰围水平的调查对象患糖尿病和空腹血糖受损的相对风险,并以ROC曲线最短距离确定上述人群的适宜腰围界值点.结果 中国中老年人腰围男性均值为80.8 cm,女性均值为79.4 cm;高个男性腰围均值为84.1 cm,女性为77.9 cm.中老年人腰围以男性85 cm、女性80 cm作为界值点,与BMI≥24的诊断一致性最好,预测糖尿病的ROC曲线距离最短.与腰围<85 cm组相比,85 cm～组、90 cm～组和95 cm～组的中老年男性患糖尿病[OR值分别为2.1(95%CI:1.6～2.8)、3.0(95%CI:2.3～4.0)和4.5(95%CI:3.4～5.8)]和空腹血糖受损[OR值分别为1.6(95%CI:1.2～2.2)、2.6(95%CI:1.9～3.5)和3.5(95%CI:2.6～4.6)]的相对风险明显增加.与腰围<80 cm组相比,80 cm～组、85 cm～组和90 cm～组中老年女性患糖尿病[OR值分别为1.9(95% CI:1.4-2.6)、3.2(95%CI:2.4～4.3)和4.8(95%CI:3.7～6.1)]和空腹血糖受损[OR值分别为2.5(95%CI:1.8～3.4)、3.2(95%CI:2.4～4.4)和4.2(95%CI:3.2～5.6)]的相对风险明显增高.高个成年人腰围以男性90 cm、女性85 cm作为界值点,预测糖尿病患病的ROC曲线距离最短.与腰围<85 cm组相比,95cm～组高个男性患糖尿病和空腹血糖受损的相对风险明显增高[OR值分别为3.6(95%CI:2.1～6.4)和5.5(95%CI:3.0～10.1)].与腰围<80cm组相比,85 cm～、90 cm～组高个女性患糖尿病的相对风险明显升高[OR值分别为5.0(95%CI:2.7～9.4)和8.0(95%CI:4.6～14.1)],90 cm～组患空腹血糖受损的相对风险OR=3.7(95%CI:2.0～6.9).结论 男性85 cm和女性80 cm是中老年人群的适宜腰围界值点;对于高个成年人,此腰围界值点对于空腹血糖受损有预测价值;人群中心型肥胖预防指标建议使用男性85 cm和女性80 cm作为腰围界值点.     

老年慢性病患者社会化住院现状调查及影响因素分析

目的 调查老年慢性病患者社会化住院现状及其影响因素。方法 便利抽样某三甲医院于2018年1月 - 2019年1月收治866例老年慢性病患者作为调查对象,logistic回归分析其影响因素。结果 866例老年慢性病患者符合“社会化住院”标准人数252例,比例为29.09%,住院阶段转科室（OR = 4.403,95%CI:2.855～6.789）、入院时ADL水平（OR = 1.478,95%CI:1.151～1.897）、达到出院标准ADL水平（OR = 1.359,95%CI:1.074～1.718）、年龄（OR = 1.128,95%CI:1.084～1.173）、家庭人均收入（OR = 2.484,95%CI:1.990～3.101）、医院获得性感染（OR = 2.078,95%CI:1.301～3.320）、入院途径（OR = 2.222,95%CI:1.424～3.467）、合并其他慢性病（OR = 3.743,95%CI:2.373～5.902）、抑郁（OR = 2.336,95%CI:1.485～3.674）、焦虑（OR = 2.272,95%CI:1.471～3.509）、认知障碍（OR = 1.970,95%CI:1.230～3.156）、病程（OR = 1.121,95%CI:1.057～1.189）、公费（OR = 3.116,95%CI:1.041～ 9.326）、新农合（OR = 0.376,95%CI:0.142～ 0.991）、自费（OR = 0.117,95%CI:0.029～0.473）均是“社会化住院”的显著影响因素（P＜0.05）。结论 老年慢性病患者“社会化住院”程度较高,其受到入院途径、医院内感染、生理、心理、精神状态、对他人依赖程度、经济收入和医保类型影响。     

重庆市农村留守老人自评健康状况及影响因素分析

目的 探索重庆市农村留守老人的自评健康状况及影响因素,为有关部门制定留守老人健康保障政策提供实证参考。方法 采用多阶段随机抽样法对重庆市600名农村留守老人进行问卷调查,描述其自评健康状况,并采用有序logistic回归分析其自评健康状况的影响因素。结果 自评健康为差、一般、好的农村留守老人分别占44%、40.67%、15.33%。高家庭人均年收入（OR = 0.396,95%CI:- 1.349～- 0.505）、未购买商业健康保险（OR = 0.424,95%CI:- 1.344～- 0.370）、两周内未出现不适（OR = 0.601,95%CI:- 0.884～- 0.135）、一年内未住院（OR = 0.448,95%CI:- 1.197～- 0.406）、高BMI指数（OR = 0.406,95%CI:- 1.530～0.301）的农村留守老人自评健康更倾向于积极（OR＜1）,医疗费用负担重（OR = 2.433,95%CI:0.313～1.464）、所患慢性病数多（OR = 5.877,95%CI:1.223～2.319）和不饮酒（OR = 2.948,95%CI:0.637～1.524）的老人自评健康更倾向于消极（OR＞1）。结论 加强农村留守老人医疗卫生服务体系建设,健全农村留守老人的家庭支持和社会支持体系,积极开展农村留守老人专项健康教育行动,降低疾病风险。     

A risk model for the prediction of recurrent falls in community-dwelling elderly: a prospective cohort study

The object of this article was to determine the predictive value of risk factors for recurrent falls and the construction of a fall risk model as a contribution to a mobility assessment for the identification of community-dwelling elderly at risk for recurrent falling in general practice. The design was a prospective cohort study (n = 311). There were four primary health care centers. A sample stratified on previous falls, age, and gender of community-dwelling elderly persons aged 70 years or over (n = 311) was taken from the respondents to a mail questionnaire (n = 1660). They were visited at home to assess physical and mental health, balance and gait, mobility and strength. A 36-week follow-up with telephone calls every 6 weeks was conducted. Falls and fall injuries were measured. During follow-up 197 falls were reported by 33% of the participants: one fall by 17% and two or more falls by 16%. Injury due to a fall was reported by 45% of the fallers: 2% hip fractures, 4% other fractures, and 39% minor injuries. A fall risk model for the prediction of recurrent falls with an area under the curve (AUC) of 0.79, based on logistic regression analysis, showed that the main determinants for recurrent falls were: an abnormal postural sway (OR 3.9; 95% Cl 1.3-12.1), two or more falls in the previous year (OR 3.1; 95% Cl 1.5-6.7), low scores for hand grip strength (OR 3.1; 95% Cl 1.5-6.6), and a depressive state of mind (OR 2.2; 95% CI 1.1-4.5). To facilitate the use of the model for clinical practice, the model was converted to a "desk model" with three risk categories: low risk (0-1 predictor), moderate risk (two predictors), and high risk (> or =3 predictors). A fall risk model converted to a "desk model," consisting of the predictors postural sway, fall history, hand dynamometry, and depression, provides added value in the identification of community-dwelling elderly at risk for recurrent falling and facilitates the prediction of recurrent falls.     

Risk factors for hospital admissions among asthmatic children and adolescents

OBJECTIVE: To assess the prevalence rate and risk factors for hospital admissions among asthma children and to evaluate care delivered to these patients. METHODS: Three-hundred and twenty-five asthmatic children attending a public outpatient reference clinic were studied. Of them, 202 were hospitalized. Care was evaluated using a questionnaire covering general aspects of hospital stay and biological, demographics, socioeconomic and asthma-related factors. Univariate and multivariate analyses were performed to measure the association between hospital admissions and selected independent variables. RESULTS: Of the total, 62.2% had already been hospitalized due to asthma, 64.9% developed asthma episodes, and 60.9% were hospitalized in their first year of life. Most (76.0%) had moderate to severe asthma. Despite that, 94.2% were not on anti-inflammatory drugs and were treated only during isolated acute episodes. None of these were regularly seen in primary health care centers for a periodic control of their steroid inhalants. Most parents (97.8%) referred not to know how to take care of asthma children. Symptoms onset is normally seen before the age of 12 months (OR=3.20; 95%CI 1.55-6,61) or between 12 and 24 months (OR=3.89; 95%CI 1.62-9.36). Mothers have attended school for less than 7 years (OR=3.06; 95%CI 1.62-5.76). Disease severity (OR=2.32; 95%CI 1.24-3.88), 2 or more monthly visits to emergency wards (OR=2.19; 95%CI 1.24-3.88), and referred recurrent pneumonia (OR=2.00; 95%IC 1.06-3.80) were the main risk factors for hospital admissions. CONCLUSIONS: Organizing health care services is crucial to reduce hospital admissions and provide adequate care for asthma children and adolescents, especially those less than 2 years old.     

Characteristics of elderly leaders volunteering to participate in a fall prevention programme

OBJECTIVES: This study was conducted to assess characteristics of elderly leaders volunteering to participate in a fall prevention programme. METHODS: We surveyed 1,503 individuals (75 elderly leaders volunteering to participate in a fall prevention programme and 1,428 non-leader elderly) among the elderly population living in a rural community, Miyagi Prefecture. Subjects were aged 70-84 years. The questionnaire covered socio-demographic factors, as well as physical, psychology and social variables. To analyze the characteristics of the elderly leaders volunteering to participate in this programme, the relationships of socio-demographic, physical, psychology and social factors to whether the elderly were leaders in the programme were analyzed using logistic regression. RESULT: As a result of multiple logistic regression analysis, the characteristics of elderly leaders volunteering to participate in the fall prevention programme were as follows; 1) being male (OR = 0.25, 95%CI 0.14-0.44); 2) young age (OR=0.43, 95%CI 0.25-0.73); 3) having a high intellectual activity (OR = 2.72, 95%CI 1.65-4.48); 4) being well satisfied with their health (OR = 1.45, 95%CI 1.02-2.07), and 5) having a high IKIGAI (OR = 1.06, 95%CI 1.01-1.13). CONCLUSION: Only elderly individuals capable of high-level intellectual activities can fill the roles of elderly volunteer group leaders discussed in this study.     

中国老年人不同严重程度跌倒风险与慢性病和睡眠的关联研究

目的 探索老年人慢性疾病和睡眠状况与不同严重程度跌倒风险之间的关联,为老年人跌倒所致伤害的预防和干预提供线索.方法 采用病例对照研究发生风险,以"中国健康与养老追踪调查项目"数据为基础,利用2011-2015年抽样调查数据,运用多因素Logistic回归分析模型分析慢性疾病和睡眠的暴露与中国老年人普通跌倒和跌倒就医发生...     

Risk factors for and influence of bloodstream infections on mortality: a 1-year prospective study in a Greek intensive-care unit

To determine the incidence, risk factors for, and the influence of bloodstream infections (BSIs) on mortality of patients in intensive-care units (ICUs), prospectively collected data from all patients with a stay in an ICU >48 h, during a 1-year period, were analysed. Of 572 patients, 148 developed a total of 232 BSI episodes (incidence 16.3 episodes/1000 patient-days). Gram-negative organisms with high level of resistance to antibiotics were the most frequently isolated pathogens (157 strains, 67.8%). The severity of illness on admission, as estimated by APACHE II score (OR 1.07, 95% CI 1.04-1.1, P<0.001), the presence of acute respiratory distress syndrome (OR 3.57, 95% CI 1.92-6.64, P<0.001), and a history of diabetes mellitus (OR 2.37, 95% CI 1.36-4.11, P=0.002) were risk factors for the occurrence of BSI whereas the development of an ICU-acquired BSI was an independent risk factor for death (OR 1.76, 95% CI 1.11-2.78, P=0.015). Finally, the severity of organ dysfunction on the day of the first BSI episode, as estimated by SOFA score, and the level of serum albumin, independently affected the outcome (OR 1.44, 95% CI 1.22-1.7, P<0.001 and OR 0.47, 95% CI 0.23-0.97, P=0.04 respectively).     

我国老年人焦虑状况及其影响因素分析

目的 研究我国老年人焦虑症状检出率及其影响因素。方法 基于2018年中国老年健康影响因素跟踪调查（CLHLS）数据,选取数据库中11 127名65岁及以上的老年人为研究对象,利用二分类logistic回归模型分析老年人焦虑症状检出状况与影响因素之间的关系。结果 11 127名老年人中有焦虑症状的有1 359人,占比12.2%。二分类logistic回归分析显示,女性老年人（OR = 1.374,95%CI:1.190～1.586）、居住在中部（OR = 1.420,95%CI:1.234～1.634）和西部（OR = 1.436,95%CI:1.208～1.708）、从不社交（OR = 1.249,95%CI:1.088～1.433）、自评健康较差（OR = 3.549,95%CI:2.953～4.267）、生活满意度较差（OR = 2.436,95%CI:1.870～3.173）、生活富裕程度较差（OR = 2.186,95%CI:1.722～2.775）是老年人焦虑发生的危险因素;非文盲（OR = 0.830,95%CI:0.724～0.951）、睡眠时长为7～9 h（OR = 0.476,95%CI:0.415～0.544）与＞9 h（OR = 0.487,95%CI:0.408～0.582）是老年人焦虑发生的保护因素。结论 我国老年人焦虑症状检出率较高,应加强对老年人心理健康的关注,改善我国老年人的焦虑检出状况。     

Persistent chlorinated pesticides and intra-uterine foetal growth retardation: a possible association

OBJECTIVE: To examine the association between DDT (dichlorodiphenyl trichloroethane) and HCH (hexachlorocyclohexane) exposure and intra-uterine growth retardation (IUGR, <10th percentile of birth weight for gestational age). METHOD: We detected p,p'-DDT, o,p'-DDT, p,p'-DDD, p,p'-DDE and alpha-HCH, beta-HCH, gamma-HCH, delta-HCH in maternal blood, placenta and cord blood, collected at parturition, from mothers with IUGR babies ( n=30) and from those with babies of normal weight ( n=24), using gas-liquid chromatography equipped with electron capture detector ((63)Ni). The adjusted odds ratios (ORs) for these pesticides in mothers and infants were determined by multiple logistic regression. RESULTS: There were statistically significant associations ( P<0.05) between maternal blood levels of alpha-HCH (OR=1.22; 95% CI: 1.02-1.46), gamma-HCH (OR=1.38; 95%CI: 1.05-1.80), delta-HCH (OR=1.61; 95% CI: 1.01-2.54), total HCH (OR=1.07; 95% CI: 1.01-1.13) and p,p'-DDE (OR=1.21; 95%CI:1.03-1.42) and IUGR after adjustment for potential confounders. Also, significant association (P<0.05) between cord blood levels of gamma-HCH (OR=1.14; 95% CI: 1.00-1.31), delta-HCH (OR=1.31; 95% CI: 1.00-1.75), total HCH (OR=1.07; 95% CI: 1.00-1.14) and IUGR were found after adjustment for potential confounders. A significant negative correlation between body weight of newborn babies and p,p'-DDE in maternal blood (r= -0.25; P<0.05) and delta-HCH and p,p'-DDE in the cord blood (r= -0.27 and -0.26; P<0.05) was noticed after gestational age had been accounted for. CONCLUSION: Exposure of pregnant women to organochlorine pesticides may increase the risk of IUGR, which is a contributing factor for infant mortality in India.     

Preventing childhood falls at home: meta-analysis and meta-regression

BACKGROUND: Childhood falls are an important global public health problem, but evidence on their prevention has not been quantitatively synthesized. Despite social inequalities in childhood injury rates, there is a lack of evidence examining the effect of fall-prevention practices by social group. METHODS: A systematic review of literature was conducted up to June 2004 and meta-analysis using individual patient data to evaluate the effect of home-safety interventions on fall-prevention practices and fall-injury rates. Meta-regression examined the effect of interventions by child age, gender, and social variables. Included were 21 studies, 13 of which contributed to meta-analyses. RESULTS: Home-safety interventions increased stair-gate use (OR=1.26; 95% CI=1.05, 1.51), and there was some evidence of reduced baby-walker use (OR=0.66; 95% CI=0.43, 1.00), but little evidence of increased possession of window locks, screens, or windows with limited opening (OR=1.16, 95% CI=0.84, 1.59) or of nonslip bath mats or decals (OR=1.15; 95% CI=0.51, 2.62). Two studies reported nonsignificant effects on falls (baby-walker-related falls on flat ground [OR=1.35; 95% CI=0.64, 2.83] or down steps or stairs [OR=0.70; 95% CI=0.14, 3.49]) and medically attended falls (OR=0.78; 95% CI=0.61, 1.00). CONCLUSIONS: Home-safety education and the provision of safety equipment improved some fall-prevention practices, but the impact on fall-injury rates is unclear. There was some evidence that the effect of home-safety interventions varied by social group.     

Correlates of falling during 24 h among elderly Danish community residents

OBJECTIVES: To identify dietary, medical, and environmental correlates of falling during the last 24 h among elderly community residents. The limited accuracy of recall of falls in the elderly in previous studies was the reason for a 24-h time frame. METHODS: The study composes 4281 community residents aged 66+ years. The statistical analyses included Pearson's chi(2) test and multiple logistic regression. RESULTS: Mutually independent correlates of falls were a family history of fracture (OR, 3.0; 95% CI: 1.3-7.1); osteoarthrosis of the knee (OR, 2.9; 95% CI: 1.3-6.2); dizziness (OR, 4.1; 95% CI: 1.9-8.9); a diet not including sour dairy products (OR, 3.0; 95% CI: 1.4-6.3) or fish (OR, 3.4; 95% CI: 1.5-7.5); drinking tea (OR, 5.8; 95% CI 2.15-15.30); needing help for shopping (OR, 3.9; 95% CI: 1.6-9.3); and for administration of medicine (OR, 9.0; 95% CI: 2.0-40.6). Independent environmental correlates were vinyl on the floor in the bathroom (OR, 6.6; 95% CI: 2.1-20.9) and using indoor footwear without soles (OR, 5.5; 95% CI: 2.3-13.4). CONCLUSION: The present analyses suggest that several factors are associated to the risk of falling among elderly community residents. It appears relevant for further studies to test if modifications of the potential risk factors identified may reduce falls among community dwelling older persons.     

2018年中国因跌倒/坠落就诊患者损伤严重程度及影响因素

  目的  了解中国因跌倒/坠落就诊病例流行特征和影响损伤严重程度的因素,为制定跌倒/坠落防控措施、政策提供依据。  方法  通过提取2018年中国伤害监测系统（national injury surveillance system,NISS）中跌倒/坠落病例数据,描述其流行特征,采用多因素Logistic回归分析模型分析损伤严重程度影响因素。  结果  共收集跌倒/坠落病例500 621例。损伤严重程度以轻度为主（76.00%）,中、重度损伤所占比例为24.00%。单因素分析显示,性别、年龄、城乡、发生季节、发生时段、发生地点、发生时活动、发生前饮酒情况的跌倒/坠落病例损伤严重程度差异具有统计学意义（均有P＜0.001）。多因素分析显示,男性（OR=1.056,95% CI:1.041~1.071）;年龄为5~岁（OR=1.412,95% CI:1.366~1.460）、15~岁（OR=1.382,95% CI:1.337~1.427）、30~岁（OR=1.844,95% CI:1.787~1.903）、45~岁（OR=2.746,95% CI:2.666~2.829）、≥65岁（OR=4.524,95% CI:4.390~4.663）;夏季（OR=1.097,95% CI:1.077~1.118）、秋季（OR=1.110,95% CI:1.089~1.131）、冬季（OR=1.137,95% CI:1.116~1.159）;地点为家中（OR=1.169,95% CI:1.143~1.196）、学校与公共场所（OR=1.102,95% CI:1.069~1.136）、体育和运动场所（OR=1.066,95% CI:1.016~1.119）、工业和建筑场所（OR=1.800,95% CI:1.727~1.877）、农场/农田（OR=1.257,95% CI:1.196~1.320）;活动为步行（OR=1.084,95% CI:1.045~1.126）;发生前饮酒（OR=1.318,95% CI:1.257~1.381）是中重度损伤的危险因素。  结论  中国因跌倒/坠落就诊患者中重度损伤占一定比例,且影响因素较多,相关部门应开展针对性的防控工作。     

上海市长宁区糖尿病高危人群筛查结果分析

目的 利用长宁区糖尿病高危人群的血糖筛查结果数据,分析长宁区糖尿病高危人群中糖尿病和糖调节受损的检出率,分析影响高危人群中糖尿病和糖调节受损的危险因素,为加强社区糖尿病防治力度提供参考依据。方法 收集糖尿病高危人群的基本信息、糖尿病危险因素及相关症状、体格检查数据及血糖数据进行统计分析。结果 2016 - 2017年,12 567名糖尿病高危人群中共检出糖尿病1 171人,糖调节受损者1 547人,检出率分别为9.3%、12.3%。多因素logistic回归分析发现,高龄（OR:1.032,95%CI:1.026～1.038）、男性（OR:1.161,95%CI:1.036～1.301）、低学历（P＜0.05）、糖调节受损史（OR: 6.257,95% CI:4.756～8.232）、亲属患2型糖尿病（OR: 1.388,95% CI:1.169～1.649）、高血压（OR: 1.463,95% CI:1.268～1.688）和体型超重/肥胖（OR: 2.228,95% CI: 1.940～2.559）是血糖代谢障碍的独立预测因素;高龄（OR:1.040,95% CI:1.035～1.045）、男性（OR:1.361,95% CI:1.224～1.581）、低学历（P＜0.05）、糖调节受损史（OR: 2.644,95% CI:1.949 ～3.586）、亲属患2型糖尿病（OR: 1.417,95% CI:1.217～1.650）、高血压（OR: 1.360,95% CI:1.199 ～1.543）、血脂异常（OR = 1.208,95% CI:1.019～1.432）、一过性类固醇糖尿病史（OR = 2.397, 95% CI:1.195～4.807)、长期静坐生活方式（OR = 2.542,95% CI:1.376～4.699）以及体型超重/肥胖（OR: 1.975,95% CI:1.754～2.224）是检出糖尿病的独立预测因素。结论 长宁区糖尿病高危人群的糖尿病和糖调节受损检出率较高。在高危人群中筛查,能使超过五分之一的血糖异常者得到早期诊断,应持续开展此项工作。     

中国老年人群阿尔茨海默病发病危险因素的Meta分析

目的 通过Meta分析探讨我国老年人群阿尔茨海默病发病危险因素。方法 利用Meta分析对国内外公开发表的有关中国老年人群发表危险因素的32篇研究进行定量综合分析。结果 影响阿尔茨海默病发病危险因素包括:年龄OR = 1.38 (95%CI:1.05～1.82)、受教育程度低OR = 2.17 (95%CI:1.68～2.81)、痴呆家族史OR = 3.37 (95%CI:1.90～5.96)、精神病家族史OR = 4.86 (95%CI:2.58～9.18)、负性生活事件OR = 2.13 (95%CI:1.37～3.33)、高血压OR = 1.46 (95%CI:1.14～1.87)、糖尿病OR = 2.20 (95%CI:1.36～3.56)、心血管病史OR = 2.05 (95%CI:1.49～2.80)、脑外伤OR = 2.79 (95%CI:1.66～4.69)和血脂异常OR = 1.71 (95%CI:1.44～2.03)和不参加体育锻炼OR = 1.99 (95%CI:1.58～2.52)。结论 阿尔茨海默病发病受多种危险因素影响,其早期预防应采取有针对性的预防措施,如积极控制相关疾病病情、加强体育锻炼等。     

Health effects of a sulphur dioxide air pollution episode

BACKGROUND: A sulphur dioxide (SO(2)) episode occurred in the United Kingdom in 1998. The worst affected area was the city of Nottingham. METHODS: Emergency hospital admissions in Nottingham in the episode week were compared with those in the previous week. RESULTS: A statistically significant increase in admissions for all respiratory diseases occurred in the episode week (odds ratio (OR) = 1.40, 95 per cent confidence interval (CI) = 1.00-1.94). Ten of the 25 excess admissions were for asthma, although the excess for asthma alone was not statistically significant (OR = 1.90, 95 per cent CI = 0.87-4.15). CONCLUSIONS: The excess admissions for respiratory diseases could have been caused by exposure to SO(2), to other pollutants present in increased concentrations during the pollution episode, or by seasonal variations in the frequency of asthma symptoms, or prevailing weather conditions. This study shows how simple analyses of routinely collected health data can be used to assess public health impacts of pollution episodes.