2012年广州市海珠区居民脑卒中患病率及相关危险因素调查分析

目的了解广州市海珠区18岁以上社区居民脑卒中患病率及高血压、糖尿病等常见危险因素在人群中的分布。方法 2012年12月采用KishGrid表法分层抽样后问卷调查的方法,在海珠区瑞宝社区抽取1000人为调查对象,采用χ2检验和t检验对结果进行统计分析。结果海珠区居民脑卒中、冠心病的患病率均较2008年有明显上升（3.4%vs1.6%,18.5%vs4.5%）,而高血压病、糖尿病、血脂异常、肥胖率和吸烟率均较2008年下降（16.2%vs22.9%,7.0%vs9.2%,37.9%vs59.7%,6.2%vs7.1%,18.2%vs24.6%）,差异有统计学意义（P〈0.05）。男性高血压患病率、吸烟率和饮酒率分别为20.0%、29.0%和11.2%,与女性11.9%、5.8%和5.1%相比较高,差异有统计学意义（P〈0.05）。结论海珠区脑卒中患病率上升呈年轻化趋势,冠心病患病率较前增高,应提倡早期对心脑血管疾病相同危险因素进行筛查并控制预防。     

高血压并发脑卒中危险因素的调查

高血压是最常见的心血管病,是心脑血管病诸多危险因素中最重要的独立危险因素.不良生活方式、吸烟、饮酒、高盐高脂饮食、精神心理应激等因素与高血压病(essential hypertension,H)都是引起脑卒中的主要因素.本文就某地区人群EH患者发生脑卒中的危险因素与其它地区是否存在差异,分析高致病因素,结合针对性干预,对早期预报、有效预防EH患者发生脑卒中的意义报告如下.     

高血压脑出血预后的相关因素：——附78例分析

本文对78例高血压脑出血患者的年龄、性别、出血部位及预后相关因素做了简要分析,其中对脑出血合并脑疝等十余种情况及死亡率做了数字统计。结果表明,脑出血死亡的主要危险因素为脑疝,其次是中枢性高熱、过高血压、消化道出血、高年龄、心律失常、昏迷、出血量大等。强调了对预后的影响往往是多因素作用;抢救时除应加强急性期的一般处理外,还要根据病情采取针对性治疗措施,以达挽救生命及降低致残率的目的。     

广州市白云区≤4岁麻疹病例发病危险因素研究

目的研究广州市白云区≤4岁麻疹病例发病危险因素及探讨麻疹防治对策。方法调查白云区≤4岁麻疹病例385例,收集病例就诊情况、乘坐交通工具情况、免疫史及相关信息,与麻疹个案调查表进行整合分析。结果8个月～4岁麻疹病例23.1%发病前有麻疹疫苗（MV）接种史,7.22%病例发病前3周内有MV接种史,30.13%麻疹病例发病前3周（最长潜伏期）内有就诊史,29.16%病例发病前3周内有乘坐交通工具史,6.23%病例发病前3周内有现症麻疹病人接触史。结论白云区≤4岁麻疹病例表现出医院聚集性,存在院内感染的可能;≤4岁病例发病危险因素还可能与发病前3周内乘坐过交通工具及接触过麻疹现症病人有关。     

武汉某高校教职工高血压检出率及相关危险因素分析

目的:了解武汉某高校教职工体教检人群的高血压检出情况及相关危险因素,为社区高血压综合防治措施的制定提供科学依据。方法:对该校职工进行血压测量并收集相关危险因素,用SAS软件包进行统计分析。结果:健康体检6504人中,高血压患者1959人,检出率为30.12%。其中男性检出率为33.30%,女性检出率为26.20%,两者差异有统计学意义(P<0.01),且其检出率随年龄增高而递增。广义线性模型分析显示,年龄、性别、体重指数(BMI)、糖尿病史、高血糖、高血尿酸和高胆固醇血症为该校教职工高血压的相关危险因素。结论:在饮食调整基础上,降低BMI、控制血糖、血脂和血尿酸是该校教职工防治高血压的重要措施。     

原发性高血压患者血压晨峰的相关因素分析

目的研究原发性高血压患者血压晨峰（MBPS）的发生情况及相关因素。方法采用24h动态血压监测仪（ABPM）分析415例原发性高血压患者的血压,确认晨峰组与非晨峰组,对两组性别、年龄、动态血压、动态心电图及超声心动图、颈动脉彩色多普勒检查结果、血脂、空腹血糖、体重指数（BMI）进行比较分析。结果①有晨峰现象的129例（MBPS组）,发生率为31.1%,与非MBPS组相比较,MBPS组24h平均收缩压、脉压均显著高于非MBPS组（P〈0.001）。②凌晨血压增高与年龄相关（P〈0.01）,调整年龄后,男女MBPS发生率分别为28.5%,16.9%,男性明显高于女性（P=0.0105）。③不论男女,MBPS组的左室肥厚发生率、左室重量指数（LVMI）、颈动脉内膜中层厚度（IMT）、24h平均心率、房性早搏、室性早搏的发生率均高于非MBPS组,差别有统计学意义（P〈0.001）,MBPS与BMI、空腹血糖、血脂无显著关联。结论原发性高血压患者MBPS与年龄、性别、心室重构、心律失常密切相关,MBPS患者有更明显的颈动脉粥样硬化。MBPS可能使清晨心血管事件的风险增加。     

北京月坛社区老年高血压患者抑郁情绪调查及危险因素分析

目的 探讨北京月坛社区老年高血压患者抑郁的流行病学特征及危险因素,为健康老化制定个体化干预方案提供依据。方法 2019年6月至2019年10月,采用整体抽样方法,在北京市西城区月坛社区选取60岁及以上老年高血压患者613例,采用患者健康问卷(PHQ-9)抑郁量表行抑郁情绪判定。同时搜集受试者一般人口学信息及慢性病史等健康情况。分别采用单因素及二元Logistic回归模型分析不同性别老年高血压患者抑郁情绪的影响因素及独立危险因素。结果 老年高血压患者抑郁情绪总体阳性检出率为11.58%,9.81%的男性患者存在抑郁状态,12.53%的女性患者存在抑郁状态。男性中患有冠心病、存在睡眠障碍者的抑郁情绪发病比例更高,女性中存在经济压力、患有听力障碍、视力障碍、慢性胃炎、慢性肝胆疾病及存在睡眠障碍者存在抑郁情绪的比例更高(P<0.05)。存在睡眠障碍的男性患者发生抑郁情绪的风险更高,OR值为4.825(95%CI:1.777～13.105);存在经济压力、患有听觉障碍、视力障碍、慢性胃炎及存在睡眠障碍的女性患者发生抑郁情绪的风险更高,OR值分别为：14.362 (95%CI:2.224～9...     

社区高血压人群发病危险因素干预研究进展

高血压是一种常见的心脑血管疾病。缺血性心脏病,心脏和肾衰竭的发生引起脑血管疾病的主要原因,常常引起严重的并发症。目前我国<有心血管病患者2.3亿人,其中高血压患者就占其中的87%左右。我国每年死于心血管疾病的<有350万人,其中50%以上发病与高血压有关,高血压已经成为危害人们健康的第一杀手。高血压也是一种与行为方式有密切关系的疾病,服药,膳食,运动等行为对疾病的发生发展具有重要的作用。因此,加强对高血压病的防治研究、提高防治效果具有重要的社会意义。本文综述了我国社区高血压人群发病的主要可干预危险因素,并综述了相关的干预研究进展,为有效进行高血压防控提供依据和建议。     

东营市城乡40～79岁人群高血压前期患者的现患率及相关危险因素

目的:观察东营市40～79岁人群高血压前期患者的城乡现患率差异.比较及合并不同心血管危险因素时高血压前期患者的城乡分布情况.方法:采取整群随机抽样方法,2015年至2016年对东营市2个社区和2个农村的40～79岁人群进行问卷调查,并测量身高、体重、体重指数、血压,采集清晨空腹静脉血检测空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白、高密度脂蛋白、血同型半胱氨酸.结果:所有完成研究的4 109人中,高血压前期患者1 287人,现患率为31.32％,男性患者582人(31.34％),女性705人(31.31％),性别间差异无统计学意义(x2=0.0006,P＞0.05).城市高血压前期现患率为41.63％,农村为20.32％,差异有统计学意义(x2=216.620,P＜0.001).高血压前期人群合并高同型半胱氨酸血症的现患率最高,为76.38％,城市现患率低于农村(74.41％vs.80.69％),差异有统计学意义(x2=6.0739,P＜0.05),城市男性与农村男性、城市女性与农村女性之间现患率差异均无统计学意义.高血压前期人群中,城市吸烟率高于农村(36.24％ vs.27.97％),差异有统计学意义(x2=8.491,P＜0.05);城市女性吸烟率为农村女性的2.35倍(21.76％vs.9.25％),差异有统计学意义(x2=16.5028,P＜0.05).城市高血压前期合并肥胖人群高于农村(23.67％ vs.17.57％),差异有统计学意义(x2=6.0491,P＜0.05),且城市男性高于农村男性(24.44％vs.12.99％),差异有统计学意义(x2=9.7466,P＜0.05).高血压前期合并血脂异常、糖代谢异常时,城乡之间差异均无统计学意义(P＞0.05).结论:高同型半胱氨酸血症和血脂异常是高血压前期人群最主要合并的危险因素.应重点干预农村高血压前期合并高同型半胱氨酸血症的居民.高血压前期现患率与日常生活习惯密切相连,因此高血压前期的防治应结合城镇及农村高血压前期的危险因素的流行特征,有针对性的制定防治策略和措施.     

妊娠期高血压的发病特点及危险因素分析

目的 分析妊娠期高血压的发病特点及危险因素,为制定相应的治疗与预防措施提供参考依据。方法 选择我院2018年7月~2019年7月收治的200例孕妇作为研究对象,根据血压水平分为正常组（181例）及妊娠期高血压组（19例）,收集两组孕妇年龄、孕次、孕周、肝功能、心功能、高血压史及合并症等临床资料,分析妊娠期高血压的发病特点及危险因素。结果 200例孕妇中19例为妊娠期高血压,发生率9.50%。妊娠期高血压组收缩压与舒张压均高于正常组,差异有统计学意义（P＜0.05）;单因素分析显示,年龄≥34岁、无产前检查、家庭住址在农村、既往有高血压史、多胎妊娠、合并有慢性肾炎的妊娠期高压疾病发生风险更高,差异有统计学意义（P＜0.05）;多因素分析显示,年龄≥34岁、无产前检查、家庭住址在农村、既往有高血压史、多胎妊娠、合并有慢性肾炎均属于妊娠期高血压的主要危险因素（P＜0.05）。结论 妊娠期高血压发生率较高,其主要受到年龄、生活环境、既往疾病、合并症及多胎妊娠等因素影响,临床应及时明确妊娠期高血压疾病的危险因素,并针对性的制定治疗与预防措施,对分娩结局及预后的改善有积极意义。     

Risk factors related to the severity of COVID-19 in Wuhan

Objective: To evaluate the characteristics at admission of patients with moderate COVID-19 in Wuhan and to explore risk factors associated with the severe prognosis of the disease for prognostic prediction.Methods: In this retrospective study, moderate and severe disease was defined according to the report of the WHO-China Joint Mission on COVID-19. Clinical characteristics and laboratory findings of 172 patients with laboratory-confirmed moderate COVID-19 were collected when they were admitted to the Cancer Center of Wuhan Union Hospital between February 13, 2020 and February 25, 2020. This cohort was followed to March 14, 2020. The outcomes, being discharged as mild cases or developing into severe cases, were categorized into two groups. The data were compared and analyzed with univariate logistic regression to identify the features that differed significantly between the two groups. Based on machine learning algorithms, a further feature selection procedure was performed to identify the features that can contribute the most to the prediction of disease severity.Results: Of the 172 patients, 112 were discharged as mild cases, and 60 developed into severe cases. Four clinical characteristics and 18 laboratory findings showed significant differences between the two groups in the statistical test (P<0.01) and univariate logistic regression analysis (P<0.01). In the further feature selection procedure, six features were chosen to obtain the best performance in discriminating the two groups with a linear kernel support vector machine. The mean accuracy was 91.38%, with a sensitivity of 0.90 and a specificity of 0.94. The six features included interleukin-6, high-sensitivity cardiac troponin I, procalcitonin, high-sensitivity C-reactive protein, chest distress and calcium level.Conclusions: With the data collected at admission, the combination of one clinical characteristic and five laboratory findings contributed the most to the discrimination between the two groups with a linear kernel support vector machine classifier. These factors may be risk factors that can be used to perform a prognostic prediction regarding the severity of the disease for patients with moderate COVID-19 in the early stage of the disease.     

老年糖调节受损患者合并心脑血管疾病的危险因素分析

目的探讨老年糖调节受损(impaired glueose regulation IGR)患者心脑血管病变的特点及相关危险因素。方法通过回顾性分析的方法,将106例老年糖调节受损患者分为心脑血管病变组(病变组)和无血管病变组(无病变组)各53例。病变组,含缺血性心脏病(inchemic heart disease,IHD)患者35例,和脑血管病变(cerebrovascular disease CVD)患者26例。其中二者并存者11例。对两组患者的临床数据进行比较及回归分析。结果病变组的年龄,高血压患病比率、糖调节受损病程、C反应蛋白异常比无病变组明显增高;各亚组与无病变组的比较也有相似的趋势。回归分析显示,年龄、高血压是老年糖调节受损患者总的心脑血管病变的独立危险因素,同时也是IHD和CVD的独立危险因素。另外高甘油三脂血症与病变组和IHD分别独立相关。结论对于老年糖调节受损除了年龄、高血压外,高甘油三脂血症是心脑血管病变的独立危险因子。     

Risk factors influencing the occurrence of injuries in koreans requiring hospitalization

PURPOSE: This study focused on local communities and the factors influencing injuries requiring hospital admission that affect the quality of life for Koreans. MATERIALS AND METHODS: This study used data collected from 4,400 households during the 2001 Korea National Health and Nutrition Examination Survey (KNHANES). A stratified multistage probability sampling method was applied and the final sample included 7,924 subjects over 20 years old who had completed the questionnaire regarding factors influencing injuries requiring hospital admission. Multiple logistic regression analysis was used to estimate the risk factors influencing injuries. RESULTS: The incidence of injuries requiring hospital admission in Koreans was higher in men than in women at 2.3% (95% CI: 1.8-2.8) and 1.7% (95% CI: 1.3-2.1), respectively. Statistically significant factors affecting the occurrence of injuries requiring hospital admission were marital status (OR: 2.60, 95% CI: 2.22- 5.56), state of health (OR: 0.63, 95% CI: 0.43-0.92), frequency of heavy drinking (OR: 1.96, 95% CI: 1.01-3.79), normal physical activities (OR: 1.68, 95% CI: 1.07-2.65), and sleep (OR: 1.54, 95% CI: 1.01-2.35). CONCLUSION: The results of this study can be used to develop measures to prevent fatal injuries and be used as basic data for community health programs.     

Risk factors for sensitization to furred pets

The risk factors for sensitization to pets was investigated in 169 male pupils. A recent or former contact with cats, dogs, and guinea pigs in own home was reported in 52 (30.8%), 42 (24.9%), and 20 (11.8%) study subjects, respectively. Clinically manifested allergy was found in two probands to cats and in two others to guinea pigs, three of them had formerly had pets and one proband with allergic rhinitis to cats had never had any pet. Sensitization to animals and aeroallergens was investigated with Phadezym-RAST. Only owners of cats had a higher incidence of cat sensitization than probands without direct contact (26.9% versus 10.3%, P less than 0.01). No statistically significant difference in sensitization to dogs and guinea pigs was found in groups with and without these pets. A strong correlation existed between sensitization to pets and other aeroallergens (house dust mite: P less than 0.025, birch pollen: P less than 0.0001, mugwort: P less than 0.0001, and grass pollens: P less than 0.0001). No association was found between sensitization to pets and smoking history, bronchial hyperreactivity to methacholine or radiological findings of the paranasal sinus.     

Radiological score for hemorrhage in the patients with portal hypertension

Goal: To analyze the risk factors from radiological indices for hemorrhage in the patients with portal hypertension and weight risk factors. Method: We retrospectively analyzed all cases of portal hypertension with hepatitis B from June 2008 to June 2014 in Nanjing Drum Tower hospital. Patients with hepatocellular carcinoma, portal vein thrombosis, or portal hypertension with other causes, such as autoimmune hepatitis, pancreatitis, or hematological diseases were excluded. Results: Ninety-eight patients were recruited and divided into hemorrhage and non-hemorrhage groups. There were no statistical differences in clinical indexes such as age, prothrombin time, serum albumin, serum creatinine, serum sodium, hemameba, and blood platelet count. However, the differences were statistically significant in total bilirubin, hemoglobin, and liver function with the p values of 0.023, 0.000, and 0.039 respectively. For radiological indices, hemorrhage was correlated with diameter of inferior mesenteric vein (P=0.0528), posterior gastric vein (P=0.0283), and esophageal varices scores (P=0.0221). Logistic procedure was used to construct the model with stepwise selection and finally inferior mesenteric vein, posterior gastric vein, esophageal varices, and short gastric vein were enrolled into the model. These veins were scored according to the diameters and the rates of hemorrhage were increased with the score. We then validated the model with 26 patents from July 2014 to December 2014. The AUC value was 0.8849 in ROC curves for this radiological model. Conclusions: A risk model was constructed including inferior mesenteric vein, esophageal varices, posterior gastric vein, and short gastric vein. This radiological scoring model may be a valuable indicator for hemorrhage of portal hypertension.     

成都市农村社区精神分裂症患者犯罪行为的危险因素

目的:探讨农村社区中精神分裂症患者犯罪行为的发生率及其相关因素。方法:对成都市新津县农村社区中510例精神分裂症患者的犯罪行为及其临床症状、社会功能、治疗、照管等情况进行了14年(1994-2008年)的随访调查。调查工具包括精神现况检查第9版(Present State Examination,PSE-9)、社会功能缺陷筛查表(Social Disability Screening Schedule,SDSS),以及阳性与阴性症状量表(Positive and Negative Syndrome,PANSS)等。结果:在14年的随访调查中有489例患者(95.9%)完成了随访。随访患者终身犯罪行为的发生率为13.5%。犯罪行为在未婚(19.1%)、较年轻[平均年龄(41.2±16.6)岁]、发病年龄较早的精神分裂症患者[平均发病年龄(28.4±10.4)岁]中较常发生。随访资料中,患者家庭经济状况较差(16.6%)、缺乏监护照管人(28.6%)、无家可归(25.0%),及PANSS总分(68.7±28.7)和阳性(14.1±7.4)、阴性(19.3±10.2)分较高的患者中犯罪行为的发生率较高(P0.05)。结论:精神分裂症患者的犯罪行为在农村社区中较为常见,其影响因素是多方面的。在制定社区精神卫生服务政策、提供精神卫生服务及家庭干预时,应考虑社区中精神分裂症患者的犯罪行为及其危险因素(如患者的婚姻、家庭及监护照管状态、社会支持系统等)。     

髋关节置换术后发生早期脱位的危险因素分析

目的探讨影响老年患者髋关节置换术后发生早期脱位的危险因素,为患者采用个性化治疗方案提供思路。方法收集2006年1月1日至2011年12月31日获得明确诊断并接受髋关节置换术治疗且有术后随访资料的老年股骨颈移位骨折患者共247例为研究对象,对8个可能与置换术后早期脱位发生有关的因素进行单因素和多因素Logistic回归分析。结果通过比较发现,性别、手术方式、人工股骨头直径大小等因素在有脱位组与无脱位组的差异具有统计学意义(P0.05)。进一步多因素Logistic回归分析显示,女性(OR=1.862)、手术方式为后外侧入路(OR=3.478)、人工股骨头直径为22 mm(OR=2.558)可作为预测置换术后早期脱位发生的独立危险因素(P0.05),而当股骨头直径大于或等于30 mm(OR=0.635)时则是保护性因素(P0.05)。结论置换术后早期脱位的发生与多个因素有关,建议术前、术中应将各危险因素纳入考虑并选择个体化最优治疗方案。