上海市居民健康期望寿命的分析

国家人口普查办公室第四次人口普查资料显示 ,上海市居民期望寿命男、女均居全国首位。 1995年世界人口数据表明 ,发达国家预期寿命为 77岁 ,上海已达欧美等发达国家水平。随着期望寿命的增长 ,寿命质量越来越受到重视。丧失日常生活活动能力和参与社会活动受限的残疾不仅给本人的生活质量带来影响 ,而且给社会和家庭造成一定的负担。期望寿命实际上是去除死亡后所能生存的年限 ,并不能反映生存者的健康、现状和功能状况〔1〕。人在生命过程中 ,无时不受到疾病的威胁 ,在人的一生中有多少时间处于健康状态 ,有多少时间处于疾病状态。如何延…     

2000～2010年版纳州预期寿命与婴儿死亡率变化趋势分析

目的:了解掌握版纳州人均预期寿命和婴儿死亡率,改善儿童健康和生存,促进人口均衡发展。方法:简略寿命表编制采用PEMS.3.0统计软件包完成,出生时预期寿命(人口平均寿命)根据出生时的人口横断面死亡率来推算出婴儿的存活年龄。结果:西双版纳州2010年预期寿命为75.7岁,男73.2岁,女78.6岁,低于全国和全省水平;老年人口系数13.09%已进入老龄化社会;出生性别比1.03波动在正常范围;预期寿命与婴儿死亡率呈负相关。结论:提高预期寿命,降低婴儿死亡率是人类进步速度最快的措施,提升孕产妇、儿童保健水平达到人口均衡发展。     

中国肢体残疾人口预期寿命研究

目的 估算中国肢体残疾人口预期寿命.方法 基于2007-2010年监测肢体残疾人口平均死亡率,使用生命表方法 估算不同特征人口预期寿命及其标准误(s-x).结果 (1)肢体残疾人口女性预期寿命高于男性,女性和男性0岁预期寿命分别是63岁(s-x=2.6)和55岁(s-x=3.1);(2)35～50岁人口预期寿命城镇高于农村;(3)轻度肢体残疾人口预期寿命高于重度残疾人口,0岁预期寿命分别为62.5岁(s-x=2.4)和42岁(s-x=5.4);(4)肢体残疾人口预期寿命低于中国普通人群,男性和女性0岁预期寿命差距分别为17.1岁和12.7岁.结论 中国肢体残疾人口死亡水平较高,需要采取措施提高其预期寿命.

Abstract：

Objective To estimate the life expectancy of persons with physical disabilities in China based on data related to representative national disability.Methods Life table technique was used to estimate the life expectancy and its standard error by various characteristics on the basis of average mortality rates from the monitoring cases during 2007-2010.Results (1)Females were expected to live longer than males.The life expectancy at birth for females was 63 years with standard error(SE)=2.6 while for males it was 55 years(SE=3.1).(2)Persons aged 35-50 in urban areas had higher life expectancy than those in rural areas.(3)Life expectancy of persons with mild disability [62.5 years(SE=2.4)] was higher than that of persons with severe disability[42 years(SE=5.4)].(4)Life expectancies of persons with physical disability were much lower than that of the Chinese general population.Gaps of male and female life expectancy at birth were 17.1 years and 12.7 years,respectively.Conclusion Persons with physical disability had higher mortality and actions should be taken to improve their life expectancy,accordingly.     

发达国家预期寿命变化和原因及对我国的启示

预期寿命是度量人口健康状况的最重要指标,也是衡量一个国家或地区经济社会发展和医疗卫生服务水平的综合指标,并受生物学因素、环境因素、生活方式以及医疗卫生服务等因素的影响.新中国成立以来,我国人口预期寿命不断提高,由建国初期的35岁,上升至1982年的68岁,2010年的74.8岁,上海、天津、北京等经济发达地区预期寿命已超过80岁,但还有一些经济欠发达省份预期寿命尚未达到70岁.201 1年,《国民经济和社会发展第十二个五年规划纲要》提出"人均预期寿命提高1岁"的预期性指标,如何达到这一目标,如何缩小不同省份居民预期寿命的差距,是亟待我们研究的课题之一.笔者拟从流行病学范畴(探讨死亡模式的改变)和社会经济学范畴(分析死亡模式转变的根本原因)来分析日本、韩国、美国等国家预期寿命变化的历程及原因,对提高我国人均预期寿命工作有一定启示.     

人均预期寿命指标应用与发展规律

目的 了解国际上在预期寿命指标监测与应用上的成熟经验,分析预期寿命发展变化规律,为完善我国相关工作机制、实现预期寿命不断增长提供依据。方法 利用世界卫生组织、联合国人口基金会、部分国家及我国官方发布资料,总结全球预期寿命相关指标监测与发布机制,分析发展变化规律。结果 在2000—2019年期间,全球范围内预期寿命呈现不同程度的增长态势,我国预期寿命水平及增长幅度较为瞩目。结论我国居民预期寿命持续快速增长,是党和政府坚持以人民为中心的发展思想、实践以人民幸福安康为高质量发展最终目标的真实体现。预期寿命发展阶段的变化要求我们进行体制机制上的创新。今后,需将关注点从生命长度延伸至生命质量。     

深圳市人口平均预期寿命的估计

目的：在缺乏准确年龄别死亡率的情况下，估计人口平均预期寿命。方法：分别根据人口普查数据估算，通过平均预期寿命和婴儿死亡率的相关关系推算，采用“最佳老龄平均余生”公式，以及通过模型寿命表对85岁以上年龄组过高预期寿命校正等进行间接估计。结果：深圳市0岁平均预期寿命1989年约为74．32岁，1998年约为75．49岁，该结果与深圳市人口健康发的实际水平较吻合，有关专家一致认为其接深圳市的实际情况，被区域卫生发展规划采用，结论：在没有准确死亡数据的国家、城市或者地区，应用间接方法估计平均预期寿命是可行的。     

中国的死亡率进度效应与去进度效应平均预期寿命

目的：介绍死亡率进度效应，其也是高估中国人口平均预期寿命的不可忽略的因素之一，说明去进度效应平均预期寿命是衡量人口寿命水平和健康水平变动趋势的更佳指标。方法：采用1994-2016年中国的死亡数据，以John Bongaarts和Griffith Feeney提出的三步估计策略，考察了中国的去进度效应平均预期寿命。结果与结论：（1）与常规预期寿命指标相比，去进度效应平均预期寿命呈更加平稳增长的趋势，女性的平均预期寿命及其增长速度均高于男性；（2）中国1994-2016年平均预期寿命的进度效应在2~5岁之间波动，平均在2.5岁以上，明显高于已有研究所涉及欧美国家的进度效应，表明中国死亡率下降速度更快；（3）就"六普"而言，进度效应会造成常规平均预期寿命高估寿命水平，男性、女性和两性合计人口的幅度分别为2.43岁、2.63岁和2.57岁，去进度效应预期寿命或许可以更好地测度中国人口的寿命水平及其变化趋势。     

影响中国人口平均预期寿命的社会因素模式

本文以全国28个省、自治区和直辖市的统计资料为基础,以文化、经济等社会因素作为自变量,平均预期寿命作为因变量,应用多元线性回归分析,对影响我国人口平均预期寿命的社会因素模式作一讨论。结果提示:努力提高人民文化水平,发展社会主义经济和促进医疗卫生事业的发展是提高人口预期寿命的重要“社会处方”。     

中国预期寿命变动的地区差异及其社会经济影响因素:1981—2010

利用最近四期人口普查数据估算的分省预期寿命及相应年份的社会经济统计资料,分析改革开放以来不同省份人口预期寿命之间的地区差异及其历时变动情况,并通过拟合针对面板数据的随机效应模型考察影响人口预期寿命地区差异的社会经济因素。结果研究发现,中国不同地区人口预期寿命差距明显,这一差距在1990—2010年总体上经历了先升后降的变动过程。面板数据模型分析结果显示,经济发展水平和增长速度、收入不平等程度以及教育和卫生基础资源状况是导致不同地区人口预期寿命差异的重要影响因素。     

基于失能调整预期寿命的老年人自理时间测算

目的 了解老年人自理时间与预期寿命的关系.方法 利用失能调整预期寿命推算老年人自理时间及其占预期寿命的比例.结果 老年人失能调整预期寿命与失智调整预期寿命占预期寿命的比例均随寿命的增长呈现出下降的趋势,且失智所占的比例下降速度更快.结论 失能与失智调整预期寿命的计算均支持疾病扩张理论,在寿命延长的背景下,应该更加关注老年人的生活质量.     

758例艾滋病抗病毒治疗患者生活质量现状及相关因素研究

目的 了解艾滋病抗病毒治疗患者生活质量的现状并分析其相关因素.方法 应用SF-36量表评价758例艾滋病抗病毒治疗患者的生活质量,同时调查可能影响生活质量的人口学特征和与HIV感染相关的特征.采用t检验、方差分析进行均数显著性检验,采用多元线性回归模型分析艾滋病抗病毒治疗患者生活质量生理健康总分和心理健康总分的相关因素.结果 758例艾滋病抗病毒治疗患者生理健康总分45.34±8.77,心理健康总分41.92±12.01.患者年龄越小生理健康总分越高,心理健康总分则越低.抗病毒治疗时间越长心理健康总分越低.男性、血CD4+T淋巴细胞计数水平高的患者生理和心理健康总分比女性、血CD4+T淋巴细胞计数水平低的患者得分高.性途径、静脉吸毒途径和其他途径或尚不明确途径感染生理和心理健康总分高于单采血浆途径.结论 应加强对年龄较小、女性、单采血浆感染、血CD4+T淋巴细胞计数水平低、抗病毒治疗时间较长的艾滋病感染者或患者的心理健康辅导,以提高其生活质量.     

Health-related Quality of Life and Virologic outcomes in an HIV Clinic

Objective: The purpose of this study was to describe the relationship between viral load and health-related quality of life (HRQOL) in a cohort of persons with human immunodeficiency virus (HIV) infection. Design: We evaluated HRQOL measurements in a clinical cohort of HIV-positive patients recruited from a university-associated HIV primary care clinic. HRQOL instruments included the medical outcomes survey-short form-36(MOS-SF-36) from which mental and physical component summary scores (MCS and PCS) and subscale scores were calculated. Results: Significant negative associations were found between viral load and SF-36 PCS, physical functioning (PF), role-physical (RP), bodily pain (BP), general health (GH), role-emotional (RE), and vitality (VT). Similar negative associations were found between CD4 cell count and SF-36 summary and subscale scores, with the notable exception of bodily pain. Multivariate analyses controlling for the effects of CD4 cell count and other clinical variables indicated viral load as an independent predictor of SF-36 PCS, RP, BP and VT scores. Conclusions: The relationship between viral load, a measure of HIV disease activity, and several dimensions of the SF-36, a patient-focused measure of HRQOL, appears to be strong and independent of CD4 cell count. These findings suggest that having a lower viral load positively impacts the quality of life of HIV-positive patients. This revised version was published online in July 2006 with corrections to the Cover Date.     

Quality of life in HIV subtype C infection among asymptomatic subjects and its association with CD4 counts and viral loads – a study from South India

Objective

To study the association between quality of life (QOL) domains and biological markers of disease progression of HIV infection, i.e. viral load (VL) and CD4 counts among asymptomatic subjects with HIV subtype C infection in South India.

Design

Quality of life was measured using the locally validated version of the WHOQOL HIV-BREF. The subjects were neurologically asymptomatic, non psychiatrically ill HIV infected men and women participating in a cohort study.

Results

The results indicated mixed findings, with some QOL dimensions being associated with high VLs and low CD4 counts while several others did not show any associations. Significant associations were seen between low CD4 counts and the psychological and social relationships domain, with lower mean scores in these domains being reported by subjects having CD4 counts <200 /mm. However, there were no significant differences between the CD4 subgroups for the domains related to physical health, level of independence, environment, and spirituality domains. Significant lower mean QOL scores were found in the highest VL subgroup compared to other groups for the following WHOQOL HIV-BREF domains: physical, psychological, level of independence, and environmental.

Conclusions

In this sample of HAART naïve asymptomatic HIV infected subjects, some QOL dimensions were associated with the biological markers of disease progression i.e. VL and CD4 counts, while several were not. The associations were significant only in the high VL and low CD4 groups.     

中国四城市15家医院门诊病例2型糖尿病合并症与生存质量关系研究

目的 探讨城市人群2型糖尿病合并症与患者生存质量的关系.方法 采用横断面调查的方法,从4个大城市15家医院门诊募集现患病例,采用问卷调查结合实验室检测的方法收集资料.分别运用t检验、方差分析和广义线性方程分析合并症与2型糖尿病患者生存质量的关系. 结果 合并症患者生存质量各维度得分均低于无合并症患者(得分降低4.68～16.06),合并症对患者生存质量各维度影响不同,对生理职能(降低22.45%)和情感职能(降低16.28%)影响较大.对生理机能(降低5.61%)和精神健康(降低6.65%)影响相对较小.合并症患者生存质量较无合并症患者总体低11.02%.随着合并症数量增加,患者生存质量逐渐降低,患者每增加1种合并症,其生存质量各维度得分平均降低2.82～10.33分. 结论 有合并症患者生存质量总体低于无合并症患者;随着合并症数量增加,患者生存质量逐渐下降,预防和减少患者合并症的发生对提高糖尿病患者的生存质量至关重要.     

299例人类免疫缺陷病毒感染者生命质量的调查

目的用定性访谈和36条目简明量表（short form-36,SF-36）定量调查的方法研究人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者的生命质量,评价HIV感染者的敌意心理趋势。方法在四川、湖北和贵州抽取299例HIV感染者,用SF-36调查其生命质量,并进行信度效度分析。对感染者和防治人员进行访谈,以了解感染者目前最关注的内容。SF-36曾用于与本次调查对象具有相似经济文化背景的四川普通农村居民（1603例）,将两次调查的结果进行比较。通过与相关专家及防治人员进行小组讨论,设计7个条目以评价感染者的敌意心理趋势。结果SF-36共有8个维度,各维度内部一致性信度系数范围0．75～0．90,重测信度系数范围0．54～0．80（40例）。条目与其维度的相关系数范围为0．46～0．97。HIV感染者各个维度平均得分在28．50～77．87之间,四川普通农村居民各个维度平均得分在70．27～91．87之间,各维度得分经Mann-Whitneytest检验,U值在-17．43～-23．87之间,P值均〈0．01。评价敌意心理趋势的7个条目平均得分范围为46．21～82．89。结论HIV感染带来生命质量的严重恶化。SF-36可用于HIV感染者生命质量的研究。     

安徽省艾滋病病毒感染儿童的生活质量评价

目的用“儿科健康相关生活质量普适性核心量表4.0”评价安徽省儿童艾滋病病毒感染者/病人（简称艾滋病儿童）的生活质量。方法采用普查方法,对安徽省所有艾滋病儿童及其监护人进行问卷调查。结果共调查艾滋病儿童60人,平均年龄（10.23±3.25）岁;男性32人（53.3%）;艾滋病病人48人（80.0%）。大多数艾滋病儿童认为自己的身体较好或一般,近四成的孩子在最近两周内生过病,两周患病率为38.3%。艾滋病儿童的生理、情感、社会和角色功能的得分分别是75.2、85.0、77.6和70.8分;后三项构成心理领域,平均为78.5分;生活质量总平均为77.8分。与一般儿童相比,除情感功能外,艾滋病儿童在各方面得分均较低,且差异具有统计学意义。儿童艾滋病病毒感染者与儿童艾滋病病人相比,生理功能上两组儿童差异有统计学意义;而在其他方面、整个心理领域以及总体得分等指标上,两组儿童差异无统计学意义。艾滋病儿童生理功能同年龄、家庭经济状况和儿童的身体状况有关联关系;社会功能与家庭经济状况和儿童的身体状况有关联关系;心理领域同家庭经济状况有关联关系;生活质量总分同家庭经济状况和儿童的身体状况有关联关系。结论安徽省儿童艾滋病病毒感染者/病人的生活质量受到严重影响,亟需干预措施改善生活质量。     

Quality of life of people living with HIV/AIDS and its relationship with CD4+ lymphocytes, viral load and time of diagnosis

Quality of life (QOL) has accompanied the treatment of AIDS patients, along with pharmacological innovations that have allowed patients to live longer and maintain their well-being. The present study aimed at evaluating the QOL of these patients and correlate it with clinical and laboratory data. The study included 205 patients with HIV/AIDS, who answered the WHOQOL-120-HIV; and whose socio-demographic data, clinical and laboratory findings were collected. The average age was 40.59 ± 11.81 years; CD4+ lymphocyte count, 397.9 ± 232.84 mm3; and years of diagnosis of HIV, 5.23 ± 3.94. Viral load was <50 copies/ml in 115 patients; 50 to 10.000 in 61; and above 10.000 copies in 29 patients. Domains achieved satisfactory average scores, and the best were the psychological (14.5 ± 2.7), followed by social relationships (13.7 ± 2.2), physical (12.7 ± 3.5), independence (12.6 ± 2.5), personal beliefs (12.4 ± 2.4), and environment (12.4 ± 1.8). The best scores on pain, pleasure, social support, physical environment, and personal belief facets were observed for those with higher CD4 levels (p < 0.05). The best scores for the finance, leisure, concerns about the future, overall QOL, and perceived health facets were observed for patients with viral load <50 (p < 0.05). The highest rates for energy, fatigue, sexual activity, information, transportation, symptoms, care, and concerns about the future facets were seen in patients with less time of diagnosis (p < 0.05). HIV/AIDS patients in the study had an intermediate QOL correlating to CD4 levels, VL, and time of diagnosis.     

Quality of life and the related factors in Iranian transgender people: a cross-sectional study

Aim

This study aimed to evaluate the quality of life (QOL) of transgender (trans) people in Iran.

Subject and methods

In this cross-sectional study, participants were included in the study using the snowball sampling technique. Two hundred thirty-five transgender people from different provinces of Iran were identified and agreed to participate in the study. To measure the QOL of these individuals, we used the short form of the QOL SF-36 questionnaire, which was completed as self-administered.

Results

In this study, the highest and lowest mean scores of trans individuals’ QOL belong to the physical functioning (88.59?±?13.81) and bodily pain (30.78?±?25.68) domains, respectively. Moreover, the mean scores of mental health, emotional role, vitality, general health, and bodily pain domains were less than 50. Reassignment surgery, vocation, and age were significantly associated with quality of life score (P?<?0.05).

Conclusion

Iranian transgender individuals lack appropriate QOL. It seems that gender reassignment surgery and job creation for these individuals improve their QOL.

     

Determination of Quality of Life and Their Perceived Social Support from Family of Patients with HIV/AIDS

Acquired immunodeficiency syndrome (AIDS) is a significant disease which affects the individual physically, emotionally, and socially. The aim of this study was to determine the relationship between the quality of life and social support of patients with HIV/AIDS. 49 patients with HIV/AIDS who applied to the Infectious Diseases Polyclinics of the university hospital between November 2010 and December 2011 were enrolled in study. All the data were collected using a personal information form, SF 36 quality of life scale (QOL) and perceived social support from the family scale (PSS-Fa). Average age of patients was 41.23 ± 10.62, 65.3 % of them were male. It was found that the diagnosis period for 55.1 % of patients was 24 months or longer, and 55.1 % of them were diagnosed at a university hospital, 81.6 % received a treatment. When the average scores of QOL was analyzed, it was found that the average score of functional status subscale was 39.35 ± 8.90, well-being subscale was 42.59 ± 14.70, general health perception subscale was 19.18 ± 6.25 and global quality of life score was 33.70 ± 9.31. The mean PSS-Fa score of patients was 28.65 ± 9.56. Comparing socio-demographic and clinical characteristics of patients and average scores of QOL and PSS-Fa, there was not a statistically significant relation (p > 0.05). No statistically significant correlation was found between the average scores of QOL and PSS-Fa. These results showed that quality of life was poor and perceived social support was moderate in patients with HIV/AIDS. According to these results, it is recommended that patients with HIV/AIDS should be supported in this regard.     

社会资本与HIV感染者生命质量的关联研究

目的 探索社会资本与某戒毒康复社区HIV感染者生命质量之间的统计学关联。方法 采用分层等比抽样法在某少数民族集中戒毒康复社区中抽取400名HIV感染者,问卷调查其人口学特征、生命质量和社会资本现状等;应用SPSS 21.0进行描述性统计分析、因子分析、χ2检验、logistic回归模型构建等。结果 收回有效问卷370份,有效问卷回收率为92.5%。分别有88.9%和82.7%的HIV感染者生理领域和心理领域生命质量较差;家庭支持状况越好,HIV感染者的生理（ORB1 = 1.334,95%CI:0.956～1.861）和心理领域（ORB1 = 1.649,95%CI:1.158～2.348）生命质量评分等级为“好”的发生率越高;人际支持状况越好,HIV感染者心理领域生命质量评分等级为“好”的发生率越高（ORA1 = 2.408,95%CI:1.556～3.725）。结论 较好的家庭支持对戒毒康复社区HIV感染者的生理和心理领域生命质量均有促进作用;良好的人际支持环境对该群体心理领域生命质量具有一定的保护作用。