中国9省市中老年人群体重指数与健康相关生命质量的关系

Objective To study the association between body mass index (BMI) and the health-related quality of life (HRQOL) in the middle-aged and older Chinese people. Methods Data of 9539 middle-aged and older adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan province). MO SSF-36 was used to measure HRQOL. BMI classification was in accordance with the criteria recommended by the Ministry of Health of China. Rank sum test was used to compare HRQOL between subjects with normal weight and those with different BMI classification. Multiple logistic regression analysis was used to assess the association of HRQOL with BMI after adjusted for sex, age, marital, education, physical activity status and chronic diseases. Results When compared with middle-aged and older adults at normal weight range (18.5≤BMI<24) , data on physical domain (P<0.001) , mental domain (P< 0.01) and 8 dimensions of HRQOL (physical functioning, mental health, P<0.05; role-physical, bodily pain, general health, vitality, social functioning, role-emotional, P<0.01)among subjects with underweight (BMI<18.5) were significantly lower while mental component summary (P<0.05) of overweight subjects (24≤BMI<28) was significantly higher. Obese subjects (BMI≥28) had worse physical function (physical functioning, P<0.01) but better mental health (mental health, P<0.01; mental component summary, P<0.05). After adjusting for other factors, and compared to middle aged and older adults with normal weight, data on odds ratios (ORs) of impaired HRQOL in physical domain (OR=1.67, 95% CI: 1.35-2.06), mental domain (OR=1.39, 95%CI: 1.13-1.70) and 8 dimensions increased among underweight subjects while ORs of impaired HRQOL in mental domain (0R=0.86,95% CI: 0.78-0.95) and role-physical, vitality, social functioning, role-emotional and mental health dimensions decreased among overweight subjects. ORs increased (OR=1.51,95% CI: 1.27-1.80) in impaired HRQOL in physical functioning dimension but decreased in mental domain (OR=0.71,95%CI: 0.60-0.85) as well as vitality, role-emotional and mental health dimensions among obese subjects. Conclusion HRQOL of each domain were different among middle aged and older adults with different BM1 classification. Underweight people had poor HRQOL in both physical domain and psychological domain, and obese people had poor physical function but good mental health condition.     

慢性心力衰竭患者生命质量测评的现状

学术背景:生命质量是测评慢性心力衰竭患者的一种新的健康评价方法,有助于临床、护理以及社会工作者全面了解心力衰竭对患者生理、心理、社会等各方面的损害,从而实施更具针对性和人文关怀的早期预治.目的:系统阐述慢性心力衰竭患者健康相关生命质量研究的进展,分析存在的问题,展望研究发展趋势.检索策略:应用计算机检索MEDLINE数据库1990-01/2004-12有关采用量表评价慢性心力衰竭患者生命质量的英文文献,检索词为"heart failure,quality of life".同时检索中国学术期刊全文数据库1994-01/2004-12、中国优秀博硕士学位论文全文数据库2000-01/2004-12有关采用量表评价慢性心力衰竭患者生命质量的中文文献,检索词为"心衰/心力衰竭/心功能不全,生命质量/生活质量/生存质量".纳入标准:采用量表测量慢性心力衰竭患者生命质量的临床研究、护理康复、流行病学调查及方法学探讨的一次及二次文献;排除标准:重复性研究、急性心力衰竭研究、慢性心力衰竭伴严重肝肾功能障碍研究及未采用量表作为测评工具的一次文献.对文献中综述及其中的随机、对照、盲法情况未限制.文献评价:共收集到176篇采用量表评价慢性心力衰竭患者生命质量的文献,符合纳入标准的文献36篇,其中有关慢性心力衰竭患者生命质量研究背景的文献8篇,有关慢性心力衰竭生命质量测评工具的文献17篇,有关慢性心力衰竭患者生命质量现状的文献7篇,有关影响慢性心力衰竭患者生命质量因素的文献4篇.资料综合:慢性心力衰竭生命质量研究已从单纯的临床试验扩展至临床、护理和社会医学等诸多领域,国内外都开发了适用于该疾病的生命质量测评工具.存在的问题是国内开发的一些测评工具缺乏信度和效度,生命质量作为主观的测评结果其标准尚未统一.结论:生命质量已广泛应用于国内外慢性心力衰竭患者的健康评价当中,并产生了多语言、多版本的测评量表.有必要对该疾病现有的生命质量测评量表进行科学地评价,并标准化生命质量测量结果以利于它的实际应用.同时,生命质量资料本身的局限性影响了评价的可靠性,改进测量方法是该疾病生命质量研究的发展趋势.     

消毒供应中心职业防护依从性的管理措施

消毒供应中心是医院医疗物品消毒灭菌和配送中心,它担负着各种复用医疗器械的回收、清洗、消毒、包装、灭菌、储存、发放的工作。特定的工作环境和工作性质,使消毒供应中心工作人员是职业暴露的高危群体,若自我防护意识不强,医院采取的预防措施不当,极易出现长期亚健康状况,甚至发生疾病。我院消毒供应中心通过多年的总结,充分了解各种危害因素,并采取了主动职业防护,取得了良好的效果,现报告如下。     

505例健康体检者的中医体质类型与血糖、血脂、体质量指数关系分析

目的 研究不同体质与血脂、空腹血糖（fasting blood glucose,FBG）、体质量指数（body mass index,BMI）的关系,从宏观和微观角度探究体质的形态结构特质.方法 对505例健康体检人群进行横断面的中医体质调查,同时测定各受试者的血清总胆固醇（total cholesterol,TC）、三酰甘油（triglyceride,TG）、低密度脂蛋白（low density lipoprotein,LDL）、高密度脂蛋白（high density lipoprotein,HDL）、FBG,计算BMI,比较每种偏颇体质与平和质的TC、TG、LDL、HDL、FBG、BMI及高脂血症发生率,对每种体质的转化分与TC、TG、LDL、HDL、BMI进行多元线性回归分析.结果 阳虚质者TC、TG、BMI显著低于平和质者（P〈0.05,或P〈0.01）,痰湿质者BMI显著高于平和质者（P〈0.05）,气郁质者BMI显著低于平和质者（P〈0.01）.与平和质比较,阳虚质者高脂血症的发生率呈下降趋势,痰湿质者呈升高趋势.多元线性回归分析显示,LDL越高,阳虚质转化分越低;TG越高、BMI越大,阴虚质转化分越低,FBG越高,阴虚质转化分越高;HDL越高,痰湿质转化分越低;BMI越大,瘀血质、气郁质、特禀质转化分越低.结论 阳虚质、阴虚质、瘀血质、气郁质者体型偏瘦,痰湿质者体型偏胖;阳虚质者血TC、TG、LDL、FBG偏低,阴虚质者血FBG偏高,痰湿质者TG、LDL偏高,HDL偏低;痰湿质者具有易发高脂血症的倾向.     

“中医原创思维与健康状态辨识方法体系研究”项目启动

日前,由北京中医药大学教授王琦为首席科学家的973计划"中医原创思维与健康状态辨识方法体系研究"项目启动会举行。该项目对揭开中医理论背景、哲学体系、思维模式和价值观的重大理论具有一定意义,对"健康医学"具有现实意义。     

中医体质类型与骨质疏松症关系的Logistic回归分析

[目的]研究不同中医体质类型与骨质疏松症之间的关系,为调护中医体质防治骨质疏松症提供依据。[方法]采用病例对照研究设计,病例组和对照组各401例样本来源于中医体质与健康状况调查数据库。9种中医体质类型判定基于中医体质量表得分,骨质疏松症为自我报告。多元Logistic回归分析的方法使用于分析中医体质类型与骨质疏松症的关系。[结果]以平和质为参照,5种偏颇体质为骨质疏松症的危险因素,其相对危险度比值比(OR)和95%的可信区间(CI)分别为:气虚质(OR:2.3,95%CI:1.5~3.4)、阳虚质(OR:2.1,95%CI:1.3~3.3)、阴虚质(OR:2.1,95%CI:1.2~3.5)、湿热质(OR:2.5,95%CI:1.3~4.5)和血瘀质(OR:2.8,95%CI:1.7~4.5)。[结论]中医体质类型与骨质疏松症之间存在着一定的关联性,应积极调整偏颇体质,降低骨质疏松症发生的风险。     

心功能不全QOL量表中文译本信度效度的初步评价

目的将心功能不全QOL量表 (MinnesotaLivingwithHeartFailureQuestionnaire ,LHFQ)开发为中文译本 ,评价其信度和效度。方法以符合纽约心脏协会 (NewYorkHeartAssociation ,NYHA)分级Ⅱ～Ⅳ级的心功能不全稳定态患者 44例为调查对象 ,用调查 再调查 (test retest)方法实施调查。通过重测信度和内部一致性Cronbach’sα系数评价其信度 ;并通过效标效度、判别效度考察其效度。结果LHFQ量表前后两次调查再现性的相关系数在综合分r =0 .468(P =0 .0 0 9)、身体领域r =0 .45 8(P =0 .0 11)、情绪领域r =0 .44 6(P =0 .0 14 ) ,重测信度尚可。Cronbach’sα系数在综合分及身体领域、情绪领域是 0 .776～ 0 .881的范围 ,说明有充分的内部一致性。LHFQ得分与效标SF 3 6之间的相关分析在综合分r =0 .610 (P <0 .0 0 0 1)、身体领域r =0 .660 (P <0 .0 0 0 1) ,情绪领域r =0 .414 (P =0 .0 0 7) ,显示了较好的效标效度。根据NYHA分级 ,以t检验进行分析的结果 ,LHFQ在综合得分和身体领域得分存在显著性差异 (P <0 .0 5 ) ,确认有较好的判别效度。结论LHFQ中文译本具有较好的信度和效度。     

气虚体质和痰湿体质人群体重指数影响因素的对比分析

[目的]分析比较气虚体质和痰湿体质人群体重指数(BMI)影响因素存在的差异。[方法]从健康状况调查数据库中筛选出体质判定结果为气虚质和痰湿质的研究对象共4 071例,分别构建多元回归模型进行BMI影响因素的差异性分析。[结果]对于人口学因素,男性、年龄增加、已婚对两种体质BMI的增加均产生正向影响,且男性对"痰湿胖"的影响更大,而年龄增加、已婚对"气虚胖"的影响更大;文化程度对"气虚胖"有影响。对于行为生活习惯,喜油腻、喜冷凉、睡眠时间少对两种体质BMI的增加产生正向影响,且对"痰湿胖"的影响更大;饮酒偏好和不喜清淡饮食正向影响"气虚胖";运动水平低和喜辛辣饮食正向影响"痰湿胖"。[结论]两种体质人群BMI影响因素及各因素的影响程度存在差异。在体重调控时,应对不同体质加以区分。     

中国9省市中老年人群体重指数与健康相关生命质量的关系

Objective To study the association between body mass index (BMI) and the health-related quality of life (HRQOL) in the middle-aged and older Chinese people. Methods Data of 9539 middle-aged and older adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan province). MO SSF-36 was used to measure HRQOL. BMI classification was in accordance with the criteria recommended by the Ministry of Health of China. Rank sum test was used to compare HRQOL between subjects with normal weight and those with different BMI classification. Multiple logistic regression analysis was used to assess the association of HRQOL with BMI after adjusted for sex, age, marital, education, physical activity status and chronic diseases. Results When compared with middle-aged and older adults at normal weight range (18.5≤BMI<24) , data on physical domain (P<0.001) , mental domain (P< 0.01) and 8 dimensions of HRQOL (physical functioning, mental health, P<0.05; role-physical, bodily pain, general health, vitality, social functioning, role-emotional, P<0.01)among subjects with underweight (BMI<18.5) were significantly lower while mental component summary (P<0.05) of overweight subjects (24≤BMI<28) was significantly higher. Obese subjects (BMI≥28) had worse physical function (physical functioning, P<0.01) but better mental health (mental health, P<0.01; mental component summary, P<0.05). After adjusting for other factors, and compared to middle aged and older adults with normal weight, data on odds ratios (ORs) of impaired HRQOL in physical domain (OR=1.67, 95% CI: 1.35-2.06), mental domain (OR=1.39, 95%CI: 1.13-1.70) and 8 dimensions increased among underweight subjects while ORs of impaired HRQOL in mental domain (0R=0.86,95% CI: 0.78-0.95) and role-physical, vitality, social functioning, role-emotional and mental health dimensions decreased among overweight subjects. ORs increased (OR=1.51,95% CI: 1.27-1.80) in impaired HRQOL in physical functioning dimension but decreased in mental domain (OR=0.71,95%CI: 0.60-0.85) as well as vitality, role-emotional and mental health dimensions among obese subjects. Conclusion HRQOL of each domain were different among middle aged and older adults with different BM1 classification. Underweight people had poor HRQOL in both physical domain and psychological domain, and obese people had poor physical function but good mental health condition.     

日本体质医学研究态势述评

体质医学在日本受到较大关注。日本体质学会．每年定期召开体质医学总会，出版日本体质学杂志，从体质的概念和构成因素、体质的分类和诊断、汉方的体质分类和治疗等多方面、多角度，以多种方法研究体质问题，促进了体质医学的发展。同时，分析了日本体质医学研究的困难性和跨学科研究的重要性。