丽水市城镇机关干部人群心脑血管病危险因素监测

目的　监测城镇社区 2 5～ 6 4岁机关干部人群 1999年～ 2 0 0 1年间心脑血管病危险因素水平及变化趋势。方法　采用随机抽样问卷调查和健康体检调查方法 ,监测吸烟、饮酒、体力活动、血压、血脂、血糖及体重指数指标。结果机关干部人群中男性吸烟率 51 50 %、饮酒率 4 9 83% ,6 0 %以上男女干部均缺少体力活动 ;1999年监测超重者男性31 59% ,女性 13 2 0 % ,高血压男性 12 81% ,女性 5 58% ,高血脂男性 32 10 % ,女性 16 54 % ,高血糖男性 3 4 5% ,女性3 53% ,并且三年来呈增长趋势 ,尤其是多个危险因素个体聚集的增多现象更为突出。结论　心脑血管病社区防治工作中应将机关干部作为重点防治人群加以综合干预 ,有效控制机关干部人群心脑血管病危险因素水平。     

丽水城镇机关干部人群血压监测研究

慢性非传染性疾病综合防治工作的重点是高血压病的防治 ,1 999～ 2 0 0 1年期间 ,我们对丽水城镇社区机关干部人群的血压水平及高血压现患率作了连续监测研究 ,现将结果报告如下 :1　研究对象与方法1 .1　采用健康体检调查方法 :以机关团体为单位 ,连续三年监测调查 2 5～ 64岁机关干部人群血压水平和高血压现患率 ,并测定血脂、血糖 ,测量身高、体重 ,计算体重指数。监测人群年龄性别结构 ,见表 1。1 .2　判断标准 :高血压指 SBP≥ 1 40 mm Hg和 /或 DBP≥90 mm Hg或近二周内服降压药者 ;高血脂指血清甘油三脂水平≥ 2 .2 6mmol/L和 /…     

丽水市机关干部人群心血管病危险因素干预效果评价

目的评价丽水市机关干部人群心血管病主要危险因素的干预效果。方法在丽水市25~64岁机关干部人群中采取以健康体检后健康教育和电话随访为主的综合性干预措施,采用健康体检调查方法收集心血管病主要危险因素资料,评价干预效果。干预措施包括:(1)开设体检报告咨询室,针对个体存在的健康问题进行咨询;(2)电话随访;(3)组织体检团体机关干部开展专题健康教育讲座活动。结果本次调查分析显示:(1)2016年男、女性机关干部平均舒张压较2012年分别下降2.35mmHg、2.64mmHg,平均空腹血糖分别下降0.11mmol/L、0.14mmol/L,平均血尿酸分别升高18.19μmol/L、28.75μmol/L。(2)2016年男、女性机关干部高血压率及高血糖率较2012年均下降,而高尿酸血症率则较2012年升高。2016年男、女性机关干部高脂血症率较2012年无明显变化。结论通过对心血管病危险因素进行干预,机关干部人群高血压率和高血糖率明显下降,但高脂血症率、超重肥胖率无明显下降,高尿酸血症率则显著上升,今后应加强超重肥胖、高脂血症以及高尿酸血症方面的干预措施。     

浙江丽水城区人群心脑血管病危险因素水平调查报告

目的：探索丽水城镇社区人群心脑血管病危险因素水平,为综合防治提供科学依据。方法：于1999年5月对丽水城镇社区8万人口中35－64岁人群进行了一次心血管疾病危险因素随机抽样调查。结果：人群吸烟率24．8％,其中男性高达51．0％;饮酒率29．9％,其中男性高达49．1％;超重占32．8％;高甘油三酯血症占29．4％;高血压患病率21．92％。结论：本地区上述危险因素水平均相当突出,采取社区综合防治措施,进行有效控制已刻不容缓。     

顺德市容桂地区中年农业人群心血管病危险因素探讨

目的：探讨顺德容桂地区农业人群心血管病的危险因素。方法：1997－1999年对本地区小黄圃等6个村委会35－39岁有农业户口的常住人群共4083名人员作为调查对象，进行病史询问以及血压，身高，体重，腰围，臀围、血糖、血脂、心电图等检查。结果：高血压患病率为14．8％（标化率），血脂异常率41．3％，超重率20．8％，饮酒率36．7％；现在吸烟率男性58．4％，女性4．7％。结论：本地区中年农业人群多项心血管病危险因素水平较高，特别要注意腰臀比、体重指数，血脂、血糖指标测定，应予重视并进行干预，以期降低心血管疾病的发病率及死亡率。     

哈密市碘缺乏病固定监测点15年病情监测报告

以推广食用加磺盐防治碘防治病（ＩＤＤ）为主的综合防治方法，连续监测１５年，取得了明显效果。结果为：１９８１年患病率为２１．２４％，到１９９５年患病率下降为１．４７％，人群尿碘１９８７年仍不高，到１９９５年人群尿碘已达较镐水平，居民碘盐食用率逐年上升，到１９９５年基本普及。监测结果提示，普及加碘盐是防治这类地区ＩＤＤ的根本措施。     

北京地区急性冠心病事件死亡率1984～1993年变化趋势及影响因素的探讨

在北京地区70万自然人群中，对急性冠心病事件的死亡率及有关的危险因素进行了十年（1984～1993）监测。其结果显示：35～74岁男性年平均冠心病死亡率，90．1／10万，女性死亡率为53．9／10万；1993年死亡率比1984年男性增高17％，女性增高56％。1993年比1984年男性发病率增高36％，女性增高66％。同时期三次（1984~1985，1988～1989，1993年）在监测人群中进行心血管危险因素抽样调查，结果显示：第三次与第一次相比男性吸烟率增长25％；男女两性平均收缩压均增长0．133kPa（1mmHg）（0．8％）；平均总胆固醇水平男性上升11．2mg％（7．0％），女性上升7mp％（4．4％）。本研究提示：北京地区急性冠心病死亡率呈持续上升趋势，这种趋势推测主要受发病率上升的影响，人群中冠心病危险因素水平的增加是影响发病率上升的重要原因。     

人群体重指数变化对心血管病危险因素的影响

目的探讨体重指数(BMI)变化对其他心血管病危险因素的影响。方法跟踪随访2001年参加我院健康体检且年龄在25~64岁的人群,复查该人群3年后体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、血糖(FPG)、甘油三酯(TG)、胆固醇(TC),观察体重正常者与超重肥胖者的心血管危险因素水平,BMI变化后其他心血管病危险因素的变化及BMI变化值与其他危险因素变化值之间的关系。结果超重肥胖人群由2001年的40.09%上升到2004年的44.38%;超重肥胖组的多种心血管危险因素均高于体重正常组;超重肥胖组较体重正常组患高血压的危险性增加6.88、患高血糖的危险性增加2.04、患糖尿病的危险性增加2.24、患高甘油三酯血症的危险性增加1.78、患高胆固醇血症的危险性增加5.08。BMI每上升一个单位,SBP上升1.374,DBP上升0.932,TG上升0.192,TC上升0.099;但与FPG变化无线性关系。结论BMI增高可以促进其他如血压、血糖和血脂等心血管疾病危险因素。     

机关人群高血压调查及危险因素分析

目的探讨江苏省南京市省级机关、市级机关人群高血压流行水平及其主要危险因素，为高血压的防治提供一定的依据。方法采用问卷等方式对2622名机关干部进行流行病学调查，以是否发生高血压为因变量，按所得数据进行危险因素分析。结果在2622名调查者中，高血压患者827例，患病率为31．5％，男性患病率（36．3％）高于女性患病率（24．1％）（P〈0．01）。随年龄增加患病率明显增加，影响我省机关人群高血压的独立危险因素为年龄、体质量指数、腰围、空腹胰岛素、低密度脂蛋白胆固醇、空腹血糖。结论改变生活方式，有效预防和控制包括超重和肥胖等在内的高血压发病危险因素，是目前急需解决的公共卫生问题。     

老年人代谢综合征及其不同组合成份的特征分析

目的：研究老年人代谢综合征及其不同组合成份的临床特征。方法：对上海市华阳社区≥６０岁常住中国人９１５例的代谢综合征的基线调查资料进行分析。结果：１．３２．８％惠一种代谢异常（高血糖或高血压,或血脂紊乱）;３６．２％患两种代谢异常（高血糖＋高血压,高血糖＋血脂紊乱,高血压＋血脂紊乱）,２０．９％患代谢综合征（高血糖＋高血压＋血脂紊乱）。２．两种代谢紊乱人群体重指数,腰臀比、收缩压、空腹胰岛素、甘油三酯已显增加,代谢综合征人群更明显。３．腰围、收缩压、胰岛素抗抵抗指数（ＨＯＭＡ－ＩＲ）、甘油三酯分别是代谢综合征的独立影响因素。结论;老年人代谢综合征的特点是腹型肥胖,胰岛素抵抗,高收缩压及高甘油三酯,此种聚集特征在两种代谢紊乱人群中已出现,因此,具有两种以上代谢异常的人群应首先列为心脑血管疾病重点防治对象。     

Diabetes and stress hyperglycemia associated with myocardial infarctions at an urban municipal hospital: prevalence and effect on mortality

Municipal hospitals in large cities provide care for patients from immigrant and mixed ethnic communities that are at high risk for diabetes. Both diabetes and stress hyperglycemia increase the risk of adverse outcome after myocardial infarctions, and the impact of stress hyperglycemia on the outcome of myocardial infarctions in this particular setting has not been previously studied. We therefore undertook a retrospective cohort study to determine the prevalence of diabetes and stress hyperglycemia in patients presenting to a university-affiliated Bronx municipal hospital with myocardial infarction, and the relationship of these conditions to the extent of coronary disease and mortality. We obtained data on 106 consecutive patients from July 1998 to April 1999 with a diagnosis-related group diagnosis of either myocardial infarction or acute coronary syndrome, in which myocardial infarction was confirmed by serum enzymes or characteristic electrocardiographic changes. Patients were followed until March 30, 2001. Measurements of clinical parameters and results of catheterization were obtained for all patients. Death rates were determined by laboratory database, direct patient contact, or data from National Death Index. Eighty percent of the cohort had either a diagnosis of diabetes (n = 45, 42% of cohort) or evidence of stress hyperglycemia (defined as serum glucose greater than 126 mg/dL at the time of admission without prior diagnosis of diabetes, n = 40, 38%). In-hospital mortality for patients with diabetes, stress hyperglycemia, or normal glucose was 20%, 15%, and 14%, respectively. Eighty-three percent of the cohort received beta blockers, and 61% of hospital survivors had catheterization. Left main or triple vessel disease was common in both patients with diabetes (52%) and patients with stress hyperglycemia (32%). Mortality at follow up (maximum follow up 3 years; mean follow up 19.6 months) was much higher in patients with either diabetes (42%) or stress hyperglycemia (52%) than normal subjects (24%). Kaplan-Meier analysis of the difference in mortality between patients with high glucose on admission and normal subjects was borderline significant (P = 0.06). Multivariate regression demonstrated that age (P = 0.020), increase in admission serum creatinine (P = 0.001), and reduction in either ejection fraction (P = 0.016) or admission systolic blood pressure (P = 0.005) were significant predictors of mortality. Glycemic status and sex were not independently associated with death after controlling for these other factors. These results show that the prevalence of both diabetes and stress hyperglycemia on presentation with myocardial infarction is strikingly high in this immigrant, mixed ethnic, urban population. Patients with diabetes and stress hyperglycemia had advanced disease on presentation and much higher mortality at 2 to 3 years than those with normal blood glucose. The mortality difference is the result of older age and more advanced disease rather than hyperglycemia per se.     

Measles incidence before and after mass vaccination campaigns in Burkina Faso

Burkina Faso conducted mass measles vaccination campaigns among children aged 9 months to 4 years during December 1998 and December 1999. The 1998 campaign was limited to six cities and towns, while the 1999 campaign was nationwide. The last year of explosive measles activity in Burkina Faso was 1996. Measles surveillance data suggest that the 1998 urban campaigns did not significantly impact measles incidence. After the 1999 national campaign, the total case count decreased during 2000 and 2001. However, 68% of measles cases occurred among children aged 5 years or older who were not included in the mass vaccination strategy. During 2000 and 2001, areas with high measles incidence were characterized by low population density and presence of mobile and poor populations. Measles control strategies in Sahelian Africa must balance incomplete impact on virus circulation with cost of more aggressive strategies that include older age groups.     

宁夏南部山区包虫病患者的调查分析

目的　了解宁夏南部山区包虫病患者的分布情况及与性别、民族和职业间的关系。　方法　汇集南部山区 7家县医院住院确诊为包虫病患者的病案进行回顾性调查。　结果　包虫病患者分布于固原县 12个乡镇、海原县 2 2个乡镇、同心县 2 1个乡镇、西吉县 2 2个乡镇、彭阳县 13个乡镇 ,隆德县和泾源县各 1个乡有个案病例 ;1996～ 2 0 0 1年 7家县医院收治包虫病患者 94 1例 ,发病构成比女性 (6 3.6 6 % )明显高于男性 (36 .34% ) ,回族 (70 .0 3% )高于汉族 (2 9.97% ) ;不同职业人群包虫病患者中农民为高发人群 ,占 75 .0 3% ,其次为学生 (17.5 3% ) ,干部和工人较低 ,各占 3.72 % ;棘球蚴寄生以肝脏为多发部位 ,占 78.85 % ,其次为肺脏 (11.37% )和多脏器同时寄生者 (6 .5 9% ) ;棘球蚴感染发病年龄主要是11～ 4 0岁的中青年 ,占总病例数的 80 .76 % ,5 0岁以上者逐渐减少。　结论　包虫病在宁夏南部山区 5县 90个乡镇普遍流行 ,农民为高发人群。男女、回族与汉族之间发病构成比存在一定的差异。     

高血糖对脑血管病急性期患者预后的影响

目的观察高血糖对脑血管病急性期患者预后的影响。方法对入院的脑血管患者进行常规血糖测定,分为高血糖组与正常血糖组,对其病情、预后进行观察。结果伴高血糖的急性脑血管患者较正常血糖患者病情重,预后差,死亡率高。结论脑血管病急性期血糖升高对患者的预后有不利影响。     

Effects of social intervention on detection and efficacy of treatment for arterial hypertension. Main results of the Polish Four Cities Programme

BACKGROUND: Cardiovascular diseases are the main cause of death in the adult Polish population. Beside lipid disorders and cigarette smoking, hypertension represents the most important risk factor leading to cardiovascular complications. Representative studies conducted in Poland in 1994-2002 showed that in 2002 the number of respondents in the survey who stated they knew their own blood pressure values dropped by 3.5 million, compared with 1994. This decrease was predominantly seen in small towns and in the countryside. Preventive programmes should therefore be addressed mainly to the most vulnerable communities. Modern methods of social marketing may play a substantial role in the creation of a healthy lifestyle. AIM: The aim of the Polish Four Cities Programme (PP4M), conducted in 2000-2001, was to develop the most effective methods of detection of and improvement in treatment for hypertension among the residents of small towns and rural areas. One of the programme tasks was to compare the effectiveness of a standard medical screening intervention with a similar approach combined with the use of social marketing methods.Methods. The programme was conducted by an interdisciplinary team in three small Polish towns -- Kartuzy, Oborniki Wlkp. and Braniewo, as well as in one of the districts of a large city ?ód? -- Olechów. Medical intervention combined with social marketing (community intervention) took place in Oborniki Wlkp. whereas the residents of Kartuzy and ?ód? were subjected only to the traditional medical intervention. Braniewo served as a control location -- neither medical nor community intervention was implemented. Community intervention with elements of social marketing consisted of a three-month, intensive education and information campaign, initiated four weeks prior to the start of medical intervention. Epidemiological situation was assessed in all the four cities before and after the completion of the preventive interventions (screening), using representative surveys, with the objective to assess the changes in the awareness of one's own blood pressure values, detection of hypertension and knowledge concerning cardiovascular risk factors.Results. In two survey locations -- Kartuzy and ?ód? - awareness of one's own blood pressure values after the medical intervention did not significantly change (61% and 67.6% at baseline versus 62.1% and 71.6% after the intervention, respectively). In contrast, social marketing activities conducted in Oborniki significantly increased this parameter from 61.5% to 79.8% (p<0.01). While medical intervention did not change the proportion of non-diagnosed hypertension in a small town (a non-significant decrease from 49% to 45% in Kartuzy), its effect in a large city was clearly visible (a decrease from 46% to 28% in ?ód?). In Oborniki Wlkp. (medical intervention combined with social marketing) the effects were the most noticeable -- a reduction from 50% to 27% was achieved. The efficacy of hypertension treatment at baseline was low (4.7% in Kartuzy, 6.6% in Oborniki, and 6.5% in ?ód?), but it then improved significantly (a twofold increase in Kartuzy and Oborniki, and more than twofold increase in ?ód?). When the target value of blood pressure was set at 160/95 mmHg, the highest efficacy of hypotensive therapy was observed directly after the completion of medical and community intervention in Oborniki (an almost twofold increase in treatment efficacy). CONCLUSIONS: 1. Medical intervention combined with a community intervention and marketing campaign leads to a statistically significant improvement in self-awareness of blood pressure values among residents of small towns. 2. Medical intervention combined with community intervention brings the detection rate of hypertension in small towns up to the level observed in large cities. 3. Medical intervention, especially when combined with community intervention, improves the efficacy of the treatment of hypertension, regardless of the size of agglomeration.     

辽宁省城市体检人群代谢综合征肾脏损害调查研究

目的:探讨沈阳市代谢综合征(MS)人群肾脏损害情况。方法:选取辽宁省城市体检人群与社区人群进行分层抽样调查,共调查2000人,其中体检人群1000人,社区人群1000人(来自辽宁省各城市)。根据MS的诊断标准,研究对象被分为超重肥胖组(460人)和正常体重组(1540人),高血糖组(140人)和正常血糖组(1860人),高血压组(399人)和正常血压组(1601人),血脂异常组(486人)和血脂正常组(1514人),比较各分组间肾脏损害的患病率。结果:调查人群中肾脏损害患病率为15%,男性与女性之比为1:1。超重肥胖组和非超重肥胖组肾脏损害患病率分别为10%和1%;高血糖组和正常血糖组肾脏损害患病率分别为10%和1%;高血压组和正常血压组肾脏损害患病率分别为10%和2%;血脂异常组和血脂正常组肾脏损害患病率分别为10%和1%,以上两组间比较差异均有显著性(P0.01)。结论:辽宁省城市代谢综合征患者的肾脏损害患病率较正常人群显著升高。     

Hyperglycemia correlates with outcomes in patients receiving total parenteral nutrition

BACKGROUND: Hyperglycemia is associated with higher mortality rates after myocardial infarction, stroke, and in critically ill patients. This study was made to determine the associations between hyperglycemia and adverse outcomes in patients receiving total parenteral nutrition (TPN). METHODS: A retrospective cohort study included total 457 patients (age, 66.4 +/- 16.3 years) receiving TPN in 2004. The patients were divided by mean glucose level into quartiles: quartile 1 (<114 mg/dL, Q1), quartile 2 (114 to 137 mg/dL, Q2), quartile 3 (137 to 180 mg/dL, Q3), and quartile 4 (>180 mg/dL, Q4). A logistic regression analysis was performed to determine whether the degree of hyperglycemia was associated with the adverse outcomes. RESULTS: The odds ratio of death was significantly increased in quartile 2 (OR, 2.1 [95% CI: 1.1 to 4.0]) (P = 0.02), quartile 3 (OR, 2.3 [95% CI: 1.2 to 4.5]) (P = 0.01), and quartile 4 (OR, 5.0 [95% CI: 2.4 to 10.6]) (P < 0.01) as compared with quartile 1. Each 10-mg/dL increase in mean blood glucose level was associated with an increased risk factor of infection (OR, 1.09 [95% CI: 1.05 to 1.13]) (P < 0.01), cardiac complications (OR, 1.10 [95% CI: 1.03 to 1.17]) (P < 0.01), acute renal failure (OR, 1.07 [95% CI: 1.03 to 1.11]) (P < 0.01), and respiratory failure (OR, 1.08 [95% CI: 1.02 to 1.14]) (P < 0.01). The risk of adverse outcomes increased with hyperglycemia, independent of age, sex, body weight, prior diagnosis of diabetes, ICU stay, insulin therapy, blood sugar readings before TPN treatment, and frequency of blood sugar measurements. CONCLUSIONS: Hyperglycemia in patients receiving TPN correlates with morbidities and mortality. A prospective, randomized, controlled study instituting aggressive hyperglycemic control is required to determine whether the control of blood glucose can improve outcomes in patients receiving TPN.     

Hyperglycemia and type 2 diabetes among Filipino women in the Philippines, Hawaii, and San Diego

BACKGROUND: Diabetes risk increases as immigrant populations adopt western lifestyles. We compared the prevalence of fasting hyperglycemia among Filipino women aged 40-79 years in the Philippines, Hawaii, and San Diego. METHODS: Data were obtained from the (1) Philippine National Nutrition Survey (1998), (2) Native Hawaiian Health Research Project (1997-2001), and (3) University of California San Diego Filipino Women's Health Study (1995-1999). Fasting glucose after an 8h fast, blood pressure, and body mass index (BMI) were measured in all three regions; a 75 g oral glucose tolerance test was performed in San Diego and Hawaii. RESULTS: The proportion of Filipinas with BMI > or = 30 kg/m2 was higher in Hawaii (20%) compared to women in San Diego (9.3%) or the Philippines (5.2%, p<0.001). Fasting hyperglycemia prevalence (fasting plasma glucose > or = 126 mg/dl or fasting whole blood glucose > or = 110 mg/dl) did not differ among Filipinas in the Philippines (11.8%), San Diego (14.1%), and Hawaii (14.7%, p = 0.323). Type 2 diabetes prevalence was similar among Filipinas in San Diego (31.6%) and Hawaii (24.9%, p = 0.79). CONCLUSIONS: Despite regional differences in obesity, fasting hyperglycemia was similar among Filipinas in the Philippines, San Diego, and Hawaii and type 2 diabetes prevalence was similar among Filipinas in San Diego and Hawaii.     

住院期间血糖升高对急性冠状动脉综合征患者近期预后的影响

目的:观察住院期间血糖升高对急性冠状动脉综合征(ACS)患者近期预后的影响。方法:对786例ACS患者入院4d内进行空腹血糖测定。根据空腹血糖,把患者分为糖尿病血糖异常组(空腹血糖>6·67mmol/L)、非糖尿病血糖异常组、血糖正常组(空腹血糖≤6·67mmol/L)。结果:496例(63·1%)ACS患者空腹血糖>6·67mmol/L,其中确诊糖尿病患者218例(27·7%),血糖升高组多为高龄女性,住院期间心肌缺血事件发生率及病死率明显高于血糖正常组(P<0·05)。结论:住院期间血糖升高是影响ACS患者预后的一个重要的危险因素,对血糖升高的患者应给予积极的治疗。