贵州省社区人群高脂血症患病情况及其影响因素研究

目的 了解贵州省社区人群高脂血症患病情况及其影响因素,为下一步防治措施提供依据.方法 在社区慢性病防治示范点对15岁以上人群随机抽样1 817人进行问卷调查及血脂检查.结果 社区人群高脂血症患病率高达24.21%,与血脂升高有关的危险因素主要是超重肥胖、高脂饮食.结论 贵州省的高脂血症防治工作亟待加强,以减少因血脂升高导致的冠心病等慢性疾病.     

广州社区慢性阻塞性肺疾病认知行为调查研究

目的了解社区人群对慢性阻塞性肺疾病(COPD)的认知行为情况,为制定COPD干预措施提供依据。方法采取多级抽样的策略,在广州荔湾区简单随机抽取2个街道,在每个街道再简单随机抽取2个社区,在每个社区再采用简单随机方法,抽取700例40岁及以上居民,进行COPD认知行为的横断面调查。入选的人群采用经过信度和效度检验的自制的认知行为问卷调查进行调查。结果抽查的700人中,630例(90.0%)完成认知行为调查问卷,只有46.3%(292/630)人听说过COPD,42.2%(266/630)不知晓慢性支气管炎和肺气肿的危险因素。人群吸烟率为40%(252/630),男性吸烟率为75.5%(209/277),女性吸烟率为12.2%(43/353);其中现吸烟率为26.3%(166/630),仅35.0%(59/166)的现吸烟者准备戒烟。46.0%(290/630)人长期有被动吸烟史。人群中仍有22.4%(141/630)不知道吸烟的危害,14.8%(93/630)的人觉得可以在公共场所吸烟。结论广大民众COPD防治知识贫乏,防治意识差,需要加强COPD宣传教育和防治。     

人群社区慢病相关知识知晓率及行为危险因素的分析

目的了解本社区人群慢病相关知识的知晓率及行为危险因素的分布情况。方法采用多层随机抽样的方法,对昆山市陆家镇邵村社区常驻居民进行问卷调查。结果被调查者对自身身高、体质量、腰围、血压和血糖的知晓率分别为98.0%、98.0%、80.0%、81.0%和66.0%;认为吸烟重度有害的比例在72.0%以上;认为高血压患者和冠心病患者不宜饮酒者,分别占68.0%和35.5%;冠心病和脑卒中的知晓率较低,仅62.0%和58.5%;糖尿病典型症状的知晓率为80.5%,而对肥胖者易患糖尿病、父母患糖尿病则子女易患糖尿病的知晓率仅76.0%和67.5%;吸烟率和过量饮酒率达到37.5%和5.0%,高盐饮食者占16.5%,规律锻炼者仅占16.0%,超重和肥胖的患者分别占33.5%和6.0%。结论社区应加大对吸烟的干预,提示相关部门应加大高血压和糖尿病的相关知识教育,加大肥胖相关知识的宣传。     

东莞市南城街道居民健康素养及烟草流行监测调查

目的:调查东莞市南城街道居民健康素养及烟草流行情况。方法:选取东莞市南城街道范围内621人,进行健康素养及烟草流行情况调查,统计621人健康素养总体水平及烟草流行情况调查结果。结果:2019年南城街道居民健康素养总体水平为25.40%,健康知识和理念素养、健康生活方式与行为素养、基本技能素养分别为50.4%、27.2%、39.0%,科学健康观素养、传染病防治素养、慢性病防治素养、安全与急救素养、基本医疗素养、健康信息素养分别为57.8%、26.2%、37.8%、68.2%、31.9%、47.0%,不同调查人群的差异存在统计学意义(P<0.05);南城街道居民的吸烟率为9.9%,不同人群吸烟差异有统计学意义(P<0.05)。结论:东莞市南城街道居民健康素养总体水平和吸烟情况差别较大,今后工作时应重点关注。     

太原市迎泽区艾滋病性病流行病学调查分析

本研究拟选取太原市迎泽区高危人群（如服务小姐、长途卡车司机）、脆弱人群（如大学生）和一般人群（社区居民、居委会干部）三类不同人群进行性病、艾滋病防治知识的问卷调查,并进行不同方式的干预,以观察这些人群性病、艾滋病防治知识和相关行为的变化,为了解本区范围内性病、艾滋病的发病情况,探索性病、艾滋病有效防治对策,提高各类人群的性病、艾滋病防治知识,营造社会关心、理解和帮助性病、艾滋病患者的良好氛围提供重要依据.     

某县农村老年人高血压影响因素的Logistic回归分析

目的了解贵州省农村老年人高血压患病特点,探讨其危险因素,为农村高血压的综合防治与管理提供依据。方法对平塘县593名农村老年人进行慢性病患病危险因素分层随机抽样调查。结果老年人高血压患病率为24.96%,男女间差别无显著性(χ2=1.852,P=0.186);单因素非条件Logistic回归分析显示,体质指数、吸烟、和烹调用油的种类、职业、劳动强度、文化程度对高血压的影响均具有统计学意义(P<0.05)。经多因素非条件Logistic回归分析,高血压的主要危险因素为膳食食盐行为、烹调用油行为、生活中思想紧张状态及BMI。结论贵州省某县农村老年人高血压患病率为24.96%,高于我国一般人群患病率。应针对高血压危险因素开展健康教育,实施以农村社区为基础的高血压综合防治措施。     

干预机制在结核病健康教育中的效果

目的 了解农村人群中结核病防治知识知晓率和行为形成率的情况,为有效地开展结核病健康促进工作提供依据.方法 对确诊的230名结核病患者经过1年半的健康教育.通过比较干预前后患者对结核病知识知晓率和相关行为形成率,评价健康教育的效果.结果 干预后患者结核病防治知识知晓率和相关行为形成率均有明显提高（P＜0.01）,知识总知晓率和相关行为总形成率,分别由干预前的37.86%、37.52%,上升到干预后的82.45%、80.30%.结论 农村人口文化程度较低、经济条件较差,结核病防治知识知晓率和相关行为形成率处于较低水平,应结合实际情况开展居民结核病防治知识健康教育,促进其形成健康行为.     

某社区在管理的糖尿病患者的相关知信行调查

目的了解社区在管理的糖尿病患者的相关知信行情况。方法随机整群抽取康健社区已管理的糖尿病患者151人，进行糖尿病知晓情况、疾病的相关态度行为以及需求的问卷调查。结果对于糖尿病相关的防治知识、并发症有较高的认知，而对于该凋查人群对糖尿病的重视程度、规范治疗的知晓率、依从性及自我管理能力差。结论此调查提示目前社区糖尿病的慢性病管理有一定的促进作用，但需逐渐改变以往的“重治轻防”观念，培养一支高素质的糖尿病防治专业队伍，探索更行为有效的糖尿病社区管理模式。     

社区药学服务对高血压患者认知行为的影响的调查分析

目的:评价社区药学服务对高血压患者认知行为的影响,为更好地控制高血压提供参考。方法:对江苏省东台市长青社区的高血压患者进行问卷调查,比较开展社区药学服务前后受访者高血压相关知识、行为方式和血压控制率的情况。结果:最终选取321名高血压患者为研究对象。开展社区药学服务后,受访者对高血压防治知识的正确认知率从59.6%上升到87.2%,行为正确率从58.9%上升到80.8%,血压控制率从29.3%上升到48.6%,与开展药学服务前比较差异均有统计学意义(P<0.01)。结论:开展社区药学服务有助于提高高血压患者相关知识的认知率,改善其行为方式,是控制高血压的有效途径之一。     

社区老年人群原发性高血压调查及干预措施

目的:调查社区老年人群原发性高血压的患病率、影响因素及防治措施。方法:随机选择大同市恒安新区泰昌社区常住的220位老人,年龄不小于65岁,采用心血管疾病流行病学调查研究方法和标准,对所选老人进行调查。结果:确认原发性高血压患者共124例,总患病率为56.36%,高血压的患病率与年龄大小、性别、吸烟、饮酒等都有一定的相关性。结论:对社区居民进行高血压方面相关知识的健康教育和用药指导,有利于疾病的防治和控制。     

城乡结合部高血压病患者血压控制率影响因素研究

目的 了解河北省唐山市城乡结合部高血压病患者血压控制率及其影响因素.方法 通过调查问卷了解高血压病患者的一般情况、疾病特征、生活方式、高血压知识掌握情况及血压控制率.结果 高中/中专、大专及以上文化程度组血压控制率分别为39.1%(9/23)、40.9%(29/71),高于初中、小学以下文化程度组的21.9%(25/114)、9.5%(12/126);1级高血压组血压控制率为32.9%(54/164),高于2级和3级高血压组14.6%(20/137)、3.0%(1/33);体重正常的调查对象血压控制率为37.8%(59/156),高于超重和肥胖者10.4%(15/144)、2.9%(1/34),差异均有统计学意义(均P＜0.01).吸烟者血压控制率低于不吸烟者;高血压知识掌握程度高者血压控制率明显高于中、低2组;无心血管合并症者血压控制率高于有心血管合并症者,差异亦均有统计学意义(P＜0.01).结论 文化程度低、初始治疗高血压分级较高、吸烟、心血管合并症、超重、肥胖和高血压知识较差均会降低高血压病患者的血压控制率.建立和完善社区慢性非传染病管理系统,加强人群健康教育,改变高血压病患者不良生活方式,有利于提高其血压控制率.

Abstract：

Objective To investigate the rate and the relative influencing factors of blood pressure control in Tangshan rural-urban area. Methods General conditions, disease characteristics, life style and the knowledge of hypertension were investigated by questionnaires. Results The control rate was affected by education level (40.9% in college culture degree, 39.1% in high school, 21.9% in middle school, 9.5% in primary school, P ＜0.01 ). The hypertension control rate in patients with hypertension degree 1 was 32.93%, which was higher than that in patients with hypertension degree 2 & 3. Furthermore, the control rate was also affected by overweight,smoking, knowledge and the cardiovascular omplication. Conclusions The influencing factors of hypertension are education, blood pressure value, smoking, cardiovascular complication, overweight and obesity. Enhance the chronic disease management system in community, promote education and improve the life style can improve the rate of blood pressure control.     

Smoking and attitudes toward smoking policy at a University in Egypt

To assess smoking behavior, knowledge of smoking harm, and attitudes toward campus smoking policy at an Egyptian university, an online survey of students, staff, and faculty was conducted (N = 992). The smoking prevalence of 38% among men was in line with Egypt’s national average, but the smoking prevalence among women of 20% was much higher than the national average. Smoking status influenced beliefs about smoking harm and attitudes toward smoking policy, with nonsmokers having stronger beliefs about the harm of smoking and showing stronger support for smoking regulations than smokers. Smokers were more knowledgeable about smoking policy than were nonsmokers and differed slightly in their preferences for smoking policy enforcement strategies. These findings contribute to our understanding of how to tailor college smoking policy and programs to an Egyptian context.     

吸烟对终末期肾病患者全段甲状旁腺激素与左心室重塑的影响

目的研究并分析吸烟对终末期肾病患者全段甲状旁腺激素（ierH）水平的影响以及与左心室重塑的关系。方法根据吸烟情况将139例慢性肾小球肾炎终末期肾病非透析患者分组,测定各组的iPTH及其他临床化验指标,并计算各组左心室质量指数（LVMI）。分析吸烟对ipTH的影响以及与LVMI的相关性。结果吸烟组iPTH高于不吸烟组,重度吸烟组iPTH高于轻度吸烟组,吸烟与iPTH独立正相关,且iPTH随着吸烟量增加而升高,呈剂量依赖关系;有左心室肥厚组iPTH高于无左心室肥厚组,iPTH与LVMI独立正相关。结论血iPTH指标的提升是终末期肾病吸烟患者高发左心室肥厚症状的关键因素,值得临床重视。     

Smoking relapse situations among a community-recruited sample of Spanish daily smokers

IntroductionRelapse is a common factor within the behavior change process. However, there is scarce and limited knowledge of smoking relapse situations in population-based samples. The aim of this study was to identify smoking relapse situations among a sample of Spanish relapsers from the general population.MethodsA sample of 775 relapsers was recruited among the general population using a snowball method. Participants completed a survey including sociodemographic, smoking-related and psychopathology variables. Smoking relapse situations were identified through specific questions assessing different aspects related to the last relapse episode.ResultsThe majority of smoking relapse situations were attributed to positive affect (36.6%) and negative affect (34.3%), followed by lack of control (10.1%), smoking habit (6.7%), craving or nicotine withdrawal (6.3%), and social pressure (5.9%). Being unemployed and having a mental disorder in the past increased the likelihood of relapse in situations of negative affect. Being single and having quit smoking to save money were associated with an increased likelihood of relapse in situations of positive affect.ConclusionsAffect plays a significant role in smoking relapse among a community sample of unassisted Spanish smokers. Relapse may be much more of an affective and situational process than a habit, physiological or social pressure. Findings from this study may help develop tailored community smoking relapse prevention strategies or programs.     

Galantamine reduces smoking in alcohol-dependent patients: a randomized, placebo-controlled trial

INTRODUCTION: The high morbidity and mortality caused by smoking highlights the importance of investigating new strategies for smoking cessation or reduction. Galantamine is an acetylcholinesterase inhibitor that increases the effect of acetylcholine (ACh). The nicotinic ACh receptor is activated via positive allosteric modulation (APL). METHODS: We investigated whether galantamine reduces smoking by performing a 24-week randomized, placebo-controlled, multicentric clinical trial in recently detoxified alcohol-dependent patients. We included all study subjects irrespective of an intention or motivation to abstain from nicotine. Specific treatment for cessation or reduction of smoking was not provided. Smoking behavior was assessed by means of patients' diaries. The nicotine metabolite cotinine was measured to verify the number of smoked cigarettes as documented in the patient's diary. RESULTS: 114 randomized smokers received galantamine (n = 56) or placebo (n = 58) for 12 weeks. Follow-up examinations were terminated after an additional 12 weeks without treatment. Smoking behavior did not differ between both groups at baseline. After treatment, the intention-to-treat analysis revealed significant differences with a 20% lower cumulative number of smoked cigarettes and a 15% lower number of smoking days in the galantamine group compared to placebo. The average number of smoked cigarettes per smoking day as well as the cotinine values decreased about 10%. Cotinine values showed a positive correlation with the number of documented cigarettes, validating the patients' diaries. CONCLUSION: Our tentative data indicate that galantamine reduces smoking behavior even without any additional specific intervention. We suggest introducing the term "substitution therapy" into the treatment of smoking. This result could open up a new treatment approach for groups of patients which usually have a low motivation for change.     

Use of sustained-release bupropion in specific patient populations for smoking cessation

Smoking cessation trials of sustained-release bupropion (bupropion SR) were initially conducted in a general population of smokers who were motivated to quit smoking. Bupropion SR has also been found to be a useful treatment of tobacco dependence in various special populations of smokers who often experience difficulty in overcoming tobacco addiction. Point-prevalence quit rates at 6 months were higher in those treated with bupropion SR than in those receiving placebo in studies on smokers with chronic obstructive pulmonary disease (23% vs 16%) and in those with cardiovascular disease (34% vs 12%). Abstinence from smoking after treatment with bupropion SR was not affected by a history of major depression or alcoholism. Women treated with bupropion SR were just as likely as men to abstain from smoking. Approximately one-third of a study population who were initially unwilling or unable to quit smoking were able to reduce their smoking by 50% or more during therapy with bupropion SR; 14% of these went on to achieve abstinence. Bupropion SR was well tolerated in these trials; importantly, it had no clinically significant effect on mean blood pressure in smokers, including those with hypertension, and attenuated the weight gain associated with smoking cessation, particularly in women.     

Youth crowds and cigarette smoking: A prospective study

This study examined the prospective relationship between crowd affiliation and smoking behavior among a national sample of 16–22 year old Danes (N = 952). Self-reported data were collected by means of a postal questionnaire at baseline and at 18 months follow-up. The sample included participants, who at baseline reported to identify with a crowd with either a low-smoking norm (n = 705) or a high-smoking norm (n = 247). The results showed that participants, who at baseline identified with a crowd with a high-smoking norm were compared to those, who identified with a low-smoking norm crowd, more likely to have started smoking at time of the follow-up (OR = 2.15). Further, discordance between one's behavior and the norm of the crowd resulted more often in a change in smoking behavior (OR = 2.00) and crowd identification (OR = 2.15) than the absence of such discordance. The results confirm the importance of crowds in smoking initiation and call for more attention to this issue in smoking prevention.     

中国男性精神分裂症患者吸烟、精神病理学、认知功能和治疗相关不良反应的病例对照研究(英文)

目的:美洲和欧洲的精神分裂症患者的吸烟率是社区人群对照的3至4倍,与阴性症状和锥体外系综合征的减少及认知功能的改善有关。本研究的目的是在中国精神分裂症患者中观察这些因素的临床关联性。方法:采用尼古丁依赖自评量表(Fagerstrom Test for Nicotine Dependence,FTND)和重复性成套神经心理状态测验(Repeatable Battery for the Assessment of Neuropsychological Status,RBANS),我们对776例男性和560例男性社区对照进行了比较。患者也测评了阳性和阴性症状量表(Positive and Negative Symptom Scale,PANSS)、Simpson -Angus锥体外系副反应评定量表(Simpson and Angus Extrapyramidal Symptom Rating Scale,SAES)和不自主运动量表(Abnormal Involuntary Movement Scale,AIMS)。结果:精神分裂症患者终生吸烟率较社区对照人群高(79%比63%),同时严重吸烟者与对照组之间有更明显的差异(61%比31%)。现在吸烟者的PANSS阴性症状和SAES帕金森综合征得分均低于非吸烟者。吸烟的精神分裂症患者在RBANS认知功能测试中表现最差,非吸烟精神分裂症患者较差,之后是吸烟者,非吸烟者对照表现最好。结论:中国精神分裂症患者的吸烟率高于社区对照人群,但精神分裂症患者和对照组之间尼古丁依赖率与美洲观察到的情况有很大的差异。吸烟与较低水平的阴性症状,较少的锥体外系综合征及较少的帕金森综合征相关联,提示自我治疗的存在。但是,吸烟在精神分裂症患者和对照组人群中都与显著的认知功能损害相关联。     

The association between inflammation markers,coronary artery disease and smoking

Inflammation and smoking are associated with risk of cardiovascular disease, but not much is known yet about their relationship. We studied in 15 smoking and 15 nonsmoking patients with coronary artery disease (CAD) and in 15 smoking and 15 nonsmoking healthy subjects the relationships with the inflammatory markers C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha). IL-6 and TNF-alpha were significantly higher in patients than in controls, both in smokers and in nonsmokers. Smoking only had a significant effect on IL-6, and mainly in the controls. In conclusion, inflammation is affected by both smoking and cardiovascular disease.     

戒烟药物的心血管不良反应

戒烟可降低心血管疾病发生和死亡风险,是心血管疾病二级预防的重要内容。吸烟是一种慢性成瘾性疾病,戒烟过程中常因戒断症状导致复吸,在戒烟过程中需要心理支持治疗和戒烟药物辅助治疗。许多随机对照临床试验证实,戒烟心理辅导有助于患有心血管疾病吸烟者的戒烟。但很少有临床试验证实戒烟药物在心血管疾病患者应用的安全性及有效性。由于尼古丁替代治疗,以及缓释安非他酮和伐尼克兰均可引起交感神经兴奋,理论上增加心肌作功,提高心肌耗氧量;其中尼古丁替代治疗还可能引起内皮功能障碍,使冠状动脉收缩,心肌供氧量减少,因此,越来越多的研究者开始关注合并心血管疾病吸烟者中戒烟药物应用的安全性。