彝族、汉族居民高血压流行病学分析

目的了解四川省凉山州冕宁县彝族地区彝、汉族当地人群高血压的流行病学特征,为凉山彝族地区高血压防治干预提供科学依据。方法采用分层、整群、多阶段随机抽样方法对冕宁县10个乡镇1 388名汉族、677名彝族共计2 065名当地居民进行高血压患病率调查。结果彝族居民高血压患病率为14.62%,标化率为15.29%,血压水平收缩压(SBP)为(119.99±14.55)mm Hg,舒张压(DBP)为(74.06±8.49)mm Hg,汉族居民的患病率为14.19%,标化率15.60%,血压水平为SBP为(118.06±15.91)mm Hg,DBP(74.39±9.70)mm Hg;2个民族血压水平和高血压患病率差异均无统计学意义(P0.05);但同一民族不同性别间差异有统计学意义(P0.01)。随着年龄的增长,高血压患病率呈明显的增高趋势。高血压患病率还与教育程度和劳动强度密切相关。结论冕宁县彝族居民高血压患病率与汉族居民差异无统计学意义。     

贵州省汉族和布依族人群血压水平及危险因素研究

目的:探讨汉族和布依族人群血压水平及其危险因素的差异。方法:按整群随机抽样的方法选取3000名布依族和3000名汉族作为研究对象,比较两人群的血压水平及其危险因素的差异。结果:汉族收缩压为130.05±20.96 mm Hg,布依族收缩压为132.73±22.26 mm Hg,布依族高于汉族(t=4.79,P0.001);汉族舒张压为78.15±12.08 mm Hg,布依族舒张压为78.31±12.46 mm Hg,布依族与汉族差异无统计学意义(t=0.519,P=0.604)。性别、年龄、体重指数和腰臀比是收缩压和舒张压共同的危险因素。汉族的收缩压危险因素较布依族多了高甘油三酯血症,汉族的舒张压危险因素较布依族多了高胆固醇血症。结论:汉族与布依族血压影响因素相似,应不分民族区别对人群采取相应的干预措施。     

湖北省正常人群白喉免疫水平监测

用间接血凝法测定２２０８名不同地区，年龄人群的白喉抗体水平，结果表明喉抗体≥０．０１ＩＵ／ｍｌ阳性率为６７．５％，抗体ＧＭＴ为０．０３９８ＩＵ／ｍｌ。各年龄组具有≥０．０４ＩＵ／ｍｌ白喉抗体保护率在５６．６％－８５．７％之间，ＧＭＴ为０．０２９９－０．０７０２ＩＵ／ｍｌ。     

血压水平对脑血管血液动力学检测指标的影响

目的探讨不同血压水平对脑血管血流动力学指标（CVHI）的影响。方法在1994年开始建立的24475例卒中队列人群中，选择60-65岁的人群共2987例，分别按基线调查时的收缩压和舒张压水平分成8组，比较不同组间基线调查时检测的CVHI差异。结果脑血管平均血流速度（Vmean）、最大血流速度、最小血流速度随着收缩压和舒张压水平的升高而显著降低，Vmean减低最大幅度分别为4．62cm／s和5．74cm／s，脉搏波速、外周阻力（RV）、特异性阻抗、动态阻力、临界压水平以及舒张压与临界压的差值随着收缩压和舒张压水平的升高而显著升高，RV升高最大幅度分别为66．53kPa＊s／m和93．37kPa＊s／m。各组间CVHI的差别均有统计学意义（P〈0．01）。结论收缩压和舒张压对CVHI均有显著的影响，随着血压水平的增高，CVHI异常的程度呈现渐进加重的趋势。从脑血管的血液动力学角度，理想的血压水平应不超过130／90mmHg。     

高血压患者与血糖、血脂、脂蛋白、胰岛素关系的多因素分析

以某目标人群中筛选确诊的原发性高血压病例为研究对象,探讨血糖、血脂、脂蛋白、胰岛素与高血压关系。结果：在正常体重组,高血压患者有较高的空腹及餐后血糖水平,有较低的ａｐｏＡ,与血压正常者相比,差异显著;肥胖者中高血压者与正常血压者各生化指标水平均无显著性差异;体重正常者的收缩压（ＳＢＰ）、舒张压（ＤＢＰ）均与空腹血糖呈正相关关系,与ＩＳＩ呈负相关关系,ＳＢＰ与空腹及服糖后２ 小时血胰岛素呈显著正相关;经逐步回归分析,体重正常者的高血压与ＤＢＰ、ａｐｏＡ、服糖后２ 小时胰岛素水平有关,肥胖者的高血压与ＤＢＰ和年龄有关。结论：本研究提示血糖、血脂、脂蛋白、胰岛素与高血压间可能一定的关系。     

西部偏远地区彝汉两族高血压流行现状及影响因素分析

目的了解中国西部偏远地区彝汉两族人群高血压患病现状及其影响因素。方法 2005年7月对攀枝花市盐边县农村地区采用分层整群抽样的方法,选取20岁及以上彝汉两族居民各374例和686例进行高血压流行病学调查。结果单因素分析时,彝族人群的收缩压及舒张压均低于汉族,高血压患病率亦低于汉族,分别为27.0%和33.2%;调整年龄、性别后仍显示彝族高血压患病率低于汉族。两族人群的高血压亚型中仅收缩期合并舒张期高血压(SDH)患病率彝族低于汉族,正常血压、正常高值、单纯收缩期高血压(ISH)、单纯舒张期高血压(IDH)的百分比在两族间差异无统计学意义。多因素logistic回归分析显示,性别、年龄、婚姻状态、高密度脂蛋白胆固醇(HDL-C)等可能是高血压的独立影响因素,民族未进入最后的模型。结论彝汉两族高血压患病率均较高,彝族种群因素并不一定是高血压的保护性因素。     

云南五个民族儿童血铅及血清锌、铜、钙水平现状调查

目的：了解我省同一地域民族地区不同民族儿童微量元素铅（Pb）、锌（Zn）、铜（Cu）及宏量元素钙（Ca）水平现状，探讨其影响因素。方法：对云南省某哈尼族、傣族自治县五个不同民族（汉族、白族、傣族、彝族、哈尼族）3-7岁健康儿童共751人，应用美国PE-300型原子吸收光谱仪火焰吸收光谱法测定儿童全血Pb及血清Zn、Cu含量；日立7060生化分析仪测定儿童血清Ca含量，对所得结果进行各民族问血Pb及血清Zn、Cu、Ca比较，并对各民族儿童生活环境及习俗等问卷调查情况进行分析。结果：汉族、白族、傣族、彝族、哈尼族儿童血Pb及血清Zn、Cu水平均值分别为66—671μg／L、1．21—1．28μg／ml、2．40-2．48mmol／L，三种元素含量呈现较为集中趋势，各民族三种元素比较无统计学差异（P〉0．05）；汉族、白族、傣族、彝族、哈尼族血清Zn均值分别为0．77μg／ml、0．721μg/ml、0．85μg/ml、0．85μg/ml、0．84μg/ml，血清Zn含量白族、汉族低于傣族、彝族、哈尼族儿童，各民族儿童血清Zn比较，白族与傣族、彝族、哈尼族儿童存在统计学差异（P〈0．05=，白族与汉族无统计学差异（P〉0．05）。751例民族儿童中血铅含量超过100μg／L,者104名，儿童铅中毒率13．8％，低于昆明市城区儿童（24．9％）。五个民族儿童Zn、Cu、Ca总缺乏率分别为16．1％、3．5％、13．0％，其中白族儿童Zn、Ca缺乏率为27．1％、18．7％，其次为彝族Zn、Ca缺乏率均为17．0％、14．1％，高于其它民族儿童；傣族儿童Zn、Ca缺乏率为9．1％、8．0％，低于其它民族儿童，各民族儿童间元素缺乏状况不同。本次调查对象中未检出Zn、Cu、Ca过量儿童。结论：同一地域不同民族儿童血铅及血清必需微（宏）量元素水平存在差异，应重视民族儿童生活环境及习俗对微（宏）量元素的影响。     

口服避孕药与妇女高血脂和高血压的关系

对连续服用国产１号避孕片（ＯＣ）５￣２５年的健康农村妇女９９９名及同期使用宫内节育器（ＩＵＤ）妇女１０６５名的脂代谢和血压均值进行对比，对高血压和高血压患病率及危险性进行分析。结果：长期服用ＯＣ妇女ＴＧ、ＴＣ、ＨＤＬ水平和高甘油三脂症的患病率高于ＩＵＤ组（Ｐ〈０．０１），而高胆固醇症与对照组差异无显著性。ＯＣ组的收缩压和舒张压均值分别比ＩＵＤ组高６．５７和３．２４ｍｍＨｇ（１ｍｍＨｇ＝０．１３３３     

皮层下动脉硬化性脑病和维生素D水平的相关性研究

目的探讨皮质下动脉硬化性脑病(SAE)患者的血清维生素D水平及其与年龄、血糖、血脂、血压和胰岛素水平的关系。方法选择100例SAE患者和50例健康人群,采用酶联免疫吸附法测定两组患者血清25(OH)D水平以及血压、空腹血糖、血脂和胰岛素水平,并进行两组间的比较。结果与健康组相比,SAE组患者收缩压、舒张压、空腹血糖、总胆固醇、胰岛素水平显著升高,血清25(OH)D水平显著降低,差异具有统计学意义(p<0.05,p<0.01)。甘油三酯、脂蛋白差异无显著性(p>0.05)。SAE组患者血清25(OH)D水平与年龄、收缩压、舒张压和空腹血糖负相关(p<0.05,p<0.01)。与甘油三酯、脂蛋白、胆固醇和胰岛素水平无相关性(p>0.05)。结论皮质下动脉硬化病患者的血清25(OH)D水平降低,可能通过影响机体能量代谢参与皮质下动脉硬化性脑病的发生和发展。     

孕期补充维生素D对先天性佝偻病的防治作用

将妊娠２８周的受试 妇随机分为４组，分别１次性口服维生素Ｄ（ＶＤ）１０万ＩＵ或肌注ＶＤ１０万ＩＵ或２０万ＩＵ，对照组口服空白胶囊。结果３个补充组产妇血和脐血２５－（ＯＨ）Ｄ水平以及产妇血钙水平显著高于垦，而产妇血和脐血２５－（ＯＨ）Ｄ小于２７．３ｎｍｏｌ／Ｌ（１１ｎｇ／ｍｌ）的发生率以及孕后期腿抽筋的发生率显著低于对照组，补充组产妇血２５－（ＯＨ）Ｄ水平高于其妊娠２８周时的水平。补充组发现先天性佝     

Effect of migration on blood pressure: the Yi People Study

The Yi People Study was conducted in Puge County, Sichuan Province, People's Republic of China. Four population groups were surveyed for risk factors for cardiovascular disease. Included were two groups of Yi farmers living either in a high mountainous area in extremely remote villages at or above 2,750 meters elevation, or in a mountainside area at about 1,800 meters elevation. A third study group consisted of Yi farmers who migrated to the county seat during the 1950s. Local residents of the county seat, the Han people, constituted the fourth group. Blood pressure rises very little with age after puberty in Yi farmers, but there was a trend of increasing blood pressure with age in Yi migrants and Han. Mean body mass index (kg/m2) and heart rate were higher in Yi migrants than in Yi farmers. For men, both systolic and diastolic blood pressure were greater among Yi migrants than among Yi farmers. These differences persisted after adjusting for age and body mass index. Among women, after adjusting for age, BMI, and altitude, only diastolic blood pressure was lower among Yi farmers than Yi migrants. Yi migrants and Han had similar blood pressures. In 1986, a sample of men participated in more detailed studies of diet, serum, and urine. The proportion of energy from fat ranged from less than 10% among high-mountain Yi farmers to almost 40% among Yi migrants and Han. Compared with Yi farmers, Yi migrants consumed more sodium and less potassium, calcium, and magnesium, had lower serum potassium, and a greater sodium/potassium ratio. Urinary excretion of sodium, calcium, and the sodium/potassium ratio were all greater in Yi migrants than in Yi farmers, while the reverse was seen for potassium. These data suggest that changes in life-style, including dietary changes, contribute importantly to the higher blood pressure among Yi migrants.     

Migration, blood pressure pattern, and hypertension: the Yi Migrant Study.

Rural-urban migration provides an ideal opportunity to examine the effects of environment and genes on blood pressure. The effect of migration on the Yi people of China was studied. The Yi people live in a remote mountain area in southwestern China. In 1989, blood pressure was measured in 14,505 persons (8,241 Yi farmers, 2,575 urban Yi migrants, and 3,689 Han urban residents) aged 15-89 years. Different patterns were seen for men and women. Among the men, Yi farmers had the lowest mean blood pressure, the least rise in blood pressure with age (systolic blood pressure, 0.13 mmHg/year; diastolic blood pressure, 0.23 mmHg/year), and the lowest prevalence of hypertension (0.66%). In contrast, both Yi migrant men and Han men had higher levels of mean blood pressure, rise in blood pressure with age (Yi migrants: systolic pressure, 0.33 mmHg/year; diastolic pressure, 0.33 mmHg/year; Han: systolic pressure, 0.36 mmHg/year; diastolic pressure, 0.23 mmHg/year), and prevalence of hypertension (Yi migrants, 4.25%; Han, 4.91%). Among the women, however, mean systolic pressure was higher in Yi farmers than in Yi migrants or in Han. Diastolic pressure was similar among the three groups. However, the Yi farmer women's age-related rise in blood pressure (systolic pressure, 0.06 mmHg/year; diastolic pressure, 0.14 mmHg/year) and their prevalence of hypertension (0.33%) were lower than those in the other two groups. Yi migrant women had an intermediate rise in blood pressure with age (systolic pressure, 0.37 mmHg/year; diastolic pressure, 0.23 mmHg/year) and prevalence of hypertension (2.40%). Han women had the greatest rise in blood pressure with age (systolic pressure, 0.56 mmHg/year; diastolic pressure, 0.36 mmHg/year) and the highest prevalence of hypertension (4.76%). For both men and women, the above differences were only partially explained by age, body mass index, heart rate, smoking, and alcohol use. This study, using standardized methods, demonstrates an important effect of migration on rise in blood pressure with age and on the prevalence of hypertension.     

Effects of alcohol consumption and other lifestyle behaviors on blood pressure for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations.

Han is the largest group and Zhuang is the largest minority among the 56 ethnic groups in China. Geographically and linguistically, Zhuang can be classified into 43 ethnic subgroups, in which Hei Yi Zhuang is proved to be the most conservative subgroup. Little is known about the relationship between alcohol consumption and blood pressure levels in this population. Therefore, the present study was undertaken to compare the effects of alcohol consumption and other lifestyle behaviors on blood pressure levels for the middle-aged and elderly in the Guangxi Hei Yi Zhuang and Han populations. A total of 657 subjects of Hei Yi Zhuang aged 40 and older were surveyed by a stratified randomized cluster sampling. Information on demography, diet, and other lifestyle factors was collected by standard questionnaires. Anthropometric parameters and serum lipid levels were also obtained in all subjects. The results were compared with those in 520 participants of Han Chinese from the same region. The levels of systolic blood pressure and pulse pressure in Hei Yi Zhuang were higher than those in Han (P < .01-.001). Hypertension was positively correlated with sex (male), age, physical activity, alcohol consumption, serum triglyceride levels, and total energy, total fat, and salt intakes, and negatively associated with educational level in Hei Yi Zhuang (P < .05-.001), whereas positively correlated with sex (male), age, physical activity, alcohol consumption, body mass index, waist circumference, serum total cholesterol levels, and total energy, total fat, and salt intakes, and negatively associated with educational level in Han (P < .05-.001). The difference in blood pressure levels between the two ethnic groups might result from different dietary habit, lifestyle, sodium intake, educational level, physical activity, and even genetic factors.     

体质指数与糖尿病血脂、血糖及高血压相关关系研究

目的 探讨体质指数(BMI)与糖尿病(DM)代谢指标及高血压的关系。方法 对2001年1月～2002年6月齐鲁医院内分泌科住院的2型糖尿病患者415例进行回顾性调查，分析BMI与DM代谢指标(血脂、血糖、血尿酸)及高血压的相关性。结果：BMI与血甘油三酯(TG)、空腹胰岛素(Ins)、糖化血红蛋白(HbAlc)、载脂蛋白B(apoB)、胆固醇(Ch)、尿酸(UA)水平及血压[收缩压(SBP)、舒张压(DBP)]呈正相关，而与高密度脂蛋白(HDL)呈负相关；多元线性逐步回归分析显示，高水平的空腹血清Ins对DM患者BMI影响最大，其次是血TG、DBP、HbAlc、UA。结论 肥胖是DM患者血脂异常、高胰岛素血症、高血压、高尿酸血症的危险因素。     

郑州市新疆籍维吾尔族和汉族青少年脂肪细胞因子与不同代谢指标的相关性分析

目的 了解郑州市新疆籍维吾尔族和汉族青少年脂肪细胞因子和不同代谢指标状况及其两者间的关系,为促进青少年健康成长提供支持。方法 在郑州市新疆籍学生集中的5所学校全体1 464名新疆籍维吾尔族学生作为调查对象,同时在这五所小学各随机抽取1 582名汉族学生,对其进行体质健康指标、血液指标的测试,并对结果进行比较分析。结果 郑州市新疆籍维吾尔族小学生的BMI、腰围、收缩压、舒张压、三酰甘油、血糖、稳态胰岛素评价指数、瘦素、脂肪细胞脂肪酸结合蛋白等指标均显著高于汉族学生,差异有统计学意义(t＝9.213、3.726、16.604、3.126、8.561、5.496、7.439、9.154、4.017,P＜0.01);在高密度脂蛋白胆固醇、脂联素方面汉族高于维吾尔族学生,并且差异有统计学意义(t＝-13.137、-8.198,P＜0.01)。多元线性回归分析显示,学生脂联素与年龄、性别、民族、BMI、腰围、稳态胰岛素评价指数显著相关(P＜0.05)。学生瘦素与年龄、性别、民族、BMI、腰围、收缩压、舒张压、三酰甘油、高密度脂蛋白胆固醇、稳态胰岛素评价指数显著相关(P＜0.05)。学生脂肪细胞脂肪酸结合蛋白与民族、BMI、腰围、三酰甘油、稳态胰岛素评价指数显著相关(P＜0.05)。结论 郑州市新疆籍维吾尔族青少年与汉族学生的脂肪细胞因子、不同代谢指标的分布存在差异性,并且两者相关性存在不同,也存在民族差异性。     

Higher blood pressure among Inuit migrants in Denmark than among the Inuit in Greenland

STUDY OBJECTIVE: Previous studies of blood pressure among the Inuit have given inconsistent results and studies comparing Inuit migrants with those living in traditional Inuit areas are absent. The purpose of the study was to compare the blood pressure of the Inuit in Greenland with that of Inuit migrants in Denmark. DESIGN: Questionnaire, interview, and clinical examination in a cross sectional random population sample. SETTING: A population based survey among Inuit in Greenland and Inuit migrants in Denmark. Participants: 2046 Inuit aged >/or =18, 61% of the sample. MAIN RESULTS: Age and gender adjusted blood pressures were 117/72 mm Hg in Greenland and 127/81 mm Hg among the migrants (p<0.001). In both populations, blood pressure increased with age and body mass index, and was higher among men and non-smokers. In Greenland, blood pressure increased with the level of school education. The associations with Inuit heritage, alcohol, diet, and physical activity were not significant. The difference between the two populations persisted after adjusting for age, gender, body mass index, education, and smoking. Among those who had completed high school, there was no difference between the systolic blood pressure of the two populations while the difference for diastolic blood pressure was much less than for those with less education. CONCLUSIONS: Blood pressure was lower among the Inuit in Greenland than among the Inuit migrants in Denmark but the difference was absent (systolic pressure) or reduced (diastolic pressure) among the better educated. The results suggest that the blood pressure of the Inuit, especially Inuit men, may be responsive to factors related to the modern Western way of life.     

职业接触镉对工人胰岛素水平的影响

目的研究镉对职业暴露人群胰岛素和血糖水平的影响。方法以我国中南地区某冶炼厂98名镉作业工人为职业接触对象,同时选取该厂职工医院未接触镉的健康医生作为对照。按照研究对象镉接触工龄及血镉、尿镉分组,调查了不同接触工龄组及不同血镉、尿镉组工人血清胰岛素水平的变化,同时检测机体血锌、尿锌水平的改变,并就血镉、血锌及血胰岛素等水平之间的相关关系进行分析。结果接触工龄20-年组血糖水平[(4．9±0．6)mmol／L]明显高于对照组[(4．6±0．5) mmol／L],差异有统计学意义(P<0．01)。接触工龄10～年组血清胰岛素水平[(8．58±4．91)μIU/ml]明显低于对照组[(11．57±5．42)μIU/ml],差异有统计学意义(P<0．05);且随血镉、尿镉水平的增加,血清胰岛素水平明显降低。接触工龄20-年者尿锌水平明显增高。相关分析显示,胰岛素与血镉、尿镉呈明显的负相关关系,血糖与胰岛素、C肽水平之间呈正相关关系。结论职业接触镉可以导致血清胰岛素水平的降低,可能影响血糖水平。     

四川彝族人群原发性高血压移民流行病学调查

目的比较四川省凉山彝族农民与移民原发性高血压患病率水平及其影响因素。方法2007-2008年对四川凉山地区(包括西昌市、金阳县、昭觉县、布拖县、喜德县、德阳县、宁南县)彝族人群进行问卷调查及血样生化检测,对原发性高血压可能危险因素进行多因素非条件Logistic回归分析。结果彝族农民原发性高血压患病率为3.19%,其中男性为4.73%,女性为1.92%。彝族移民原发性高血压患病率为15.10%,其中男性为17.74%,女性为10.83%。彝族农民和移民血压正常高值分别为12.53%(男性为16.05%,女性为9.68%)和25.93%(男性为32.65%,女性为16.52%)。年龄和糖尿病是彝族农民原发性高血压危险因素。年龄、超重或肥胖是彝族移民原发性高血压危险因素,而血压尿酸异常是其保护因素。结论彝族农民移居城镇后,生活环境发生变化,原发性高血压患病风险增加。     

Sex differences in the coronary heart disease risk profile: a possible role for insulin. The Beaver County Study

The mortality rate from coronary heart disease is much higher among men than women except in diabetes mellitus, which appears to reduce this sex difference. It is hypothesized that the female advantage is due, at least partly, to the more efficient insulin mediated glucose homeostasis in females, an advantage lost in the diabetic state. The authors studied 170 young adult men and women aged 20-24 years from a population-based survey in Beaver County, Pennsylvania, in 1981-1982, in an attempt to further elucidate the sex-specific relationships between fasting serum insulin concentrations and several risk factors. Women who used oral contraceptives and subjects whose fasting serum glucose exceeded 110 mg/dl were excluded. Insulin was related to body mass index in both sexes (r = 0.31; p less than 0.01 for men; r = 0.26, p less than 0.01 for women) and to systolic blood pressure (r = 0.27, p less than 0.01 for men; r = 0.36, p less than 0.001 for women). Insulin was related to diastolic blood pressure in men only (r = 0.31, p less than 0.05). Multivariate analysis revealed fasting serum insulin to be an independent predictor of systolic blood pressure in both sexes and of diastolic blood pressure in men only. Insulin was inversely related to high density lipoprotein cholesterol only among men and this relationship appeared to be largely independent of body mass index and triglycerides. Results indicate that insulin concentration is associated with an adverse coronary heart disease risk factor profile especially among men, consistent with their excess risk of cardiovascular disease.