上海地区某院体检人群血脂异常分析

目的研究上海地区某20岁及以上体检人群血脂异常的特点,为血脂异常防治工作提供依据。方法以2014年在某疗养院接受常规体检的9997人为研究对象,测定血脂指标包括血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,分析上海市体检人群血脂异常的人群特征。结果上海地区某体检人群9997名研究对象中,总血脂异常37.79%,男性血脂异常47.09%、女性血脂异常21.36%。低HDL-C22.72%;高TC、高TG、高LDL-C分别为10.09%、5.98%和9.18%。40岁以上中老年人是血脂异常的高发人群。结论上海市体检人群血脂异常的患病率较高。血脂异常防治的重点是中老年男性和老年女性群体。     

北京14372例企事业单位人员血脂异常分析

目的研究北京市部分企事业单位人群血脂异常分布及其影响因素,为血脂异常防治工作提供依据。方法以2012年在北京同仁医院接受常规体检的14 372人为研究对象,按照不同年龄段分为6组,分别测定身高、体重及空腹血脂指标,血脂指标包括血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。结果北京部分企事业单位人群总血脂异常率为30.75%,男性为44.75%,女性为18.66%。男性、高血压、糖耐量异常、肥胖者更易于患有血脂异常,随年龄增长患病风险升高血脂异常率增高。结论该体检人群血脂异常的患病率较高,且与年龄、性别有关,提示30岁以后应每年进行健康体检。     

137名中老年旅行者血脂水平调查分析

目的了解中老年旅行者的血脂水平,为有关疾病的早期预防提供科学依据.方法于2004年分别对137名55-80岁的中老年旅行者进行血清血脂四项(总胆固醇、甘油三酯、高密度脂蛋白胆固醇及低密度脂蛋白胆固醇)检测.结果血脂异常总检出率为58.3%;男、女性总胆固醇升高检出率分别为6.6%和11.6%,女性高于男性;甘油三酯升高检出率分别为21.6%和10.3%,男性高于女性;低密度脂蛋白胆固醇升高检出率分别为51.6%和64.9%,女性高于男性.结论通过保健体检对血脂水平异常的中老年旅行者尤其是更年期妇女给予正确的防治知识,有利于预防或减少心血管疾病的发生,提高中老年旅行者晚年的生活质量.     

北京市3175名在职机关人员血脂水平调查

目的 了解北京市在职机关人员血脂水平及异常情况,为该人群的健康保健提供参考.方法 以北京市3175例在职机关人员为对象,对其总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)进行检测分析.结果 血脂异常检出率为55.4％,男、女性分别为62.6％和45.2％.TC、LDL-C、TG水平及异常检出率在不同性别间随年龄增长而升高,男性TG水平在50岁后和女性TC水平在60岁后均有所下降.高TC和高TG检出率在50岁前各年龄组中男性高于女性,50岁后女性高于男性;高LDL-C和低HDL-C检出率各年龄组男性均高于女性.结论 中青年男性和更年期后女性血脂异常检出率较高,男性高LDL-C年轻化对血脂的影响尤为重要,须尽早建立以合理的饮食和生活方式为基础的干预措施.     

温州地区部分人群非高密度脂蛋白胆固醇和血致动脉硬化指数水平分析

目的:分析温州地区部分人群非高密度脂蛋白胆固醇(non-HDL-C)和血致动脉硬化指数(AIP)水平情况,为防治血脂异常提供依据.方法:收集2004年1月～2006年12月在我院体检30448例人员资料,并测定甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),计算出non-HDL-C、AIP;并按性别及不同年龄段、LDL-C不同水平进行分组,将各组进行比较分析.结果:男性non-HDL-C、AIP水平明显高于女性.并随年龄增高而逐渐升高;男性在41岁～60岁时non-HDL-C、AIP水平呈最高,而后呈下降趋势;女性在老年组时non-HDL-C、AlP水平呈最高;AIP与TG、non-HDL-C、LDL-C成正相关,non-HDL-C与TG、TC、LDL-C、AIP成正相关,两者与HDL-C均成负相关.结论:温州地区该部分人群non-HDL-C、AIP水平男性明显高于女性,并随着年龄增高而均呈升高趋势,故应引起关注.     

广州市部分电信企业职工血脂水平调查

目的：分析广州市电信企业部分职工的血脂水平分类及分型特征，为临床血脂研究与心血管病诊治提供参考。方法：收集2004年广州市电信企业职工血脂调查资料。按我国“血脂异常防治建议”并参考美国“APTⅢ指南”作血脂水平分类及分型研究。结果：该人群中男性40岁以上年龄组中总胆固醇（TC）及甘油三酯（TG）都在合适水平者不足30％，胆固醇≥6．2mmol／L者超过20％。女性50岁以上年龄组中总胆固醇（TC）及甘油三酯都在合适水平者不足31％，胆固醇≥6．2mmol／L者超过30％。女性50岁以上高TC者比男性50岁以上明显增多。该人群同一年龄组中高TC者明显多于高TG者，男性及女性Ⅱa型高脂蛋白血症比Ⅳ型分别多2和6倍。男性中有15．10％，女性有2.88％高密度脂蛋白胆固醇（HDL-C）水平降低；女性有42．49％，男性有18．67％HDL-C水平增高。结论：该人群血脂异常者检出率较高。提示该人群发生高血压、动脉粥样硬化、冠心病的危险性较大。     

某高校教职工血脂异常检测结果分析

目的 了解高校教职工血脂异常的发生情况，为制定有效的防控策略提供依据。方法 对617例教职工体检结果进行统计分析。结果 体检人群血脂异常总检出率为19.77%,高胆固醇血症检出率为4.38%,高甘油三酯血症检出率为13.61%,混合型高脂血症检出率为2.43%,低HDL-C血症检出率为5.51%。血脂水平处于边缘升高状态的人群数量明显高于血脂升高人数。男性、BMI≥24 kg/m²、吸烟、饮酒、空腹血糖升高以及血压升高者血脂异常检出率显著升高，差异具有统计学意义(P<0.05)。血脂异常检出率随年龄增加呈逐渐上升趋势(P=0.001)。结论 该高校教职工血脂异常率低于全国平均水平。男性、年龄增长、超重或肥胖、吸烟饮酒和空腹血糖升高、血压升高仍然以较高比例与血脂异常合并出现，代谢性疾病应系统、全面、综合防治。血脂水平处于边缘升高状态的人群数量明显高于血脂升高人数，应增加对此类人群的关注，采取非药物治疗方法预防血脂异常的发生发展。     

广州地区军队离退休干部血脂状况与相关疾病谱分析

目的探讨广州地区军队离退休干部血脂状况特点及其与老年心脑血管疾病的关系.方法对2107例离退休干部体检血脂结果进行分析.结果血脂异常总检出率为75.1%,依次为混合性血脂异常、高胆固醇(TC)血症、高甘油三酯(TG)血症,检出率分别为30.4%、20.8%和13.0%;80岁以上组TC、TG值比60-组和70-组明显减低(P均＜0.01).老年女性TC、TG异常总检出率均高于老年男性(P均＜0.01);血脂异常者伴有的疾病依次为高血压病、冠心病、糖尿病和中风,患病率分别为32.7%、20.1%、19.5%和13.7%.结论广州地区离退休干部血脂异常检出率较高,提示该人群发生动脉粥样硬化的危险性增加,应重视血脂的检测以及对血脂异常的干预.     

贵州省5市(县)18岁及以上人群血脂异常流行特点

目的:研究贵州省城乡不同地区成年居民血脂异常及高胆固醇血症、高甘油三酯血症、低高密度脂蛋白血症流行特点,为制定心血管疾病防控措施提供科学依据。方法:对3322名18岁以上调查对象空腹血浆采用酶法进行胆固醇、甘油三酯、高密度脂蛋白检测;血脂异常患病率采用《中国成人血脂异常防治指南(2007年版)》推荐的标准判定。结果:贵州省5市(县)18岁及以上居民血脂异常患病率33.50%,男性39.59%、女性28.73%,男性高于女性,差异有统计学意义(P0.05)。城市血脂异常患病率为45.71%,农村为24.37%,城市高于农村,差异有统计学意义(P0.05)。贵州省5市(县)18岁及以上人群高胆固醇血症患病率为4.94%,胆固醇边缘升高患病率为18.51%。高甘油三酯血症患病率为16.32%。低高密度脂蛋白胆固醇血症患病率为21.52%。结论:贵州省5市(县)18岁及以上人群血脂异常患病率较高。男性居民、城市居民人群是重点预防人群。     

鄞县农村社区中老年居民血脂水平分析

目的 了解农村社区中老年居民的血脂水平。方法 用常规法测定总胆固醇，甘油三酯水平。结果 高血脂症总检出率45．5％，50岁以上女性血脂水平高脂血症检出率均高于同年龄男性。结论 该社区人群血脂异常情况已十分严重，应引起重视和采取防治措施。     

浙江省社区高血压综合防治研究

目的 通过以社区为基础对一般人群、高危人群和高血压现患人群进行5年的高血压及相关危险因素的综合干预，降低高血压和心血管急性事件的发生率和死亡率。探讨以社区为基础的高血压综合防治模式。方法 选择嘉兴、丽水、绍兴三地区分别代表农村、城镇社区、城市，每个地区均设有干预区和对照区。在干预区内对一般人群进行健康促进，对高危人群进行强化干预，对患病人群进行系统管理。结果 通过社区综合干预，(1)提高了人群高血压知识知晓率、服药率(44．65％)和血压控制率(11．78％)；(2)多种高血压危险因素得到进一步控制；(3)高血压患者收缩压下降2．69mmHg．舒张压下降了3．22mmHg；(4)心血管急性事件的发生率和死亡率逐年降低。结论 以社区为基础的高血压综合干预措施对减少人群的高血压危险因素水平，增加高血压患者的治疗率和血压控制率，降低心血管急性事件的发生率和死亡率不仅有效，而且是切实可行的。     

浙江丽水健康体检老年人群静脉血细胞参数参考范围调查

目的:建立丽水地区老年人静脉血细胞分析参数的参考范围。方法:随机抽取丽水地区18岁以上健康体检人数13734例,检测该人群血细胞参数,并分析其结果。结果:男性(>65岁)WBC、RBC和Hb浓度均低于男性(18岁～65岁);女性(>65岁)与女性(18岁～65岁)之间RBC、Hb差别有统计学意义;未分年龄组结果与操作规程相比较女性白细胞血小板稍低;与其它地域比较血小板测定差异明显。结论:丽水地区静脉血血细胞大部分参数存在性别与年龄的差别,并与不同地域静脉血细胞参数存在差别,应根据不同年龄组建立本地区的静脉血血细胞参考范围。     

Improving the cost-effectiveness of cardiovascular disease prevention in Australia: a modelling study

ABSTRACT: BACKGROUND: Cardiovascular disease is the leading cause of death worldwide. Like many countries, Australia is currently changing its guidelines for cardiovascular disease prevention from drug treatment for everyone with 'high blood pressure' or 'high cholesterol', to prevention based on a patient's absolute risk. In this research, we model cost-effectiveness of cardiovascular disease prevention with blood pressure and lipid drugs in Australia under three different scenarios: (1) the true current practice in Australia; (2) prevention as intended under the current guidelines; and (3) prevention according to proposed absolute risk levels. We consider the implications of changing to absolute risk-based cardiovascular disease prevention, for the health of the Australian people and for Government health sector expenditure over the long term. METHODS: We evaluate cost-effectiveness of statins, diuretics, ACE inhibitors, calcium channel blockers and beta-blockers, for Australian men and women, aged 35 to 84 years, who have never experienced a heart disease or stroke event. Epidemiological changes and health care costs are simulated by age and sex in a discrete time Markov model, to determine total impacts on population health and health sector costs over the lifetime, from which we derive cost-effectiveness ratios in 2008 Australian dollars per quality-adjusted life year. RESULTS: Cardiovascular disease prevention based on absolute risk is more cost-effective than prevention under the current guidelines based on single risk factor thresholds, and is more cost-effective than the current practice, which does not follow current clinical guidelines. Recommending blood pressure-lowering drugs to everyone with at least 5% absolute risk and statin drugs to everyone with at least 10% absolute risk, can achieve current levels of population health, while saving $5.4 billion for the Australian Government over the lifetime of the population. But savings could be as high as $7.1 billion if Australia could match the cheaper price of statin drugs in New Zealand. CONCLUSIONS: Changing to absolute risk-based cardiovascular disease prevention is highly recommended for reducing health sector spending, but the Australian Government must also consider measures to reduce the cost of statin drugs, over and above the legislated price cuts of November 2010.     

Dietary habits, lifestyle and cardiovascular risk factors in a clinically healthy Italian population: the 'Florence' diet is not Mediterranean

OBJECTIVE: To evaluate dietary habits and lifestyle of Italian subjects, to provide current data on adequacy of the nutritional guidelines and recommendations especially in relation to primary prevention of cardiovascular diseases and to assess the influence of dietary habits on lipid profile and homocysteine levels. DESIGN: Cross-sectional. SETTING: Population-based study. SUBJECTS: A sample of 520 clinically healthy subjects (211 males, 309 females) with a mean age of 46 y, living in Florence area, Italy. INTERVENTIONS: Dietary pattern was assessed by trained dietitians through a semiquantitative food questionnaire. Fasting blood samples were drawn for assessment of lipid profile, homocysteine and circulating vitamins. RESULTS: Contribution from total fats was over 30% in about 70% of subjects and intake of saturated fatty acids (SFA) was above the recommended values in at least 40% of the study population. Furthermore, almost the whole (99.6%) population reported low intake of polyunsaturated fatty acids (PUFA). High levels of total cholesterol were present in over 40% of the study population, whereas abnormal values of LDL-cholesterol were observed in about 30%. High levels of homocysteine were found in 11.7% of the study population. An extremely high percentage of subjects reported low intake of vitamins, especially with regard to folic acid (89%), vitamin B(6) (70.1%) and vitamin E (99.6%). In a multiple linear regression model, circulating levels of vitamin B(12) and folic acid, and intake of alcohol and vitamin C resulted in being independently associated with homocysteine plasma levels. CONCLUSIONS: In a typical Mediterranean country, general outlines of Mediterranean diet are not completely followed, especially concerning total fats, SFA, PUFA and vitamins' intake. SPONSORSHIP: Ministero della Salute (Italy) - 'Progetto per la Salute e la Prevenzione di Malattia' 2001-2003.     

丽水地区农村围绝经期妇女健康状况和保健需求研究

目的:了解丽水地区农村围绝经期妇女的健康现状和保健需求,为改善农村围绝经期妇女健康状况提供帮助,为建立农村围绝经期妇女保健服务模式提供依据。方法:采用多阶段随机组群抽样方法,选取丽水地区农村40～55岁的妇女540人为调查对象,使用统一问卷进行入户现场调查。结果:在540例接受调查的妇女中,月经正常或基本正常306例,月经紊乱119例,绝经115例,自然绝经平均年龄为(49.21±2.18)岁。围绝经期综合征发生率为78.1%,主要症状为骨关节肌肉痛380例,失眠355例,头痛316例,头晕心悸316例,烦躁不安281例,易激动292例。不同年龄组别之间的妇女生存质量状况比较差异均有统计学意义(P<0.01)。只有17.4%妇女了解围绝经期知识,围绝经期激素补充治疗(HT)率2.4%;仅有35.6%的围绝经期妇女1～2年内有过健康体检。结论:丽水地区农村妇女保健意识薄弱,围绝经期综合征发病率高。开展农村妇女围绝经期的全科医疗卫生保健服务,加强围绝经期综合征的综合防治,有利于提高农村妇女的健康水平和生存质量。     

Serum apolipoproteins in relation to intakes of fish in population of Arkhangelsk County

ABSTRACT: BACKGROUND: Diets rich in omega-3 fatty acids and low in saturated fat were found beneficially associated with blood lipids and cardio-vascular health. Lean reindeer meet and local cold water whitefish species high in omega-3 are among the main sources of nutrients in the rural area of the Nenets Autonomous Okrug (NAO) in Russia and are not normally consumed by the urban population from the same region. The aims of the study were firstly, to compare serum lipid profiles of residents of urban (Arkhangelsk city) and rural (NAO) regions of Arkhangelsk County, and secondly, to investigate the effects of fish consumption on the predictor of cardiovascular events apolipoprotein (Apo) B/ApoA-I ratio in these populations. METHODS: A cross-sectional study conducted in Arkhangelsk County, Russia. Sample size of 249 adults: 132 subjects from Arkhangelsk city, aged 21-70 and 117 subject (87% Ethnic Nenets) from NAO, aged 18-69. RESULTS: We observed more favorable lipid levels in NAO compared to Arkhangelsk participants. Age-adjusted geometric means of ApoB/ApoA-I ratio were 1.02 and 0.98 in men and women from Arkhangelsk; 0.84 and 0.91 in men and women from NAO respectively. Age and consumption of animal fat were positively associated with ApoB/ApoA-I ratio in women (pooled samples from Arkhangelsk and NAO). Body mass index and low levels of physical activity were positively associated with ApoB/ApoA-I ratio in men (pooled samples from Arkhangelsk and NAO). Reported oily fish consumption was not significantly correlated with ApoB/ApoA-I ratio. CONCLUSION: The population sample from rural NAO, consisting largely of the indigenous Arctic population Nenets with healthier dietary sources, had a relatively less atherogenic lipid profile compared to the urban Arkhangelsk group. Fish consumption had no effect on apolipoproteins profile.     

Cardiovascular risk factors for Surinamese in the Netherlands: a literature review

OBJECTIVE: To obtain an overview of the prevalence of cardiovascular risk factors in Surinamese (Hindustani and Creoles) individuals in the Netherlands and the implications of this for secondary prevention. DESIGN: Literature study. METHOD: A Medline literature search was carried out for the period 1985-2001 with the keywords 'cardiovascular risk factor' or 'cardiovascular risk factors', and 'Surinamese'. In addition to this, so-called grey literature was searched and the reference lists of articles found were also checked. A total of 7 studies were selected. RESULTS: Smoking is less frequent among Surinamese individuals in the Netherlands compared to the indigenous population, especially in women. The prevalence of both hypertension and diabetes is higher among the Surinamese. Data on dyslipidaemia are almost absent; it is only known that hypercholesterolaemia is less prevalent among the Surinamese. Ethnicity is not included in the risk cards used in the secondary treatment of cardiovascular diseases. CONCLUSION: The lack of research with respect to the cardiovascular risk profile of Surinamese (Hindustani and Creoles) in the Netherlands indicates an unfavourable profile compared to the indigenous Dutch population. This difference justifies further research into the differentiation of prevention and treatment according to ethnic origin.     

丽水市莲都区产前妇女TORCH感染情况调查

目的:探讨丽水市莲都区产前妇女TORCH感染的疫情动态,为本地区育龄妇女产前保健提供科学的参考依据。方法:采用流行病学回顾性调查分析方法,对丽水市莲都区过去3年的TORCH感染情况进行回顾性统计分析。结果:2009年-2011年共检测TORCH2839例,IgM类抗体总的阳性率为1.66%,其中CMV感染率最高,为0.92%,IgG类抗体中CMV-IgG的阳性率高达98.13%。结论:丽水市莲都区产前妇女TORCH主要以防治CMV感染为主,应积极进行检测做到早发现,早治疗,做好优生优育。     

2型糖尿病视网膜病变患者血脂谱分析

目的了解2型糖尿病视网膜病变患者血脂谱的变化及其与糖尿病视网膜病变(DR)发生的关系。方法选取2型糖尿病患者224例,分为无视网膜病变(NDR)组110例,DR组114例。进行血脂和糖化血红蛋白等生化指标的检测,分析两组患者间病程、糖化血红蛋白及各项血脂指标与视网膜病变的相关性。结果在各项血脂指标中,DR组载脂蛋白B(ApoB)、脂蛋白(a)[Lp(a)]高于NDR组,而载脂蛋白A(ApoA)/ApoB低于NDR组,两组差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析显示,DR的发生与Lp(a)水平(OR=1.30,95%CI:1.01～1.67),ApoA/ApoB(OR=0.54,95%CI:0.33～0.87)及病程(OR=1.73,95%CI=1.30～2.30)相关联。结论 Lp(a)及ApoA/ApoB等血脂异常可能是DR的危险因素之一,积极地纠正血脂紊乱有利于糖尿病视网膜病变的防治。     

溧水区成年男性HPV疫苗的认知和接种意愿影响因素研究

目的：了解南京市溧水区成年男性对HPV疫苗的认知情况及接种意愿影响因素,为HPV疫苗在男性人群中推广提供参考建议。方法：采用简单随机抽样对溧水区成年男性进行问卷调查。结果：65.7%的人听过HPV疫苗,48.61%(140/288)有接种意愿,感知障碍性、感知疾病严重性、认知得分对HPV疫苗接种意愿的差异有统计学意义。多因素回归分析显示感知障碍性、感知疾病严重性、学历、婚姻状态、是否有过生殖系统疾病、是否听说过HPV疫苗对接种影响非常显著。结论：溧水区成年男性对HPV疫苗的认知匮乏,接种意愿不高。建议将低文化水平、低家庭收入人群作为健康教育的重点人群,通过医院、社区、网络等多途径、多形式的宣传方式,提高认知水平,并且政府对疫苗价格进行调控或者纳入医保,减轻接种人群的负担,提高人群的接种率。