成人肥胖测量指标与高血压患病关系

目的探讨成人肥胖测量指标与高血压患病的关系。方法利用江苏省2010年成人慢性病及其危险因素监测数据,描述新发现高血压患者在不同人群中的分布差异;运用双变量相关和非条件Logistic回归方法,分析体质量指数(BMI)、腰围、腰身比和体脂百分比等肥胖测量指标与血压及高血压患病的关系。结果江苏省成人新发现高血压患病率为35.3%,男性高于女性,患病率随年龄增长呈上升趋势(P0.05)。双变量相关分析结果表明,BMI、腰围、腰身比和体脂百分比等肥胖测量指标与收缩压和舒张压均成正相关。多因素非条件Logistic回归分析结果显示,肥胖(χ2=129.67,P0.05)、中心型肥胖(χ2=157.05,P0.05)、BMI(χ2=176.21,P0.05)、腰围(χ2=187.73,P0.05)、腰身比(χ2=221.49,P0.05)和体脂百分比(χ2=155.22,P0.05)均与高血压患病显著相关;BMI、腰围、腰身比和体脂百分比每增加1个标准差(SD),高血压患病风险分别增加59%(OR=1.59,95%CI:1.50~1.70)、60%(OR=1.61,95%CI:1.50~1.71)、68%(OR=1.68,95%CI:1.57~1.79)和149%(OR=2.49,95%CI:2.21~2.80)。BMI、腰围、腰身比和体脂百分比等肥胖测量指标对高血压患病风险的影响依次升高。结论 BMI、腰围、腰身比和体脂百分比与高血压患病相关,高血压患病风险随肥胖程度的增加而升高。     

中国老年人群不同肥胖类型与血脂异常关系的meta分析

目的系统评价中国≥60岁老年人群不同肥胖类型与血脂异常的关系。方法检索中英文数据库中与肥胖和血脂异常相关的研究,对符合纳入排除标准的文献进行meta分析。结果最终纳入19篇横断面研究,样本总量为63 844。研究间异质性较大(I~250%),采用随机效应模型合并。多因素meta结果显示,与体质量指数(BMI)正常人群相比,超重和普通肥胖人群患血脂异常的合并OR值分别为1.92(95%CI:1.21~3.05)和2.13(95%CI:1.41~3.22)。与腰围正常人群相比,腹型肥胖人群患血脂异常的风险亦增加(OR=2.00,95%CI:1.47~2.72)。结论我国老年人群肥胖可能显著增加患血脂异常的风险,亟待临床诊疗关注。     

甘肃陇西县35岁及以上人群高血压流行病学现况调查

目的调查甘肃陇西县≥35岁的居民高血压的患病现况,分析其相关危险因素。方法整群分层随机抽取陇西县5个社区≥35岁的居民共12040例,对所选对象进行问卷调查,测量身高、体质量指数(BMI)、腰围、血压,并测定空腹血糖及血脂。计算不同年龄及性别的调查对象高血压及相关疾病的患病率,分析高血压的相关危险因素。结果标化后高血压患病率为26.8%,男性为28.3%,女性为21.4%。Logistic逐步回归分析结果表明,盐摄入量(OR=2.403,95%CI2.066～2.759)、超重(OR=1.566,95%CI1.417～1.730)、高血糖(OR=1.700,95%CI1.303～2.217)、总胆固醇(OR=2.617,95%CI2.294～2.986)、三酰甘油(OR=2.147,95%CI1.960～2.351)、脑力劳动(OR=0.640,95%CI0.490～0.830)、吸烟(烟龄>10年)(OR=1.567,95%CI1.413～1.738)、饮酒(每周>2次)(OR=1.372,95%CI1.340～1.479)是高血压的独立危险因素。结论陇西县35岁以上居民中高血压患病率较高,年龄、男性、高盐饮食、超重及肥胖、高血糖、腰围超标、血脂异常、高三酰甘油是高血压的危险因素。     

中国中年人正常高值血压检出率及影响因素研究——基于中国健康与养老追踪调查数据分析

目的了解中国中年人正常高值血压检出情况及影响因素。方法利用2015年"中国健康与养老追踪调查(CHARLS)"数据,整理7178名45~59岁的中年人血压、腰围、身高、体质量等基本情况和健康行为因素。正常高值血压定义为:收缩压120~139和(或)舒张压80~89mm Hg,且排除高血压病史或正在服用降压药物。结果中年人正常高值血压检出率为45.2%。男性正常高值血压检出率(48.3%)高于女性(42.6%)。在女性中,正常高值血压检出率随着年龄增长而升高(P0.01),在男性中相对稳定。多因素回归分析显示:在男性中,偏瘦(OR=0.264,95%CI0.075~0.929)是正常高值血压的保护因素;腹型肥胖(OR=1.554,95%CI1.027~2.350)、超重(OR=1.734,95%CI1.139~2.640)和肥胖(OR=2.350,95%CI 1.266~4.363)是正常高值血压的危险因素。在女性中,偏瘦(OR=0.509,95%CI 0.280~0.926)是正常高值血压的保护因素;年龄55~59岁(OR=1.553,95%CI1.227~1.966)和肥胖(OR=2.655,95%CI1.976~3.568)是正常高值血压的危险因素。结论中国中年人正常高值血压检出率较高,腹型肥胖、超重和肥胖是中年男性正常高值血压的危险因素,而年龄55~59岁和肥胖为中年女性正常高值血压的危险因素。     

40岁以上在职人群体质量指数与动脉粥样硬化的相关性研究

目的:通过探讨40岁以上在职人群BMI与动脉粥样硬化(AS)的相关性,为人群AS防治提供科学依据。方法:对参加北京市某三甲医院2018年健康体检,年龄在40岁以上在职人员571例的体检结果进行统计。按我国卫生部在《中国成人超重和肥胖症预防控制指南》中公布的诊断标准,将该人群分为:偏瘦体质量组(6例)、正常体质量组(271例)、超重组(201例)和肥胖组(93例),因偏瘦一组例数较少,所以本次不做研究。比较三组的血压、血脂浓度、血糖浓度和AS指数情况,以及高血压、血脂异常、高血糖和AS发病情况,并分析这些因素与AS之间的关系。结果:收缩压、舒张压、TG、TC、LDL-C、空腹血糖浓度和AS指数均与BMI呈正相关,而HDL-C则相反;高收缩压、高舒张压、高TG血症、高TC血症、高LDL-C症、低HDL-C血症、高空腹血糖和AS发病率均随BMI增长而增高,超重组和肥胖组AS发病率分别为21.9%和48.4%,与正常体质量组的7.7%比较显著增高(P0.01);单危险因素Logistic回归分析显示:男性、年龄增加、超重、肥胖、高收缩压、高舒张压、高TG血症、高TC血症、高LDL-C症、低HDL-C血症、高空腹血糖均为AS危险因素(P0.01);多危险因素Logistic回归分析结果:与AS有关的危险因素有年龄增长、超重、肥胖、高收缩压、高空腹血糖,其中可控危险因素有肥胖、超重、高收缩压和高空腹血糖,特别是肥胖(OR=10.06,95%CI:4.39～23.03,P0.01)和超重(OR=2.76,95%CI:1.40～5.45,P0.01)危险性较大。结论:40以上的在职群体的BMI是其AS发病的相关因素,BMI越高患AS风险越大。由于此人群中超重和肥胖人数占比超过50%,应高度重视。     

温州市成人体质量指数、腰围与高血压的关系

目的了解温州市成年人高血压患病率、超重率、肥胖率、中心性肥胖率,并探讨成人体质量指数(BMI)、腰围与高血压患病危险的关系。方法采用多阶段随机抽样方法,从温州市11个区县随机抽取年龄≥18岁的居民进行调查。调查方法包括问卷调查和身体测量。并采用Logistic回归分析探讨BMI、腰围与高血压的关联。率的标化采用2010年全国第6次人口普查数据。结果共调查42 747人,有效问卷41 054份,有效率96.04%。居民标化超重率、肥胖率、中心性肥胖率分别为25.9%、5.9%、42.3%,标化高血压患病率为25.2%。以无超重/肥胖/中心性肥胖人群为参照,超重+中心性肥胖、肥胖+中心性肥胖者患高血压的风险分别为2.475(95%CI 2.330~2.628)、4.140(95%CI3.751~4.570)倍,糖尿病+肥胖+中心性肥胖及血脂异常+肥胖+中心性肥胖者患高血压的风险分别是无糖尿病或血脂异常,无超重/肥胖/中心性肥胖者的6.298(95%CI 5.086~7.800)和4.159(95%CI3.633~4.763)倍。结论 BMI和腰围的增加均能增加高血压发病风险。超重、肥胖和中心性肥胖对高血压患病存在联合作用。     

湖北地区老年人腰围及体质量指数与高血压的相关性研究

目的探讨湖北地区老年人腰围及体质量指数(BMI)与高血压的相关性。方法于2013年2~10月采用分层多阶段随机抽样的方法,对湖北地区5个城区及5个农村年龄60~89岁居民5417例进行调查研究。男性2672例,女性2745例;60~69岁2450例,70~79岁2167例,80~89岁800例。通过问卷调查、体格检查的方式收集调查对象的个人基本情况、腰围、基础代谢等所需要的资料,并进行分析。结果 5417例入选者中,高血压2170例,患病率为40.1%。男性与女性在高血压发病率比较有统计学差异(38.2%%vs 41.8%,χ2=7.199,P0.05)。60~69、70~79、80~89岁高血压发病率比较有统计学差异(32.5%vs 44.4%vs 51.4%,χ2=118.437,P=0.000)。性别(OR=7.511,P=0.000)、身体脂肪率(OR=1.035,P=0.000)、内脏脂肪指数(OR=1.925,P=0.000)均为BMI的危险因素,年龄为BMI的保护因素(OR=0.938,95%CI:0.926~0.950,P=0.000)。对于男性,身体脂肪率(OR=1.021,P=0.001)、内脏脂肪指数(OR=1.438,P=0.000)为腰围的危险因素;对于女性,身体脂肪率(OR=1.094,P=0.000)、内脏脂肪指数(OR=1.448,P=0.000)为腰围的危险因素,年龄为腰围的保护因素。结论湖北地区老年人超重及肥胖形势严峻,腰围及BMI与高血压关系密切。     

机关中青年干部高血压患病及相关危险因素分析

目的了解机关中青年(年龄60岁)干部高血压发病率及与相关危险因素关系。方法入选2012年3月~5月在武警总医院健康医学中心进行体检的机关中青年干部538例,其中男性445例,女性93例。将是否患高血压作为因变量,以性别、年龄、体质指数(BMI)、腰围(WC)、空腹血糖(FPG)、血尿酸(UA)、血脂指标等做为自变量,进行单因素分析及多因素非条件Logistic回归分析。结果机关中青年干部高血压患病率为17.3%。与血压正常组相比,高血压患者男性构成比,BMI、WC、三酰甘油(TG)、低密度脂蛋白(LDL-C)、UA及餐后2 h血糖(2h PBG)明显升高,差异有显著统计学意义(P0.01);高血压组合并超重/肥胖、糖耐量异常、高胆固醇(TC)血症、高UA血症比例明显增高(P0.05)。多因素非条件Logistic回归分析结果表明,男性(OR=4.24,95%CI:1.47~6.36)、BMI(OR=5.16,95%CI:1.36~5.76),2h PBG(OR=2.73,95%CI:1.31~5.69)、TC(OR=2.03,95%CI:1.02~7.31)是高血压的独立危险因素。结论机关中青年干部高血压患病率较高,男性、BMI、TC及2h PBG是高血压的独立危险因素。     

青年学生高血压检出率

目的研究青年学生血压情况、高血压检出率及危险因素。方法利用新生入学体检和毕业生离校体检,对黄冈职业技术学院入学5879名新生和即将离校的5445名毕业生进行血压测量,对初检出的高血压学生进行重复测量,并随机抽取部分新生进行膳食习惯、高血压家族史、肾病病史、生活习惯、精神状况等问卷调查,分析青年学生高血压的流行病学特点。结果青年学生高血压检出率约为9.33%(1056/11 324);男性高血压检出率高于女性(10.94%比7.62%,P0.01),中部省份生源高血压检出率高于西部和东部(10.13%比3.12%,5.69%,均P0.01);超重和肥胖学生高血压检出率高于体质量指数(BMI)正常及以下学生(14.26%,26.96%比7.18%,均P0.01)。多因素Logistic回归分析显示,超重/肥胖(OR=2.086,95%CI 1.193~3.648)、来源于中部省份(OR=2.961,95%CI1.595~5.498)、高血压家族史(OR=1.544,95%CI 1.013~2.352)、吸烟(OR=2.827,95%CI1.256~6.364)、自我感觉孤独(OR=1.700,95%CI1.010~2.860)为高血压的危险因素。结论青年学生高血压与性别、BMI、地域、吸烟及孤独等有关。     

中老年糖尿病高危人群血脂异常现状调查

目的探讨广州市中老年糖尿病高危人群血脂异常的分布情况及其危险因素。方法选取广州市5个社区年龄≥45岁且无糖尿病史居民619名,采用芬兰糖尿病风险积分(FINDRSC)表筛查糖尿病高危人群,FINDRSC≥9分者即为糖尿病高危人群并纳入研究。结果共208例糖尿病高危人群纳入研究。血脂异常患病率75.0%。单纯型血脂异常者占22.6%,混合型血脂异常者占52.4%。Logistic回归分析显示,WC(OR=1.063,95%CI:1.018~1.111)、臀围(OR=1.077,95%CI:1.022~1.134)、BMI(OR=1.154,95%CI:1.035~1.286)、FPG(OR=2.050,95%CI:1.316~3.195)、2hPG(OR=1.115,95%CI:1.012~1.228)、高血压(OR=2.220,95%CI:1.093~4.513)和FINDRSC(OR=1.320,95%CI:1.093~1.594)进入回归方程。结论广州市糖尿病高危人群血脂异常患病率较高,肥胖、高血压、高血糖和FINDRSC是血脂异常的危险因素。     

Acceptability of blood and blood substitutes

Alternatives to donor blood have been developed in part to meet increasing demand. However, new biotechnologies are often associated with increased perceptions of risk and low acceptance. This paper reviews developments of alternatives and presents data, from a field-based experiment in the UK and Holland, on the risks and acceptance of donor blood and alternatives (chemical, genetically modified and bovine). UK groups perceived all substitutes as riskier than the Dutch. There is a negative association between perceived risk and acceptability. Solutions to increasing acceptance are discussed in terms of implicit attitudes, product naming and emotional responses.     

Rheological properties and function of blood cells in stored bank blood and salvaged blood

The technique involving filtration of diluted blood enables the separate analysis of the flow properties of different cell subpopulations. This study was designed to assess the changes occurring in the flow properties and function of blood cells in stored bank blood and salvaged blood compared to patient blood in a given clinical situation. We measured hydrogen peroxide production by neutrophils and the filterability, through 5 μm Nucleopore filters, of isolated red blood cells and of diluted blood. Samples were obtained from patients undergoing aortic surgery and blood intended for transfusion: either salvaged during surgery or stored bank blood. Both salvaged and bank blood were much less filterable than patient blood, with reduced deformability of both red and white blood cells. However, salvaged blood contained highly activated neutrophils with a prolonged transit time of the 'fast-flowing' cells in the analysis compared to bank blood. Bank blood contained significantly more particles which acted as pore-blockers. Cells in bank and salvaged blood therefore have markedly abnormal flow and biochemical properties compared to patient blood.     

Red blood cell function and blood storage

Red blood cells are ideal vehicles for delivering oxygen to tissues, but their functions deteriorate during liquid preservation. In this article, we review the role of red blood cells in oxygen delivery and methods to evaluate the effectiveness of red blood cell transfusion. Quantitative estimation of transfusion effects could avoid unnecessary transfusion and reduce the risk of transfusion-associated disorders. We also describe the benefits of transfusion of red blood cells having a higher oxygen-delivering capacity. Phosphoenolpyruvate is a promising component to prepare red blood cells having a higher oxygen-delivering capacity.     

外周血白细胞计数与血压水平的关系

目的:探讨外周血白细胞计数与血压水平的关系.方法:采用横断面研究方法,从门诊及体检人群中随机抽查1136例为研究对象.根据血压水平按JNC-7标准将其分为3组:正常血压组497例(≤120/80 mmHg)、高血压前期组258例(130～139/85～89 mmHg)、高血压组371例(≥140/90 mmHg).通过...     

Factors influencing blood donations and the rational use of blood

A multicentric quasi-experimental study was conducted in Delhi, from March 2007 to September 2007, on i) the factors which stimulate the donors to donate blood, ii) major barriers and myths associated with blood donation and iii) clinicians perception of the rational use of blood. The study design included a face-to-face survey, with a pre-tested questionnaire paper in two leading blood banks of Delhi and by relevant interviewers from the community and medical fraternity. The sample size was 240-blood donors from two different blood banks and the control group included 100 potential donors from community and 50 clinicians from various hospitals. The data generated was analyzed using excel sheet and Epi-Info software. The study revealed the factors which influence the blood donation included replacement credit and family/peer pressure. Regarding myths and barriers, among potential donors, about a quarter of them felt that it is time consuming, and 20% felt it could lead to sexual impairment or is not rewarding. A total of 10% were not aware about the blood donation while 15% said that donation time was inconvenient. Of the 50 clinicians, a quarter of them were not aware of the rational use of blood.     

Calf blood flow and systolic blood pressure in patients with hyperviscosity of the blood.

The calf blood flow and the ankle blood pressure at rest and during post-ischemic reactive hyperemia were measured by an airfilled rubber segment plethysmograph in 5 patients with hyperviscosity of the blood. The patients had no signs of peripheral arterial disease. A normal flow and pressure pattern was obtained. It is concluded that hyperviscosity does not contribute significantly to the peripheral resistance during reactive hyperemia in the patients studied. The importance of hyperviscosity for peripheral resistance in patients with atherosclerosis obliterans is discussed.