上海市社区中老年人群心力衰竭患病率 流行病学调查研究

摘要：目的　了解上海市社区中老年人群心力衰竭患病率流行特征。方法　２０１６年１０月至２０１７年１０月， 采用随机整群抽样方法，选取宝山区和黄浦区辖区内１５个社区≥５０ 岁中老年人２５９６名，进行问卷调查和 体格检查，收集人群基本特征、心力衰竭患病率及影响因素，应用ｌｏｇｉｓｔｉｃ 回归进行多因素分析。结果　 ２５９６ 名老年人心力衰竭患病率４．０８％，其中男性心力衰竭患病率为７．１９％，女性患病率为２．２２％，差异 有统计学意义（χ ２＝３８．４６０，犘＝０．０００）。心力衰竭患病率随着年龄增长而增加（χ ２＝６．７７８，犘＝０．０３４）； 不同体质量指数心力衰竭患病率差异有统计学意义（χ ２＝１１．１６１，犘＝０．００４）；冠心病、高血压、高脂血 症、吸烟是心力衰竭的危险因素。结论　规范化和信息化管理慢性心力衰竭，有效控制冠心病、高血压、 高脂血症及不良生活习惯，降低老年心力衰竭患病率。 关键词：慢性心力衰竭；流行病学特征；患病率；危险因素 中图分类号：Ｒ１８１．３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０２ ０１２４ ０４

Factors related to sub-health of civil servants in Yuexiu district of Guangzhou

Objective To discuss the factors related to sub-health of civil servants in Yuexiu district of Guang- zhou, so as to provide scientific evidence for the intervention. Methods A stratified cluster sampling meth- od was applied to recruit randomly total 1 147 civil servants in Yuexiu district of Guangzhou. An anonymous questionnaire survey was conducted using self-assessment form, Effort-Reward Imbalance model questionnaire （ERI）, Simplified Coping Style Questionnaire （SCSQ）, Social Support Rating Scale （SSRS） and self-rating health scale. The data were analyzed by SPSS 17.0. t-test and ehi-square test as well as unconditional logistic regression were used for single and multiple factors analysis. Results The overall prevalence of sub-health was as high as 71.58% （821/1 147） among civil servants and only 28.42% were relatively healthy. There were statistically significant differences between the sub-healthy and healthy subjects in scores of each ERI di- mension. More sub-healthy servants had job stress than their healthy peers （35.57% vs 5.52%） （X2 =106.38, P〈0.01）. The average scores of objective support, subjective support, support usage, social sup port and active respond were all much lower in sub healthy servants compared to their healthy counterparts （t=13.93, 20.24, 13.36, 27.79, 25.79, P〈0.01）, while, the score of negative coping was higher （t= 5.10, P〈0.01）. The differences were also statistically significant in physical workout, weekly social activi- ties, smoking, drinking heavy tea, having breakfast, leisure activities and regular daily schedule between sub-healthy and healthy population （χ^2=15.76, 6.09, 11.63, 12.81, 10.29, 38.81, 56.25, P〈0.01, 0.05）. Unconditional logistic regression analysis revealed that heavy work stress, high input with low reward, negative response and lack of social support, heavy smoking, irregular daily schedule, less leisure activities were the risk factors of sub-health （OR=2.83, 1.37, 0.23, 0.51, 060, 0.81, 0.54, 0.78, 95%CI= 2.00-4.01, 1.02-1.87, 0.16-0.33, 0.370.70, 0.45-0.82, 0.69-0.96, 0.40-0.64, 0.65-0.93, P〈0.05）. Conclusions Civil servants become major occupational group with high prevalence of sub-health. Health educa- tion and psychological adjustment as well as behavioral intervention are very important tactics to improve their overall health condition.