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论文编号 201902-30
论文题目 苏州市心脑血管病防控措施研究
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苏州市心脑血管病防控措施研究

首发时间:2019-02-11

胡一河 1   

胡一河(1961-),男,主任医师,慢性非传染性疾病的预防控制

董晨 2   
  • 1、苏州大学医学部公共卫生学院,苏州,215321
  • 2、苏州市疾病预防控制中心,苏州,215004

摘要:目的:评价苏州市心脑血管病防控措施所产出的效果和存在的问题,并在防控有效的前提下分析各类防控措施的权重。方法:1)收集和整理相关年份死亡数据库通过区域比较进行研究,其中资料包括2010年和2014年苏州市下辖各市、区心脑血管病死亡数据库,比较区域分为慢性病综合防控示范区和非示范区;2)开展专项调查,获取社区医务人员、疾控专业人员、卫生行政人员和慢性病专家4类对象对苏州市心脑血管病防控措施的评价信息,利用层次分析法综合评价各类防控措施权重;3)应用SPSS21.0软件进行建库和进行统计学分析,包括相关分析、参数检验(t检验)和非参数检验(χ2检验);4)使用层次分析法计算各类措施的权重值,权重值通过Excel表编制公式计算获得。结果:1)示范区和非示范区高血压和糖尿病6项危险因素知晓率分别为高危对象标准43.04% vs 20.22%、营养标签50.50% vs 42.18%、自身腰围86.55% vs 57.71%、体重96.67% vs 89.21%、血压86.12% vs 55.20%和血糖57.09% vs 18.92%,二者间差异显著;2)示范区脑血管病早死概率指数评价期初与期末下降值为0.51,显著高于非示范区(下降值0.26,P=0.037),心血管病早死概率指数评价期初与期末分别为上升0.08和下降0.18,二者间无明显区别(P=0.157);3)2010-2014年,苏州市居民心脑管病早死概率与期望寿命之间显著相关(r=-0.830,P=0.003),而非示范区心脑管病早死概率与期望寿命之间无明显相关(P=0.365);4)防控措施权重计算结果显示,健康生活方式占24.94%,健康教育占24.08%,高危人群筛查与管理、控烟和疾病管理分别占18.27%、16.77%和15.95%。结论:1)苏州市示范区脑血管病早死概率显著高于非示范区早死概率,但心血管病早死概率在示范区和非示范区无显著差异;2) 在有效的5类综合防控措施中,与高危人群筛查与管理、控烟和疾病管理相比,全民健康生活方式行动和健康教育权重最大。

关键词: 心脑血管病 脑卒中 冠心病 控制措施

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Study on the prevention and control for cardiovascular and cerebrovascular diseases in Suzhou

Hu Yihe 1    2   

胡一河(1961-),男,主任医师,慢性非传染性疾病的预防控制

Dong Chen 1   
  • 1、School of Public Health, Medical College of Soochow University,Suzhou,215321
  • 2、Suzhou Center for Disease of Prevention and Control,Suzhou,215004

Abstract:Objective: To evaluate the effectiveness and existing problems of prevention and control measures for cardiovascular and cerebrovascular diseases in Suzhou, and to analyze the weight of various prevention and control measures on the premise of effective prevention and control. Method:1)The death data of relevant years including the death data of cardiovascular and cerebrovascular diseases in Suzhou were collected and collated between 2010 and 2014. The comparative regions were divided into the demonstration areas and the non-demonstration areas of comprehensive prevention and control of chronic diseases. 2) A special survey was used to obtain the evaluation information of prevention and control measures of cardiovascular and cerebrovascular diseases in Suzhou from 4 groups, including community medical workers, disease control professionals, health administrators and chronic disease experts, and to evaluate the weight of various prevention and control measures by analytic hierarchy process. 3) The database was built and statistically analyzed with SPSS software (21.0), including correlation analysis, parameter test (t test) and non-parameter test (χ2 test). 4) The weight values of various measures were calculated by the analytic hierarchy process. Results: 1) The awareness rate of six risk factors of hypertension and diabetes in demonstration area was 43.04% of high risk object standard, 50.50% of nutrition label, 86.55% of self-waist, 96.67% of self-weight, 86.12% of blood pressure and 57.09% of blood sugar, respectively. All of which were significantly higher than those in non-demonstration area, as 20.22% of high risk object standard, 42.18% of nutrition label, 57.71% of self-waist, 89.21% of self-weight, 55.20% of blood pressure and 18.92% of blood sugar, respectively. 2) The index of the premature mortality of cerebrovascular diseases has reduced 0.51 from initial stage of evaluation to late in the demonstration area. It is significantly higher than those in non-demonstration area (0.26, P=0.037). However, the index of the premature mortality of cardiovascular diseases has risen 0.08 in demonstration and reduced 0.18 in non-demonstration (P=0.157). 3) The premature mortality was significantly associated with the life expectancy in demonstration area (r=-0.830, P=0.003). However, no significant relationship was detected between the premature mortality and the life expectancy in non-demonstration (P=0.365). 4) The weight of prevention measures are 24.94% of health life style, 24.08% of heath education, the 18.27% of screening and management for high-risk groups, 16.77% of control smoke and 15.95% of management diseases, respectively. Conclusion: 1) The premature mortality of cerebrovascular disease in Suzhou demonstration area was significantly higher than that in non-demonstration area. There was no significant difference in the premature mortality of cardiovascular disease between demonstration area and non-demonstration area. 2) Among the five effective comprehensive prevention and control measures, the national health lifestyle action and health education have the greatest weight compared with the screening and management of high-risk groups, tobacco control and disease management.

Keywords: Cardiovascular and cerebrovascular diseases (CCVD) Stroke Coronary heart disease Prevention and control measures

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胡一河,董晨. 苏州市心脑血管病防控措施研究[EB/OL]. 北京:中国科技论文在线 [2019-02-11]. http://www.paper.edu.cn/releasepaper/content/201902-30.

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苏州市心脑血管病防控措施研究