山东省城乡中老年人常见慢性病现状及其危险因素研究

发布时间：2017-12-27 07:36

本文关键词：山东省城乡中老年人常见慢性病现状及其危险因素研究　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景近年来,随着我国社会经济的蓬勃发展、科学技术的进步及医学技术水平的不断提高,人们的物质文化生活水平得到不断的提升,人们的行为生活方式、工作性质及人际交往方式都发生着巨大的变化,疾病谱也发生了改变,心脑血管疾病、糖尿病、肿瘤等慢性疾病成为影响居民身体健康和生活质量的主要因素,给家庭和社会带来了沉重的疾病和经济负担。国外慢性病研究显示,慢性病所造成的疾病风险与经济负担已经超过全球金融危机的影响,全球慢性非传染性疾病的死亡率可达70%,占全球疾病负担的57%。国内慢性病研究显示,我国的慢性病患病率和死亡率迅速增加,2010年我国居民死因死亡率前四位已全部被慢性病占据,且呈现不断上升的趋势。慢性病病因具有一定的特殊性,其是由多种危险因素长期共同作用下而形成的,其病因主要包括遗传因素、环境因素、生活行为方式及老龄化等。不论是在中国还是全世界,慢性非传染性疾病都已经成为了一个非常重要的公共卫生问题,防治慢性病这一主题任重而道远。山东是东部沿海地区的人口大省,其老龄化水平已进入快速发展阶段,且在慢性病的防控及实施中存在技术零散、不系统、缺乏科学性和可操控性等问题。因此,开展以人群为基础的慢性病现状及危险因素调查,是慢性病预防控制工作中的重要环节,量化各个危险因素之间的关系及对慢性病的影响,对于制定科学的慢性病防控措施具有重要意义。研究目的本研究的主要目的是了解山东省城乡中老年人的慢性病患病现状,分析其主要的影响因素,为制定慢性病的健康促进及防控措施提供建议。具体目标如下:1.了解山东省城乡中老年人的基本情况:慢性病患病现状、社会人口经济学特征、健康相关因素;2.分析山东省城乡中老年人慢性病患病的主要影响因素;3.分析山东省城乡中老年人常见慢性病影响因素;4.为改善慢性病现状制定健康促进计划,并为慢性病防控提供建议。研究方法数据采用2013年全国卫生服务调查中的山东省部分,调查采用多阶段分层整群抽样法,覆盖全省17个市,20个县,共抽取12000户(近4万人口),选取调查样本中45岁以上的常住中老年人为研究对象,共17065人。本研究采用描述性统计学分析对山东省城乡中老年人居民常见慢性病患病情况、社会人口学经济特征、健康状况分析等进行分析;组间率的比较采用卡方检验;采用单因素、多因素Logistic分析的方法分析慢性病的主要影响因素。主要结果及结论1.共调查17065名中老年人,城市5494人,农村11571人;男性8129人,女性8936人,平均年龄(60.06±10.48)岁。除性别外,城乡间年龄分布、文化水平、婚姻状况、职业类型、城乡医疗保险、人均年收入有统计学差异;除饮酒外,城乡间自评健康状况、吸烟行为、锻炼行为、居民BMI水平、保健行为有统计学差异。2.慢性病患病率38.9%,按具体病种分析,主要慢性病类型分别是高血压、慢性牙周炎、糖尿病、COPD及癌症,患病率分别为26.1%、9.9%、7.7%、5.1%、1.6%。总体来看,山东省城乡中老年人的慢性病现状较为流行,居民健康水平较差。3.山东省城乡中老年人的健康行为现状不容乐观,其中吸烟者所占比例较大,为27.1%,主要为男性,平均每天吸17.23支,农村高于城市;饮酒所占比例大,为28.6%;从不进行体育锻炼比例高达68.9%。4.城乡、性别、年龄、婚姻状况、职业类型、人均年收入等社会人口经济学特征及吸烟行为、饮酒行为、锻炼行为、BMI水平、自评健康状况等健康相关因素是慢性病的主要危险因素。5.城乡、年龄、职业类型、人均年收入、自评健康状况、吸烟、饮酒、体育锻炼、BMI水平是高血压的主要危险因素;城乡、文化程度、自评健康状况、体育锻炼、刷牙行为是慢性牙周炎的主要危险因素;城乡、年龄、人均年收入、自评健康状况、BMI水平是糖尿病的主要危险因素。政策建议1.积极开展宣传教育,改变慢性病防治理念,由"重治疗轻防控"到"防治并重"。2.加大资金投入,向"城乡并举"转变。3.完善慢性病防控的政策支持,建立政府、社会、个人参与的综合干预措施。4.重点控烟,控制慢性病的主要行为危险因素。5.继续推进"健康山东",实现全民健身。
[Abstract]:Background: in recent years, with the progress of medical technology level and the vigorous development of China's economy, science and technology continues to improve, people's material and cultural life level has been continuously improved, people's life style, the nature of work and interpersonal communication have undergone great changes, the disease spectrum has changed, and vascular disease, diabetes, cancer and other chronic diseases become the resident health and quality of life are the main factors that bring heavy disease and economic burden of family and society. Chronic disease research abroad shows that the risk and economic burden caused by chronic diseases has exceeded the impact of the global financial crisis. The mortality rate of global chronic non communicable diseases can reach 70%, accounting for 57% of the global disease burden. Chronic disease research in China shows that the prevalence and mortality of chronic diseases in China are increasing rapidly. In 2010, the top four death causes of residents in China were all occupied by chronic diseases and showed an increasing trend. The etiology of chronic diseases has certain particularity. It is formed by long-term combined action of multiple risk factors. Its causes mainly include genetic factors, environmental factors, lifestyle and aging. Whether in China or around the world, chronic non communicable diseases have become a very important public health problem. Prevention and cure of chronic diseases is a long way to go. Shandong is a populous province in the eastern coastal area. Its aging level has entered a stage of rapid development. In the prevention and control and implementation of chronic diseases, there are many problems such as scattered technology, lack of system, lack of science and maneuverability. Therefore, the investigation of population based chronic disease status and risk factors is an important step in the prevention and control of chronic diseases. Quantifying the relationship between various risk factors and the impact on chronic diseases is of great significance for developing scientific prevention and control measures for chronic diseases. The purpose of this study is to understand the prevalence of chronic diseases in urban and rural elderly in Shandong Province, and analyze the main influencing factors, so as to provide suggestions for health promotion and prevention and control measures of chronic diseases. The specific objectives are as follows: 1. to understand the basic situation of urban and rural areas of Shandong Province in the elderly: prevalence of chronic diseases, social demographic characteristics and health related factors; analysis of 2. main influencing factors of urban and rural areas of Shandong Province in the elderly chronic diseases in urban and rural areas of Shandong Province; 3. of the elderly common factors influencing chronic disease; 4. to improve the situation chronic diseases develop health promotion programs, and provide suggestions for the prevention and control of chronic diseases. Study on the method of data by Shandong province National Health Survey in 2013, the survey by using a stratified cluster sampling method, covering the province's 17 cities, 20 counties, a total of 12000 households were selected (nearly 40 thousand people), the survey sample is selected in above 45 years old resident in elderly subjects, a total of 17065 people. This study used descriptive statistical analysis of common chronic diseases of urban and rural residents in Shandong province in the elderly prevalence, sociodemographic characteristics, health economic analysis; rate comparison between groups using chi square test; the main influence factors of chronic diseases by using the method of single factor and multi factor analysis of Logistic. Main results and conclusion 1. a total of 17065 middle-aged and elderly people, 5494 urban people, 11571 rural areas, 8129 men and 8936 women, average age (60.06 + 10.48) years. In addition to the gender, there were significant differences in age distribution between urban and rural areas, education level, marital status, occupation, medical insurance, urban and rural per capita income; in addition to drinking, and self-rated health status, smoking behavior, exercise behavior, health behavior level, residents of BMI were statistically differences. 2., the prevalence of chronic diseases was 38.9%. According to specific diseases, the main chronic diseases were hypertension, chronic periodontitis, diabetes, COPD and cancer. The prevalence rates were 26.1%, 9.9%, 7.7%, 5.1%, 1.6% respectively. In general, the status of chronic diseases in middle and old people in urban and rural areas of Shandong is more prevalent, and the health level of residents is poor. 3., the current situation of health behaviors of urban and rural elderly in Shandong is not optimistic. The proportion of smokers is 27.1%, mainly for men. The average daily intake is 17.23, the rural area is higher than that of the city, the proportion of alcohol consumption is 28.6%, and the proportion of never exercising is as high as 68.9%. 4., the socio demographic characteristics of urban and rural areas, gender, age, marital status, occupation type, annual income per capita and smoking, drinking behavior, exercise behavior, BMI level, self-rated health status and other health related factors are the main risk factors of chronic diseases. 5. urban and rural areas, age, type of occupation, per capita income, self-rated health, smoking, drinking and exercise, the level of BMI is the main risk factors of hypertension; urban and rural areas, education level, self-rated health status, physical exercise, brushing behavior is the main risk of chronic periodontitis risk factors; urban and rural areas, age, annual per capita income and self-rated health, BMI level is a major risk factor for diabetes. Policy recommendations 1. actively carry out propaganda and education to change the concept of chronic disease prevention and control, from "heavy treatment and light prevention and control" to "prevention and control". 2. increase the capital investment and change to the "urban and rural". 3. to improve the policy support for the prevention and control of chronic diseases and to establish comprehensive intervention measures for the participation of government, society and individual. 4. the key control of smoking is the main risk factor for the control of chronic diseases. 5. continue to promote "healthy Shandong" to achieve national fitness.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R195.4

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