新疆农村地区哈萨克族和维吾尔族血脂异常人群调脂干预效果评价

发布时间：2018-06-15 10:23

本文选题：血脂异常 + 哈萨克族　；参考：《石河子大学》2015年硕士论文

【摘要】：目的:通过对新疆农村地区哈萨克族、维吾尔族血脂异常患者开展健康教育联合药物治疗的综合干预研究,评价干预人群的调脂效果,为新疆农村少数民族治疗血脂异常提供科学依据。方法:本研究采用分层整群随机抽样方法选择新疆伊犁新源县那拉提镇和喀什伽师县江巴孜乡共18个自然村,随机分为干预村和对照村。对上述村中18岁及以上的哈萨克族和维吾尔族常住居民进行基线调查,筛选调查人群中诊断为血脂异常的患者作为研究对象。通过入户访问的方式收集问卷信息、体检及血标本的采集,干预组采取减盐、低脂饮食、多吃蔬菜等健康教育联合调脂药物辛伐他汀治疗,对照组不采取任何措施,定期入户随访2年。结局调查方法及内容同基线。采用OLYMPUS 2007全自动生化仪检测血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等指标。应用SPSS17.0软件进行统计分析,计量资料采用(x±s)描述,两组间均数的比较用t检验,重复测量数据采用重复测量的方差分析,率或构成比的比较采用Pearsonχ2检验。结果:1.确定研究对象784人,干预组518人、对照组266人,随访3年后共失访94人,随访率88.0%。其中干预组460人,随访率为88.8%;对照组230人,随访率86.5%。2.综合干预后,干预组TG、LDL-C的降低的幅度分别是2.80%、12.12%,HDL-C的上升幅度是23.00%,与对照组比较,差异均有统计学意义(P0.05)。3.干预组TC、LDL-C水平较基线降低至(4.06±0.94)mmol/L、(2.03±0.61)mmol/L(P0.05),HDL-C水平升高(1.23±0.46)mmol/L(P0.05)。干预组血脂控制率为38.70%,高于对照组的3.48%(χ2=62.407,P0.01)。4.通过综合干预后,干预组与对照组血脂异常知识平均知晓率分别为26.2%、5.5%,信念平均形成率分别为35.1%、7.5%,行为平均形成率分别为12.9%、3.7%,差异均有统计学意义(P0.05)。干预组血脂异常患者的知识知晓率、信念形成率、行为形成率均较干预前明显提高,差异均有统计学意义(P0.05)。5.综合干预后,干预组与对照组血脂异常知识得分分别为(3.32±2.19)分、(1.39±1.18)分,态度得分分别为(2.07±1.27)分、(0.82±0.92)分,行为得分分别为(1.11±1.10)分、(0.70±0.96)分,平均总分分别为(6.50±3.30)分、(2.91±2.31)分,且两组均有差异(P0.01)。结论:通过为期3年的健康教育联合药物治疗综合干预,干预组血脂异常患者血脂水平均有所改善,改善幅度优于对照组,4项血脂水平控制率明显提高,知识知晓率、信念形成率、行为形成率及得分明显提高。健康教育联合药物治疗对改善新疆农村地区少数民族血脂异常患者的血脂水平切实有效,适宜推广应用。
[Abstract]:Objective: to evaluate the effect of health education combined with drug therapy on the patients with dyslipidemia in Kazak and Uygur nationality in rural areas of Xinjiang. To provide a scientific basis for the treatment of dyslipidemia in rural ethnic minorities in Xinjiang. Methods: in this study, 18 natural villages were randomly divided into intervention village and control village by stratified cluster random sampling in Nalati Town, Yili County, Xinjiang, and Jiangbazhi Township, Kashgar County, Xinjiang. A baseline survey was carried out among Kazakh and Uygur residents aged 18 and above in the above villages, and the patients diagnosed as dyslipidemia in the investigated population were selected as the research objects. Questionnaire information, physical examination and blood sample collection were collected through household visits. The intervention group was treated with health education, such as reducing salt, low fat diet, eating more vegetables and simvastatin, while the control group did not take any measures. The patients were followed up for 2 years. The methods and contents of the outcome survey were the same as the baseline. Serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected by OLYMPUS 2007 automatic biochemical instrument. SPSS 17.0 software was used to carry out statistical analysis. The measurement data were described by X 卤s. T test was used to compare the mean of the two groups, the repeated measurement data was analyzed by the analysis of variance of repeated measurements, and Pearson 蠂 2 test was used to compare the rate or composition ratio. The result is 1: 1. 784 subjects, 518 cases in the intervention group and 266 cases in the control group were selected. 94 cases were lost after 3 years follow-up, and the follow-up rate was 88.0%. There were 460 patients in the intervention group and 230 in the control group with a follow-up rate of 88. 8% and a follow-up rate of 86. 5% and 2. 2% respectively. After comprehensive intervention, the decrease of LDL-C of TGN in the intervention group was 2.80 and 12.12, respectively. The increase of HDL-C was 23.00. The difference was statistically significant compared with the control group. Compared with the baseline, the LDL-C level in the intervention group was decreased to 4.06 卤0.94mmol / L, 2.03 卤0.61mmol / L, P 0.05g / L increased by 1.23 卤0.46mmol / L, 0.05g / L, respectively. The control rate of serum lipids in the intervention group was 38.70, which was higher than that in the control group (蠂 2, 62.407, P 0.01. 4). After comprehensive intervention, the average awareness rate of dyslipidemia in intervention group and control group was 26.2and 5.5, the average formation rate of belief was 35.1and 7.5, and the average rate of behavior formation was 12.9and 3.7.The difference was statistically significant (P 0.05). In the intervention group, the rate of knowledge awareness, belief formation and behavior formation in patients with dyslipidemia were significantly higher than those before intervention, and the differences were statistically significant (P 0.05). After comprehensive intervention, the scores of dyslipidemia in the intervention group and the control group were 1.39 卤1.18, 1.39 卤1.18, 0.82 卤0.92, 0.11 卤1.10 and 0.70 卤0.96, respectively. The average total score was 6.50 卤3.30 and 2.91 卤2.31, respectively, and there was a difference between the two groups. Conclusion: the level of blood lipids in patients with dyslipidemia in the intervention group was improved by 3 years of health education combined with comprehensive intervention of drug therapy, and the improvement range was better than that of the control group. The control rate of 4 items of lipid level in the control group was obviously improved, and the rate of knowledge awareness was improved. Belief formation rate, behavior formation rate and score increased significantly. Health education combined with drug therapy is effective in improving the blood lipid level of ethnic minority patients with dyslipidemia in rural areas of Xinjiang, and is suitable for popularization and application.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R589.2

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