社区中年人群十年缺血性心血管病风险评估及干预效果研究

发布时间：2018-06-20 06:04

本文选题：心血管疾病 + 危险因素　；参考：《中国全科医学》2017年11期

【摘要】：目的采用《国人缺血性心血管病(ICVD)十年发病危险度评估表》评估社区45~59岁居民10年ICVD的发病风险,并评价社区干预的效果。方法 2013年10月—2014年3月,按照随机整群抽样原则,随机选取上海市沪东社区33个居委会中的5个居委会,其中年龄为45~59岁的常住人口均纳入本研究。调查受试者基本情况,测量身高、体质量,检测总胆固醇水平,采用《国人缺血性心血管病(ICVD)十年发病危险度评估表》评估10年ICVD发病危险度。将发病危险度在中危及以上人群归为需进行社区干预者,进行为期1年的干预。干预方案采用临床干预和社区宣教相结合,并依据其自身情况进行个体化指导。结果本研究共调查690例,获得完整资料者636例,其中10年ICVD发病危险度为极低危439例,低危158例,中危30例,高危7例,极高危2例。需进行社区干预39例,实际完成干预34例。中危及以上人群干预前后体质指数比较,差异无统计学意义(P0.05)。中危及以上人群干预后收缩压、总胆固醇水平低于干预前(P0.05)。中危及以上人群干预前吸烟率为38.2%(13/34),经干预后有3例戒烟,干预后吸烟率为29.4%(10/34)。干预后,男性10年ICVD发病危险度为极低危3例,低危10例;女性10年ICVD发病危险度为极低危4例,低危10例,中危6例,高危1例。结论 ICVD的危险因素在中年人群中已经存在,部分已达到了亟待干预的状况,早期对无症状危险人群的社区干预具有较好的效果。
[Abstract]:Objective to evaluate the 10-year risk of ischemic cardiovascular disease (ICVD) and evaluate the effect of community intervention. Methods from October 2013 to March 2014, according to the principle of random cluster sampling, 5 of the 33 neighborhood committees in Shanghai's Hudong community were randomly selected, among which the resident population aged 45 to 59 years were included in the study. To investigate the basic condition of the subjects, to measure their height, body mass and total cholesterol level, and to evaluate the risk of iCVD for 10 years by using the Ten year risk Assessment Table (ICVD) of Chinese patients with Ischemic Cardiovascular Disease (ICVD). The above groups were classified as those who needed community intervention for 1 year. The intervention program combines clinical intervention with community education and individualized instruction according to its own conditions. Results A total of 690 cases were investigated and 636 cases were obtained complete data. The risk of iCVD in 10 years was very low risk in 439 cases, low risk in 158 cases, moderate risk in 30 cases, high risk in 7 cases and extremely high risk in 2 cases. The community intervention was needed in 39 cases and the actual intervention was completed in 34 cases. There was no significant difference in body mass index before and after intervention. The systolic blood pressure (SBP) and total cholesterol level were lower than that before intervention (P 0.05). Before intervention, the smoking rate was 38.2%. After intervention, 3 cases quit smoking, and the smoking rate after intervention was 29.410 / 34%. After intervention, the risk of iCVD in male was very low in 3 cases and in low risk in 10 cases, and in female in 10 years, the risk was very low in 4 cases, low risk in 10 cases, middle risk in 6 cases and high risk in 1 case. Conclusion the risk factors of iCVD have already existed in the middle aged population, and some of them have reached the state of urgent need of intervention. The early community intervention of asymptomatic risk group has a better effect.
【作者单位】：上海交通大学医学院附属仁济医院心内科;上海市浦东新区沪东社区卫生服务中心;上海中医药大学公共健康学院;
【基金】：上海市浦东新区卫生和计划生育委员会科技发展专项基金资助(PW2013C-5)
【分类号】：R54

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