某社区动脉粥样硬化性心血管病高危人群危险因素达标情况调查

    Status of risk factors for atherosclerotic cardiovascular disease high risk residents in a community-based investigation

    • 摘要:
      目的在某社区动脉粥样硬化性心血管病(ASCVD)高危人群中,对目前指南推荐的相应危险因素的达标情况进行调查,获得有关该目标人群中的健康资料,为推动社区医生规范、合理控制疾病风险,降低ASCVD发病率和死亡率提供帮助。
      方法从古美社区卫生服务中心上海市慢病管理平台中,调取ASCVD高危人群名单(包括高血压病和糖尿病人群),建立病人资料调查表,获取病人相关健康指标(年龄、性别、血压、血糖、血脂等)。通过电子处方系统,获取病人近一年内的药物治疗情况。经电话访谈确认相关信息,分析该人群的危险因素控制达标情况。
      结果共入选病人1 139例,高血压共941例,总体血压达标率91%,亚组分析提示,性别、年龄、肥胖、吸烟及规律运动对血压达标影响差异无统计学意义(P>0.05);糖尿病共708例,糖化血红蛋白达标率60%,不吸烟人群中达标率62%,高于吸烟人群的达标率44%(P < 0.05)。低密度脂蛋白胆固醇(LDL-C)总体达标率为62%,其中,男性、吸烟、未进行规律运动的人群中达标率分别高于女性、不吸烟和规律运动人群的达标率(P < 0.05)。logisitic回归分析提示,女性、无糖尿病和规律运动与LDL-C不达标相关(OR=2.392、1.383、1.545)(P < 0.05~P < 0.01)。
      结论社区ASCVD高危人群中,血压控制情况良好,但糖尿病病人的糖化血红蛋白达标率偏低,总体LDL-C达标率偏低。女性、无糖尿病和规律运动与LDL-C不达标相关,这部分人群可能是后期社区一级预防的重点。

       

      Abstract:
      ObjectiveTo investigate the control status of risk factors for atherosclerotic cardiovascular disease (ASCVD) high risk residents in a community based on guideline recommendation, which may help general physician focus on guideline-directed management and therapy, and reduce the incidence and mortality of ASCVD.
      MethodsIn this cohort study, pharmacy and medical claims data from Gumei Community Health Service Center database were queried for residents with high risk for ASCVD. Telephone interview confirmed related information. Control status and related factors were analyzed.
      ResultsOne thousand one hundred and thirty-nine residents stratified into high risk group for ASCVD were selected, including 941 hypertensive patients and 708 diabetic patients. Among 941 hypertensive patients, blood pressure control rate was 91%, and analysis in subgroups indicated that sex, obesity, smoking and exercise habit were not associated with CR (P>0.05). Among 708 diabetic patients, HbA1c control rate was 60%, which was higher in non-smokers than smokers (62% vs 44%, P < 0.05). In all patients, LDL-C control rate was 62%, which was higher in male vs female, smokers vs non-smokers, and no regular exercise vs regular exercise subgroups (P < 0.05). Binary logistic regression analysis indicated that female, non-diabetic and regular exercise were associated with LDL-C poor control (OR=2.392, 1.383 and 1.545, P < 0.05 to P < 0.01).
      ConclusionsIn these ASCVD high risk residents, control rate of hypertension was optimal, but control rates of HbA1c and LDL-C were not satisfied. Female, non-diabetic and regular exercise correlates with higher LDL-C level, which neds more attention in these subgroups.

       

    /

    返回文章
    返回