吉林省部分地区农村中老年人社会心理压力对冠心病发病影响的前瞻性队列研究  

The effects of social psychosocial stress on coronary heart disease for the middle aged and the elderly in some rural areas of Jilin province: a prospective cohort study

作　　者：刘志明[1] 褚运松 叶俊森 赵婕潼[1] 赵惠子[1] 赵桐荫 李忠民[1] 

机构地区：[1]吉林大学公共卫生学院,吉林省长春130021

出　　处：《中国慢性病预防与控制》2016年第11期804-807,共4页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：基金项目:ICDC国际协作前瞻性队列研究(3B6058583427)

摘　　要：目的 探讨社会心理压力对冠心病发病的影响,引起人们对中老年人社会心理压力足够的重视。方法 于2005年选取吉林省部分地区农村40~80岁的中老年人进行第1次基础调查建立研究队列,之后每年进行随访,随访至2014年8月。通过简式社会心理幸福指数调查问卷（PWI-SF）区分人群的社会心理压力程度,用Cox比例风险回归模型分析社会心理压力与冠心病事件发生之间的关联。结果 人群社会心理压力高低在不同婚姻状况、民族、糖尿病患者与非糖尿病患者之间差异均有统计学意义（P〈0.01）。未婚者或未同居者、朝鲜族居民、糖尿病患者具有高社会心理压力的几率大。Cox比例风险回归模型分析显示,冠心病发病在不同吸烟情况、体质指数（BMI）、总胆固醇水平人群之间差异均有统计学意义（P〈0.01）。在调整了年龄、性别后（模型1）,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值（95%CI）为4.15（1.24~13.93）;在模型1的基础上进一步调整婚姻状况、民族、糖尿病史等与社会心理压力有关的因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值（95%CI）为4.54（1.34~15.35）;在模型1的基础上进一步调整吸烟史、BMI、总胆固醇等与冠心病发病有关的因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值（95%CI）为4.34（1.29~14.58）;在模型1的基础上进一步调整婚姻状况、民族、糖尿病史、吸烟史、BMI、总胆固醇等与社会心理压力和冠心病发病有关的因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值（95%CI）为4.69（1.38~15.93）;在模型1的基础上调整所有因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值（95%CI）为4.76（1.39~16.26）。结论 社会心理压力与冠�Objective To explore the effects of social psychological stress on coronary heart disease, and to draw enough attention to social psychosocial stress in the middle aged and elderly population. Methods In 2005, the adults （40-80 years old） were selected from some rural areas of Jinlin province as the subjects of cohort study, and the first baseline data were collected, then follow-up every year at the same time had been conducted to August of 2014. A PWI-SF questionnaire was used to evaluate the social psychosocial stress level of the subjects, Cox proportional hazards regression models were applied to analyze the relationship between social psychosocial stress and coronary heart disease events. Results There were statistically significant differences of psychosocial stress levels between different marital status groups, different ethnic populations, diabetic patients and non-diabetic participants （P〈0.01）. Unmarried or non-cohabite subjects, Korean ethnic residents and diabetes patients had a greater risk of high psychosocial stress. Cox proportional hazards regression models showed that there were statistically significant differences of coronary heart disease between subjects with different smoking history, different BMI and different total cholesterol levels （P〈 0.01 ）. After adjusting age and gender （model 1 ）, as compared with healthy psyehosoeial subjects, HR value of the subjects with high psychosocial stress was 4.15 （95%CI： 1.24-13.93）. On the basis of model 1, after adjusting psychosocial stress-related factors （marital status, ethnic and diabetes history）, as compared with healthy psychosocial subjects, HR value of the subjects with high psychosoeial stress was 4.54 （95%CI： 1.34-15.35）. On the basis of model 1, after adjusting the coronary heart disease- related factors （ smoking history, BMI and total cholesterol level ）, as compared with healthy psychosocial subjects, HR value of the subjects with high psychosocial stress was 4.34 （95% CI： 1.29-14.58）. On

关 键 词：社会心理压力 冠心病 中老年 队列研究 

分 类 号：R181.3[医药卫生—流行病学]