健康相关行为改变对慢性病高风险人群转归的影响  

Effect of Health-related Behavioral Changes on Outcomes of High-risk Population of Chronic Diseases

作　　者：古孝勇[1] 姜方平[1] 王宏宇[1] 徐璐 何佳佳 GU Xiaoyong(Center for Disease Control and Prevention of Zhenjiang City,Zhenjiang,Jiangsu,212000,China)

机构地区：[1]镇江市疾病预防控制中心,江苏镇江212000

出　　处：《医学与社会》2021年第3期64-69,共6页Medicine and Society

基　　金：镇江市重点研发计划--社会发展项目,编号为SH2015030

摘　　要：目的:探讨健康相关行为改变因素在慢性病高风险人群转归过程中的作用,为慢性病一级预防提供参考。方法:选择慢性病高风险人群489名,通过个性化健康指导引导其行为改变,追踪其1年后转归情况,通过倾向评分匹配对研究对象进行分组,消除混杂因素的影响,进而建立logistic回归模型,探讨行为改变因素对慢性病高风险人群转归的影响。结果:处理组与对照组共312人完成了倾向评分匹配,匹配后,各变量标准化差异变小,1∶1匹配组的分布近似,各变量达到均衡,匹配效果较好。Logistic回归分析结果显示,影响慢性病高风险人群转归的10个行为改变因素中,饮酒行为改变、食盐摄入量改变、身体活动量改变、静态行为持续时间改变、睡眠时间改变5个行为改变因素被纳入到回归方程模型中(P<0.05),主动戒酒或保持不饮酒状态、食盐摄入量减少、身体活动量增加、静态行为持续时间减少、睡眠时间增加均可降低慢性病高风险人群向患者转归的程度。结论:通过纠正饮酒、身体活动量、嗜盐、静态行为时间等健康相关行为,可有效促进慢性病高风险人群向正常人转归。Objective:To explore the role of health-related behavioral changes on outcomes of high-risk population of chronic diseases,so as to provide reference for primary prevention of chronic diseases.Methods:489 people with high risk of chronic diseases were selected,individualized health guidance was used to guide their behavioral changes,and their outcomes were followed up after 1 year.Propensity score matching was used to group the subjects for the purpose of eliminating the influence of confounding factors.Then logistic regression model was established to explore the influence of health-related behavioral changes on the outcome of high-risk population of chronic diseases.Results:312 people in the treatment group and the control group completed propensity score matching,the standardization difference of each variable became smaller after propensity score matching,the distribution of 1:1 matching group was approximate,variables reached equilibrium,and the matching effect was better.Logistic regression model showed that changes of drinking,salt intake,physical activity,duration of static behavior and sleep time among the 10 health-related behavioral change factors were statistically significant(P<0.05).Giving up drinking or keeping no-drinking,reducing salt intake,increasing physical activity,decreasing duration of static behavior,and increasing sleep time could reduce the degree of the outcome of high-risk population to patients with chronic diseases.Conclusion:The change of situation of health-related behaviors such as drinking,physical activity,high salt intake,duration of static behavior in high-risk groups of chronic diseases can effectively promote high-risk groups of chronic diseases to return back to normal people.

关 键 词：慢性病高风险人群 健康相关行为 倾向评分匹配 

分 类 号：R195[医药卫生—卫生统计学]