青岛市市北区社区老年人群心血管疾病危险因素五年变迁及治疗策略改变  

Five-year changes in risk factors for CVD and in treatment strategies for community-dwelling elderly people in Shibei District of Qingdao

作　　者：李钊[1] 陈瞳[1] 王燕[1] 耿凡琪 张雪娟[1] Li Zhao;Chen Tong;Wang Yan;Geng Fanqi;Zhang Xuejuan(Department of General Medicine,Affiliated Hospital of Qingdao University,Qingdao 266000,Shandong Province,China)

机构地区：[1]青岛大学附属医院全科医学科,266000

出　　处：《中华老年心脑血管病杂志》2023年第2期151-155,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：青岛大学附属医院科研项目(3394)。

摘　　要：目的 调查并分析近5年青岛市市北区社区老年人群常见心血管疾病危险因素变迁情况及相应治疗策略的改变。方法 采用横断面研究,以在青岛市市北区8家社区健康体检的年龄≥65岁老年人为研究对象,8家社区健康体检人数2016年共11 562人,2021年共13 320人,按照5%的抽样比例,2016年抽取578人,2021年抽取666人,共1244人。分别收集2016年和2021年的数据并进行统计学分析。结果 2021年运动达标率显著高于2016年,空腹血糖、LDL-C及确诊冠心病比例显著低于2016年,差异有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析显示,年龄、女性、体质量指数、TC、LDL-C、高血压及糖尿病均为老年人群心血管疾病发生的重要危险因素,高密度脂蛋白胆固醇是心血管疾病发生的保护因素(P<0.05,P<0.01)。2021年肥胖患病率显著低于2016年(16.1%vs 21.5%,P=0.015)。2021年糖尿病患者血糖综合达标率、药物治疗达标率、非药物治疗达标率显著高于2016年,双胍类、钠葡萄糖协同转运蛋白2抑制剂药物使用显著高于2016年;2021年高血压患者非药物治疗达标率显著高于2016年(1.5%vs 0.3%,P=0.041),钙离子通道阻滞剂、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂药物使用显著高于2016年(48.5%vs 36.9%,P=0.005;60.3%vs 50.8%,P=0.034)。结论 青岛市市北区社区老年人群近5年肥胖、高脂血症、高血压及糖尿病等心血管疾病危险因素的管理显著改善,基于指南的药物治疗及非药物治疗均取得明显成效,社区慢病管理在心血管疾病危险因素防控中发挥了重要作用。Objective To investigate and analyze the changes in common risk factors for cardiovascular disease in the elderly in Shibei District, Qingdao and explore the corresponding changes of treatment strategies in recent 5 years.Methods A cross-sectional study was conducted on the elderly(≥65 years old) who took physical examination in 8 communities in Shibei District.In 2016,there were 11 562 people in the 8 communities for physical examination, and 13 320 people in 2021.With a sampling ratio of 5%,578 individuals were sampled in 2016,and 666 in 2021,and there were totally 1244 subjects.Their data in 2016 and 2021 were collected and statistically analyzed.Results The compliance rate of physical exercise was significantly higher, and FPG and LDL-C levels and proportion of definite history of coronary heart diseases were obviously decreased in the 2021 group than the 2016 group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that age, female, BMI,TC,LDL-C,hypertension and diabetes were important risk factors for cardiovascular disease, while HDL-C was a protective factor for the development(P<0.05,P<0.01).The obesity rate of the 2021 group was lower than that of the 2016 group(16.1% vs 21.5%,P=0.015).The 2021 group had statistically higher rates of well-controlled glucose, drug treatment and non-medication intervention, and usage of biguidine and SGLT-2 inhibitors in diabetes patients;and notably higher rates of non-medication intervention for hypertension(1.5% vs 0.3%,P=0.041) and usage of calcium channel blockers and ACEI/ARB(48.5% vs 36.9%,P=0.005;60.3% vs 50.8%,P=0.034) in hypertensive patients.Conclusion In the past 5 years, the management of risk factors for cardiovascular disease such as obesity, hyperlipidemia, hypertension and diabetes has been significantly improved in the cohort.Guideline-based drug therapy and non-medication intervention have achieved significant outcomes.Community health education has played an important role in the prevention and control of risk factors for cardiovascular

关 键 词：心脏病危险因素 肥胖症 血脂异常 高血压 糖尿病 

分 类 号：R54[医药卫生—心血管疾病]