2016-2020年山东省35~75岁缺血性心血管病患者“三高”控制及二级预防用药状况分析  

Control of"three highs"and use of secondary prevention drugs in patients(35-75 years old)with ischemic cardiovascular diseases in Shandong Province from 2016 to 2020

作　　者：徐春晓[1] 郭晓雷[1] 鹿子龙[1] 唐俊利[1] 陈先献[1] 任杰[1] 董静[1] 张丙银 马吉祥[1] XU Chunxiao;GUO Xiaolei;LU Zilong;TANG Junli;CHEN Xianxian;REN Jie;DONG Jing;ZHANG Bingyin;MA Jixiang(Institute of Non-communicable Diseases Control and Prevention,Shandong Center for Disease Control and Prevention,Jinan,Shandong Province 250014,China)

机构地区：[1]山东省疾病预防控制中心慢性非传染性疾病防制所,山东省济南250014

出　　处：《中国慢性病预防与控制》2023年第5期343-348,共6页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家重大公共卫生服务项目(财社〔2015〕82号)。

摘　　要：目的了解山东省35~75岁居民中缺血性心血管病患者高血压、糖尿病、血脂异常(简称“三高”)流行和控制现状以及二级预防药物干预情况,为缺血性心血管病患者重点干预措施的制定提供依据。方法该研究数据源于2016年1月至2020年9月在山东省开展的“中国心血管病高危人群早期筛查与综合干预项目”。在山东省10个项目点采用整群抽样方法选取35~75岁常住居民139658人进行初筛调查。该研究以其中自报患有缺血性心血管病者2877人为研究对象。问卷调查社会人口学特征、生活方式、疾病史和药物使用情况,并进行体格检查和实验室检测。采用SAS 9.4进行χ^(2)检验和多水平logistic回归分析。结果2877例自报患有缺血性心血管病者中,90.06%的患者至少合并“三高”中的一种,其中79.56%合并高血压,32.99%合并糖尿病,41.36%合并血脂异常。高血压、糖尿病、血脂异常的控制率分别为11.36%、10.01%和13.95%。抗血小板药物或他汀类药物的报告使用率合计为28.85%。多水平logistic回归结果显示,女性(OR=0.74)、农村地区(OR=0.38)、诊断时间超过7年(OR=0.64)的缺血性心血管病患者服用抗血小板药物或他汀类药物的可能性较低,高年龄(与35~44岁组相比,55~64岁组的OR=4.17)、患有高血压(OR=1.28)、超重(OR=1.55)、肥胖(OR=1.54)的患者服用抗血小板药物或他汀类药物的可能性较高,均有统计学意义(P<0.05,P<0.01)。结论山东省35~75岁缺血性心血管病患者中“三高”检出率较高,“三高”控制率较低,应针对女性、农村居民、诊断时间超过7年的患者进行针对性干预并改善二级预防用药,提高“三高”控制水平。Objective To understand the prevalence and control status of hypertension,diabetes and dyslipidemia("three highs"),and the use of secondary prevention drugs in patients(35-75 years old)with ischemic cardiovascular diseases in Shandong province,and provide the basis for developing priority intervention for patients with ischemic cardiovascular diseases.Methods Data were from the early screening and comprehensive intervention project for high-risk population of cardiovascular diseases in Shandong Province from 2016 to 2020.The cluster sampling method was used to select 139658 residents(35-75 years old)from ten project points for screening investigation.The subjects were 2877 participants who self-reported their history of ischemic cardiovascular diseases.The investigationwas performed with the questionnaire(including socio-demographic characteristics,lifestyle,disease history and medication usage),physical examination and laboratory tests.Theχ^(2)test and multi-level logistic regression model were used to analyze the data.The used software was SAS 9.4.Results Among 2877 patients who self-reported a history of ischemic cardiovascular diseases,90.06%patierts had one of the"three highs"at least,the prevalence of hypertension,diabetes and dyslipidemia were 79.56%,32.99%and 41.36%,respectively.The control rates for hypertension,diabetes and dyslipidemia were 11.36%,10.01%and 13.95%,respectively.The reported use rate of anti-platelet drugs or statins was 28.85%.Multi-level logistic regression analysis showed that the ischemic cardiovascular diseases patients with female(OR=0.74),rural areas(OR=0.38)and diagnosis time>7 years(OR=0.64)had lower possibility of taking the anti-platelet drugs or statins;the ischemic cardiovascular diseases patients with high age group(as compared with 35-44 years old group,55-64 years old group,OR=4.17),hypertension(OR=1.28),overweight(OR=1.55)and obesity(OR=1.54)had higher possibility of taking the anti-platelet drugs or statins(P<0.05 or P<0.01).Conclusion The detected rate of"three highs"

关 键 词：缺血性卒中 缺血性心脏病 缺血性心血管病 二级预防 

分 类 号：R54[医药卫生—心血管疾病]