武汉道路步行环境对老年人缺血性心脏病住院风险的影响  

The effect of street walking environment on the risk of hospitalization for ischemic heart disease among the elderly in Wuhan

作　　者：杜雅婷 吴亚静 秦孟雪 邹宇量[1] DU Yating;WU Yajing;QIN Mengxue;ZOU Yuliang(School of Public Health,Wuhan University,Wuhan,Hubei Province 430071,China)

机构地区：[1]武汉大学公共卫生学院,湖北省武汉430071

出　　处：《中国慢性病预防与控制》2024年第5期364-370,共7页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的量化评估武汉市道路步行环境与老年居民缺血性心脏病(ischemic heart disease,IHD)住院风险之间的关联,为制定针对性的预防策略提供依据。方法收集2017年1月1日至2018年12月31日,武汉市全部IHD老年住院患者信息以及城乡规划数据,共纳入武汉市178个街道的61479名老年IHD住院患者。计算各街道的道路密度、交叉口密度、容积率、兴趣点(POI)密度、混合度、目的地可达性、归一化植被指数(NDVI)、土地利用类型等道路步行环境指标。使用R 4.1.3软件进行泊松回归,分析道路因素对IHD住院风险的影响程度。结果61479名老年IHD住院患者平均年龄为(75.7±8.8)岁。两年间武汉市老年居民平均IHD住院率为3.84%,男性和女性的平均住院率分别为4.11%和3.57%;慢性IHD有28320人(46.1%),心绞痛24190人(39.3%),急性心肌梗死6861人(11.2%),其他急性IHD有1986人(3.2%),急性心肌梗死后近期并发症82人(1.3‰),并发性心肌梗死40人(0.7‰)。泊松回归结果显示,道路密度高(β=0.013,95%CI:0.009~0.017)、周边容积率高(β=0.127,95%CI:0.001~0.243)、餐饮娱乐类POI密度高(β=0.001,95%CI:0.001~0.002)与老年居民IHD住院高风险相关,交叉口密度高(β=-0.001,95%CI:-0.001~-0.001)、医疗保健类POI密度高(β=-0.005,95%CI:-0.006~-0.004)、公园可达性好(β=-0.001,95%CI:-0.002~-0.001)、NDVI高(β=-0.121,95%CI:-0.165~-0.078)、土地利用类型为工业用地(β=-0.031,95%CI:-0.062~-0.000)或公共管理用地(β=-0.065,95%CI:-0.117~-0.014)与老年人IHD住院低风险相关。道路密度高(β=0.019)、周边容积率高(β=0.184)、餐饮娱乐类POI密度高(β=0.001)与男性IHD住院高风险相关,周边容积率高(β=0.048)、餐饮娱乐类POI密度高(β=0.001)与女性IHD住院高风险相关。道路密度高(β=0.006)与心绞痛住院高风险相关,道路密度高(β=0.001)和医疗保健类POI密度高(β=0.000)与急性心肌梗死住院高风险相关,道路密度高(β=0.008)、容积�Objective To quantitatively evaluate the relationship between street walking environment and the risk of hospitalization for ischemic heart disease(IHD)among the elderly in Wuhan,and provide the basis for developing the targeted prevention strategies for IHD.Methods The data of all inpatients with IHD and urban and rural planning data in Wuhan from January 1,2017 to December 31,2018 were collected;and 61479 elderly inpatients with IHD in 178 streets of Wuhan were included.The indicators of street walking environment,such as roadway density,intersection density,plot ratio,point of interest(POI)density,POI diversity,destination accessibility,normalized difference vegetation index(NDVI)and land use type were calculated.Poisson regression analysis was used to analyze the effect of road factors on the risk of IHD hospitalization,the used software was R 4.1.3.Results The mean age of 61479 older inpatients with IHD was(75.7±8.8)years old.The average hospitalization rate of IHD for two years in elderly residents of Wuhan was 3.84%(male:4.11%and female:3.57%).The patients with chronic IHD were 28320 cases(46.1%),the patients with angina pectoris were 24190 cases(39.3%),the patients with acute myocardial infarction were 6861 cases(11.2%),the patients with other acute IHD were 1986 cases(3.2%),the patients with complications of acute myocardial infarction were 82 cases(1.3‰),the patients with concomitant myocardial infarction were 40 cases(0.7‰).Poisson regression analysis showed that high roadway density(β=0.013,95%CI:0.009-0.017),high plot ratio(β=0.127,95%CI:0.001-0.243),high catering and entertainment POI density(β=0.001,95%CI:0.001-0.002)corrlated with high risk of hospitalization for elderly residents with IHD;high intersection density(β=-0.001,95%CI:-0.001--0.001),high healthcare POI density(β=-0.005,95%CI:-0.006--0.004),good park accessibility(β=-0.001,95%CI:-0.002--0.001),high NDVI(β=-0.121,95%CI:-0.165--0.078),and land use type:industrial use(β=-0.031,95%CI:-0.062--0.000)or public management use(β=-0

关 键 词：缺血性心脏病 步行环境 老年人 住院风险 

分 类 号：R541[医药卫生—心血管疾病]