陕西省成年居民慢性病共病情况及影响因素分析  

Analysis of chronic disease comorbidity conditions and influencing factors among adult residents in Shaanxi Province

作　　者：孟焕 飒日娜[1] 王维华[1] 郭凯明 邱琳[1] MENG Huan;SA Rina;WANG Weihua;GUO Kaiming;QIU Lin(Institute for Chronic and Noncommunicable Disease Control and Prevention,Shaanxi Center for Disease Control and Prevention,Xi'an,Shaanxi Province 710054,China)

机构地区：[1]陕西省疾病预防控制中心慢性病防治所,陕西省西安710054

出　　处：《中国慢性病预防与控制》2024年第10期756-761,共6页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：陕西省人群心血管疾病主要危险因素归因疾病负担研究(2024年-YBXM-023)。

摘　　要：目的 了解陕西省成年居民慢性病共病的患病情况及其影响因素,为有针对性地在陕西省成年居民中进行慢性病共病防控提供参考依据.方法 于2018年7-10月使用多阶段分层整群随机抽样法在陕西省内抽取成年常住居民6 202人,最终纳入5 795名成年居民进行问卷调查、体格检查和实验室检测.使用R 4.1.3软件进行Rao-Scott χ^(2)检验和Kruskal-Wallis秩和检验.采用多分类logit回归模型分析慢性病共病的影响因素,对符合比例优势假设的变量采用累积比数logit模型进行分析,不符合比例优势假设的变量采用偏比例优势模型进行分析.结果 5 795名陕西省成年居民中,慢性病共病加权患病率为49.23%,患0、1、2和3种及以上慢性病的加权患病率分别为23.18%、27.59%、21.78%和27.45%.11种纳入分析的慢性病中,加权患病率最高的是血脂异常(34.72%).慢性病共病加权患病率最高的二元共病组合是血脂异常和高血压(15.30%),最高的三元共病组合为血脂异常,高血压,颈、腰部疾病(6.15%).累积比数logit模型结果显示,与 30 岁以下人群相比,30~39 岁年龄组(OR=1.365,95%CI:1.038~1.794)、40~49 岁年龄组(OR=2.791,95%CI:2.153~3.616)、50~59 岁年龄组(OR=4.278,95%CI:3.307~5.534)、60~69 岁年龄组(OR=6.883,95%CI:5.280~8.972)、≥70 岁年龄组(OR=9.863,95%CI:7.334~13.264)人群慢性病共病的风险更高;相比于城市居民,农村居民慢性病共病的风险更低(OR=0.855,95%CI:0.770~0.951);与无睡眠障碍的居民相比,有睡眠障碍的居民慢性病共病风险更高(OR=2.144,95%CI:1.930~2.382);与BMI正常及偏瘦人群相比,超重、肥胖人群的慢性病共病风险更高(超重OR=1.449,95%CI:1.282~1.637;肥胖OR=2.493,95%CI:2.094~2.967).偏比例优势模型结果显示,中心性肥胖者相较于非中心性肥胖者慢性病共病可能性更大,患 2 和 3 种及以上(2 种 OR=1.380,95%CI:1.207~1.577;3 种及以上 OR=1.395,95%CI:1.215~1.602)慢性病均有统计学意Objective To understand the prevalence and influencing factors of chronic comorbidity among adults in Shaanxi Province,and provide the reference basis for targeted prevention and control of chronic comorbidity among adults in Shaanxi Province.Methods From July to October 2018,the multi-stage stratified cluster random sampling was used to select 6202 permanent residents(≥18 years old)from Shanxi Province,ultimately the included 5795 adult residents served as the subjects.The investigation was performed with questionnaire survey,physical examination,and laboratory tests.Rao-Scottχ^(2)test and Kruskal-Wallis rank test were used to analyze the data,the used software was R 4.1.2.Multi-classification logit regression model was used to analyze the influencing factors of comorbidity of chronic diseases,the variables meeting the hypothesis of proportional advantage were analyzed using the cumulative ratio number logit model,the variables that did not fit the hypothesis of proportional advantage were analyzed using a partial proportional advantage model.Results Of the 5795 adult residents of Shaanxi Province,the weighted morbidity of chronic comorbidity was 49.23%.The weighted morbidity rates of chronic diseases with 0,1,2,3 or more types of chronic diseases were 23.18%,27.59%,21.78%,and 27.45%,respectively.Among the 11 included chronic diseases,the highest weighted morbidity was dyslipidemia(34.72%).The binary comorbidities combinations with the highest weighted morbidity of comorbidities in chronic diseases were dyslipidemia and hypertension(15.30%),the highest ternary comorbidities combinations were dyslipidemia,hypertension,and neck and waist diseases(6.15%).The cumulative ratio number logit model results showed that as compared with people<30 years old,the risk of chronic disease comorbidity in 30-39 age group(OR=1.365,95%CI:1.038-1.794),40-49 age group(OR=2.791,95%CI:2.153-3.616),50-59 age group(0R=4.278,95%CI:3.307-5.534),60-69 age group(OR=6.883,95%CI:5.280-8.972),≥70 years old group(0R=9.863,95%Cl:7.334-13.26

关 键 词：慢性病 慢性病共病 影响因素 

分 类 号：R195.4[医药卫生—卫生统计学]