山东省成人健康生活方式特征及其对心血管疾病死亡和全因死亡的影响  

Characteristics of healthy lifestyle among adults and their impact on cardiovascular disease death and all-cause death in Shandong Province

作　　者：徐春晓[1] 陈先献[1] 任杰[1] 王椿淇 鹿子龙[1] 付振涛[1] 徐聪 于晓慧 郭晓雷[1] XU Chunxiao;CHEN Xianxian;REN Jie;WANG Chunqi;LU Zilong;FU Zhentao;XU Cong;YU Xiaohui;GUO Xiaolei(Institute of Non-communicable Diseases Control and Prevention,Shandong Center for Disease Control and Prevention,Ji'nan,Shandong Province 250014,China;不详)

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 [2]中国医学科学院,北京协和医学院,国家心血管病中心阜外医院,国家心血管疾病临床医学研究中心,国家卫生健康委员会心血管药物临床研究重点实验室,心血管疾病国家重点实验室

出　　处：《中国慢性病预防与控制》2025年第2期87-92,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：目的了解山东省社区居民健康生活方式的遵循情况及影响因素,并探讨其与心血管疾病死亡和全因死亡的关系。方法该研究为队列研究,选取2016—2022年参与山东省心血管病高危人群早期筛查与综合干预项目的35~75岁常住居民67611人作为研究对象,调查基本情况,不吸烟、不饮酒或适量饮酒、充足的身体活动和健康饮食等4种健康生活方式的遵循情况,通过山东省死因监测系统获得研究对象截至2022年12月31日的全因死亡和心血管疾病死亡情况。采用R 4.3.1进行χ^(2)检验、趋势检验、多因素logistic回归分析和多因素Cox比例风险模型分析。结果67611名调查对象中,遵循不吸烟、不饮酒或适量饮酒、充足的身体活动和健康饮食者的比例分别为81.1%、95.7%、19.9%、9.1%。仅有2.0%的社区居民遵循全部4种健康生活方式。男性更不可能遵循全部4种健康生活方式(OR=0.43),65岁及以上(OR=1.49)、非农民职业者(OR=1.21)、文化程度较高(与小学及以下相比,初中、高中、大学及以上的OR值分别为1.22、2.12和3.41)、具有较高的家庭收入(与年收入<1万元相比,1~5万元OR=1.39,>5万元OR=1.88),有高血压或糖尿病史者(OR=1.22)更有可能遵循全部4种健康生活方式,均有统计学意义(P<0.05)。纳入Cox回归分析的65608人中,随访期间共有1841人(2.81%)死亡,其中心血管疾病死亡763人(1.16%)。多因素Cox回归分析结果显示,体力活动充足者全因死亡(HR=0.78)和心血管疾病死亡风险(HR=0.68)较低,不吸烟者的全因死亡风险较低(HR=0.88);与遵循0种健康生活方式相比,遵循全部4种健康生活方式者心血管疾病死亡风险明显较低(HR=0.20),均有统计学意义(P<0.01)。结论山东省35~75岁社区居民中遵循全部4种健康生活方式的人群比例较低,需要针对不同人群的特点和需求提供有针对性的健康教育与健康促进措施。Objective To understand the adherence situation and influencing factors of the healthy lifestyle of community residents in Shandong Province,and explore its relationship with cardiovascular disease(CVD)death and all-cause death.Methods The present study was a cohort investigation,67611 permanent residents(35-75 years old)who participated in the early screening and comprehensive intervention project for high-risk groups of CVD in Shandong Province from 2016 to 2022 were selected as the objects,the investigation was performed for the basic information,the compliance of four healthy lifestyles including non-smoking,no drinking or moderate drinking,adequate physical activity and healthy diet.The all-cause death and CVD death as of December 31 in 2022 were obtained through the Shandong Province Cause of Death Surveillance System.The χ^(2)test,trend test,multivariate logistic regression analysis and multivariate Cox proportional hazards model analysis were used to analyze the data.The used software was R 4.3.1.Results Among 67611 objects,the proportions of those who followed non-smoking,no-drinking or moderate drinking,adequate physical activity,and healthy diet were 81.1%,95.7%,19.9%and 9.1%,respectively.Only 2.0%of the community residents followed all 4 healthy lifestyles.Males were less likely to follow all 4 healthy lifestyles(OR=0.43),the residents with≥65 years old(OR=1.49),non-farmer occupations(OR=1.21),higher educational level(as compared with primary school and below,the OR values of middle school,high school,college and above were 1.22,2.12 and 3.41,respectively),higher household income(as compared with an annual income<10000 yuan,OR of 10000 to 50000 yuan was 1.39,and OR of>50000 yuan was 1.88),and those with a history of hypertension or diabetes(OR=1.22)were more likely to follow all four healthy lifestyles(P<0.05).Among the 65608 people included in the Cox regression analysis,a total of 1841 cases(2.81%)died during follow-up,including 763 cases(1.16%)died from CVD.Results of the multivariate Cox regres

关 键 词：健康生活方式 心血管疾病 死亡 健康促进 

分 类 号：R54[医药卫生—心血管疾病]