上海市社区中老年人群心力衰竭患病率流行病学调查研究
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摘要
目的了解上海市社区中老年人群心力衰竭患病率流行特征。方法 2016年10月至2017年10月,采用随机整群抽样方法,选取宝山区和黄浦区辖区内15个社区≥50岁中老年人2 596名,进行问卷调查和体格检查,收集人群基本特征、心力衰竭患病率及影响因素,应用logistic回归进行多因素分析。结果 2 596名老年人心力衰竭患病率4.08%,其中男性心力衰竭患病率为7.19%,女性患病率为2.22%,差异有统计学意义(χ~2=38.460,P=0.000)。心力衰竭患病率随着年龄增长而增加(χ~2=6.778,P=0.034);不同体质量指数心力衰竭患病率差异有统计学意义(χ~2=11.161,P=0.004);冠心病、高血压、高脂血症、吸烟是心力衰竭的危险因素。结论规范化和信息化管理慢性心力衰竭,有效控制冠心病、高血压、高脂血症及不良生活习惯,降低老年心力衰竭患病率。
Objective To understand the epidemiological features of chronic heart failure(CHF) among residents aged 50 and above in communities of Shanghai. Methods A cluster sampling method was used to randomly select 2 596 residents aged 50 and above from 15 communities in Baoshan and Huangpu District from October 2016 to October 2017. A questionnaire survey and physical examination were conducted to collect basic information, calculate the incidence of CHF and analyze disease influencing factors. Logistic regression was used for data statistical analysis. Results The overall incidence of CHF was 4.08%, which was higher in male residents than females(7.19% vs 2.22%,χ~2=38.460, P=0.000)and increased with age(χ~2=6.778, P=0.034).The incidence of CHF was different with BMI of residents(χ~2=11.161, P=0.004). Coronary heart disease, hypertension, hyperlipidemia and smoking were the risk factors of CHF. Conclusions A standardized and informative CHF management combined with effective control of risk factors as coronary heart disease, hypertension, hyperlipidemia and unhealthy lifestyle may help to reduce the incidence of CHF.
Objective To understand the epidemiological features of chronic heart failure(CHF) among residents aged 50 and above in communities of Shanghai. Methods A cluster sampling method was used to randomly select 2 596 residents aged 50 and above from 15 communities in Baoshan and Huangpu District from October 2016 to October 2017. A questionnaire survey and physical examination were conducted to collect basic information, calculate the incidence of CHF and analyze disease influencing factors. Logistic regression was used for data statistical analysis. Results The overall incidence of CHF was 4.08%, which was higher in male residents than females(7.19% vs 2.22%,χ~2=38.460, P=0.000)and increased with age(χ~2=6.778, P=0.034).The incidence of CHF was different with BMI of residents(χ~2=11.161, P=0.004). Coronary heart disease, hypertension, hyperlipidemia and smoking were the risk factors of CHF. Conclusions A standardized and informative CHF management combined with effective control of risk factors as coronary heart disease, hypertension, hyperlipidemia and unhealthy lifestyle may help to reduce the incidence of CHF.
引文
[1] 中华医学会心血管病学分会.中国心力衰竭诊断和治疗指南2014[J]. 中华心血管病杂志, 2014, 42(2):3-10.
[2] 王欣玲, 许嘉鸿.慢性心力衰竭患者的医院-社区联合双向管理模式研究[J]. 国际心血管病杂志, 2017,44(3):189-191.
[3] Ponikowski P, Voors AA, Anker SD, et al.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC).Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J]. Eur J Heart Fail, 2016, 18(8):891-975.
[4] 李锦,王引利,余秀琼,等.三级甲等医院指导下慢性心力衰竭患者的社区管理研究[J].中华心血管病杂志, 2012, 40(11):939-944.
[5] Schmidt M, Jacobsen JB, Lash TL, et al.25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity:a Danish nationwide cohort study[J]. BMJ, 2012, 344:e356.
[6] Gilbert RE, Krum H.Heart failure in diabetes:effects of anti-hyperglycaemic drug therapy[J]. Lancet, 2015,385(9982):2107-2117.
[7] Eshaghian S, Horwich TB, Fonarow GC.An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure[J]. Am Heart J, 2006, 151(1):91.
[8] Glogner S, Rosengren A, Olsson M, et al.The association between BMI and hospitalization for heart failure in 83,021 persons with Type 2 diabetes:a population-based study from the Swedish National Diabetes Registry[J]. Diabet Med, 2014, 31(5):586-594.
[9] Sundstr m J, Bruze G, Ottosson J, et al.Weight loss and heart failure:A nationwide study of gastric bypass surgery versus intensive lifestyle treatment[J]. Circulation, 2017, 135(17):1577-1585.
[10] Banks AZ, Mentz RJ, Stebbins A, et al.Response to exercise training and outcomes in patients with heartFailure and diabetes mellitus:insights from the HF-ACTION trial[J]. J Card Fail, 2016, 22(7):485-491.
[11] 常宇飞,马剡芳,刘京鹤,等.心力衰竭患者出院后转归及影响因素分析[J].中国预防医学杂志, 2016, 17(11):842-845.
[12] 柴敬杰,陆建洪,沈震,等.慢性心力衰竭社区规范化管理及实施效果评价[J].中国预防医学杂志, 2016, 17(6):458-460.
[2] 王欣玲, 许嘉鸿.慢性心力衰竭患者的医院-社区联合双向管理模式研究[J]. 国际心血管病杂志, 2017,44(3):189-191.
[3] Ponikowski P, Voors AA, Anker SD, et al.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:The task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC).Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J]. Eur J Heart Fail, 2016, 18(8):891-975.
[4] 李锦,王引利,余秀琼,等.三级甲等医院指导下慢性心力衰竭患者的社区管理研究[J].中华心血管病杂志, 2012, 40(11):939-944.
[5] Schmidt M, Jacobsen JB, Lash TL, et al.25 year trends in first time hospitalisation for acute myocardial infarction, subsequent short and long term mortality, and the prognostic impact of sex and comorbidity:a Danish nationwide cohort study[J]. BMJ, 2012, 344:e356.
[6] Gilbert RE, Krum H.Heart failure in diabetes:effects of anti-hyperglycaemic drug therapy[J]. Lancet, 2015,385(9982):2107-2117.
[7] Eshaghian S, Horwich TB, Fonarow GC.An unexpected inverse relationship between HbA1c levels and mortality in patients with diabetes and advanced systolic heart failure[J]. Am Heart J, 2006, 151(1):91.
[8] Glogner S, Rosengren A, Olsson M, et al.The association between BMI and hospitalization for heart failure in 83,021 persons with Type 2 diabetes:a population-based study from the Swedish National Diabetes Registry[J]. Diabet Med, 2014, 31(5):586-594.
[9] Sundstr m J, Bruze G, Ottosson J, et al.Weight loss and heart failure:A nationwide study of gastric bypass surgery versus intensive lifestyle treatment[J]. Circulation, 2017, 135(17):1577-1585.
[10] Banks AZ, Mentz RJ, Stebbins A, et al.Response to exercise training and outcomes in patients with heartFailure and diabetes mellitus:insights from the HF-ACTION trial[J]. J Card Fail, 2016, 22(7):485-491.
[11] 常宇飞,马剡芳,刘京鹤,等.心力衰竭患者出院后转归及影响因素分析[J].中国预防医学杂志, 2016, 17(11):842-845.
[12] 柴敬杰,陆建洪,沈震,等.慢性心力衰竭社区规范化管理及实施效果评价[J].中国预防医学杂志, 2016, 17(6):458-460.
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