摘要
目的通过对3247例军队离退休老干部体检结果进行分析,为军队老干部的医疗保健提供参考资料和理论依据。方法回顾性分析2014年3月至2016年3月在空军总医院进行健康体检的某部军队干休所离退休老干部3247例,其中男性2684例,女性563例,年龄50~95(75.0±13.8)岁。根据年龄分为四组,其中50~59岁组374例,60~69岁组1184例,70~79岁组1547例,80~95岁组142例,均行体格检查、医技检查及化验室检验,并对检查结果进行统计学分析。结果相比其他年龄组,80~95岁年龄组老干部女性、冠心病、糖尿病、高尿酸血症、用药人数比例高,25-羟基维生素D3[25-(OH)D3]水平低,差异具有统计学意义(P<0.05)。腹部超声结果比较表明,80~95岁年龄组脂肪肝、肝囊肿、胆囊息肉、胆囊结石、肾结石人数比例较高,差异有统计学意义(P<0.05)。胸片结果表明,相比其他年龄组,80~95岁年龄组老干部肺纹理增粗、胸椎退行性变、陈旧性肺结核、肺间质改变、主动脉硬化、肺气肿、肺斑片影、胸膜腔粘连人数比例较高,差异具有统计学意义(P<0.05)。心电图结果表明80~95岁年龄组缺血性改变、束支传导阻滞、窦性心率失常、心肌梗死、左心室肥厚、期前收缩和房室传导阻滞人数比例高,差异具有统计学意义(P<0.05)。同时60~69岁年龄组女性乳腺增生症和子宫肌瘤人数比例高,80~95岁年龄组男性前列腺肥大、前列腺结石、前列腺钙化患者比例高,差异有统计学意义(P<0.05)。结论离退休老干部健康体检结果异常率较高,要有针对性地进行健康指导,早期发现,积极干预,监控相关危险因素,重点加强80~95岁年龄组老干部的保健工作。
Objective To provide reference and theoretical basis for the medical care in retired military cadres by analyzing the physical examination results of 3247 cases. Methods A total of 3247 cadres retired from army who took physical examination in our hospital from March 2014 to March 2016 were enrolled in this study. They were 2684 males and 563 females,and at an age of75. 0 ± 13. 8( 50-95) years. According to their age,they were divided into 50-59,60-69,70-79 and 80-95 years groups( n = 374,1184,1547 and 142). The results of physical examination,medical examination and laboratory test were collected and analyzed. Results Compared with other aged group,the 80-95 years group had higher ratios of females,more comorbidities of coronary heart disease,diabetes and hyperuricemia,higher proportion of medication,and lower 25-( OH) D3 level( P < 0. 05). Abdominal ultrasound results showed that fatty liver,hepatic cyst,gallbladder polyps,gallbladder stones and kidney stones were more common in the 80-95 years old group( P < 0. 05). Chest X-ray filming indicated there were more images of increased pulmonary markings,thoracic vertebra degeneration,obsolete pulmonary tuberculosis,pulmonary interstitial changes,arteriosclerosis,pulmonary emphysema,pulmonary patchy shadow and adhesion of the pleural cavity in the 80-95 years old group( P < 0. 05). Electrocardiogram indicated there were more images of ischemic change,bundle branch block,sinus arrhythmia,myocardial infarction,left ventricular hypertrophy,premature contraction,atrial ventricular block in the 80-95 years group( P < 0. 05). At the same time,the incidence rates of mammary hyperplasia and uterine fibroids were higher in the females from the 60-69 years group,and those of prostate hypertrophy,prostatic calculus and prostatic calcification were common in the males of the 80-95 years group( P < 0. 05). Conclusion The abnormality rates of medical examination results are quite high in the retired cadres. So,pertinent health guidance should be carried out and related risk factors should be monitored and controlled for the senile patients,so as to get benefits from early discovery and active intervention. More attention should be paid to the health care in those aged 80-95 years.
引文
[1]苑学愚,张维东.1999~2008年中老年健康体检恶性肿瘤检出追踪分析[J].中华保健医学杂志,2010,12(1):60-61.Yuan XY,Zhang WD.Tracing analysis of malignant tumor among midst and elderly cadres undergoing physical examination in1999~2008[J].Chin J Health Care Med,2010,12(1):60-61.
[2]花荣,王林,于会宁,等.心力衰竭合并高血压的影响因素分析[J].山东医药,2015,55(13):42-43.DOI:10.3969/j.issn.1002-266X.2015.13.017.Hua R,Wang L,Yu HN,et al.Analysis of influencing factors of heart failure complicated with hypertension[J].Shandong Med J,2015,55(13):42-43.DOI:10.3969/j.issn.1002-266X.2015.13.017.
[3]陈俊贤,司徒海腾,梁蔓逸,等.两种降脂药物辅助罗非班对行介入治疗老年冠心病患者近远期疗效的影响[J].华夏医学,2016,29(6):13-15.DOI:10.19296/j.cnki.1008-2409.2016-06-004.Chen JX,Situ HT,Liang MY,et al.Effect of two kinds of blood lipid-lowering drugs assisted with tirofiban on the short and longterm clinical efficacy of elderly patients with coronary heart disease by PCI[J].Acta Med Sin,2016,29(6):13-15.DOI:10.19296/j.cnki.1008-2409.2016-06-004.
[4]郝鹰,孔冬梅,文灿华,等.探讨心电图与运动试验在招飞体检中的应用价值[J].空军医学杂志,2014,39(3):133-135.Hao Y,Kong DM,Wen CH,et al.ECG in physical examination of flying cadets and improvement of ladder exercise test[J].Med J Air Force,2014,39(3):133-135.
[5]王晓华.1218名干部保健对象体检疾病谱分析及护理对策[J].临床护理杂志,2011,10(1):5-7.DOI:10.3969/j.issn.1671-8933.2011.01.002.Wang XH.An analysis and the nursing strategy for diseases spectra among 1218 hygienical cadres[J].J Clin Nurs,2011,10(1):5-7.DOI:10.3969/j.issn.1671-8933.2011.01.002.
[6]徐贤华,彭华生,肖欣荣,等.成都地区2006、2010年军队男性中老年干部体检结果分析[J].西南国防医药,2012,22(5):527-529.DOI:10.3969/j.issn.1004-0188.2012.05.022.Xu XH,Peng HS,Xiao XR,et al.Physical examination results of military male middle-aged and senile cadres from Chengdu city in2006 and 2010[J].Med J Natl Defending Forces Southwest China,2012,22(5):527-529.DOI:10.3969/j.issn.1004-0188.2012.05.022.
[7]范春芳,朱铁梁,吴志恒,等.良性前列腺增生与代谢综合征相关性研究[J].武警医学院学报,2010,19(7):557-558.Fan CF,Zhu TL,Wu ZH,et al.Study on the correlation between benign prostatic hyperplasia and metabolic syndrome[J].Acta Academiae Medicinae CAPF,2010,19(7):557-558.
[8]Ginde AA,Liu MC,Camargo CA Jr.Demographic difference and trends of vitamin D insufficiency in the US population,1988-2004[J].Arch Intern Med,2009,169(6):626-632.DOI:10.1001/archinternmed.2008.604.
[9]刘晶,李海立,彭文华,等.飞行人员血压水平与心血管危险因素流行病学调查[J].空军医学杂志,2014,30(4):189-191.Liu J,Li HL,Peng WH,et al.Investigation and analysis of cardiovascular risk factors in different blood pressure groups of flying personnel[J].Med J Air Force,2014,30(4):189-191.
[10]陈业泰,李东,李伟,等.中青年官兵高血压病患者的临床特征及其干预措施[J].空军医学杂志,2013,29(2):100-101.DOI:10.3969/j.issn.1009-2811.2013.02.013.Chen YT,Li D,Li W,et al.The clinical features of young and middle-aged hypertension patients in army and the interventions[J].Med J Air Force,2013,29(2):100-101.DOI:10.3969/j.issn.1009-2811.2013.02.013.
[11]张丹毓,顾经宇,王昆,等.南京地区40岁以上人群2型糖尿病控制现状的调查分析[J].中国实用护理杂志,2016,32(9):672-674.DOI:10.3760/cma.j.issn.1672-7088.2016.09.008.Zhang DY,Gu JY,Wang K,et al.The current management situation of type 2 diabetes mellitus patients over 40 years old in Nanjing[J].Chin J Prac Nurs,2016,32(9):672-674.DOI:10.3760/cma.j.issn.1672-7088.2016.09.008.
[12]刘琴,严小倩,梁靖琛.2型糖尿病患者尿液中血管细胞黏附分子-1水平与肾脏损伤的相关性研究[J].中国卫生检验杂志,2017,27(5):655-657.Liu Q,Yan XQ,Liang JC.Correlation study between urinary vascular cell adhesion molecule-1 levels and kidney injury in type2 diabetes mellitus patients[J].Chin J Health Lab Tec,2017,27(5):655-657.
[13]冉隆梅,王敏健,周瑾.广州市9767例干部体检者恶性肿瘤发病情况调查分析[J].护理学报,2013,20(2B):38-39.Ran LM,Wang MJ,Zhou J.Survey of malignant tumor among cadres undergoing physical examination in Guangzhou City[J].J Nurs,2013,20(2B):38-39.
[14]汤如,刘淼,宗文漪,等.某医院老年男性体检人群主要慢性病的疾病谱与检出率分析[J].中华老年多器官疾病杂志,2017,16(2):124-127.DOI:10.11915/j.issn.1671-5403.2017.02.028.Tang R,Liu M,Zong WY,et al.Disease spectrum of major chronic diseases and their detection rates among elderly males:an analysis based on physical examination data from a hospital[J].Chin J Mult Organ Dis Elderly,2017,16(2):124-127.DOI:10.11915/j.issn.1671-5403.2017.02.028.
[15]颜伟,孙梯业,杨春敏,等.3247例军队离退休老干部的心电图变化[J].中国老年学杂志,2016,36(21):5284-5287.DOI:10.3969/j.issn.1005-9202.2016.21.031.Yan W,Sun TY,Yang CM,et al.The electrographic analysis of3247 retired cadres in army[J].Chin J Gerontol,2016,36(21):5284-5287.DOI:10.3969/j.issn.1005-9202.2016.21.031.
[16]汪荷,黄津芳,李学书,等.2011年度沈阳军区军队干部体检结果分析[J].沈阳部队医药,2012,25(3):203-204.Wang H,Huang JF,Li XS,et al.Analysis of physical examination results of cadres in Shenyang Military Area in 2011[J].Shenyang Army Med,2012,25(3):203-204.