【摘要】 目的对老年体检人群中心脑血管疾病患者健康状况进行综合评估,并分析其相关影响因素。方法选取2016年1-12月江苏省省级机关医院健康管理中心参加体检≥60岁老年人共532例,采用人口学调查、日常生活能力评估量表、营养风险筛查NRS-2002评估表、跌倒风险评估量表、国际尿失禁咨询委员会尿失禁问卷表简表、阿森斯失眠量及亚洲人骨质疏松自我筛查工具对其人口学特征、心脑血管疾病分布特征以及健康综合情况等进行调查。结果共532例参加调查研究,患心血管疾病者共122例(22.93%),冠心病患者71例(13.35%),脑梗死患者48例(9.02%)。随年龄增加,患病率逐渐上升(趋势性χ~2=54.52,P<0.001)。心血管疾病患者与未患心血管疾病者之间年龄、退休前职业构成、合并高血压或糖尿病的比例及舒张压、总胆固醇、低密度脂蛋白胆固醇水平以及低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值差异有统计学意义(P<0.05)。多因素logistic分析结果显示,肥胖者及合并糖尿病者发生患心脑血管疾病者的风险分别为BMI正常者或未患糖尿病者的2.13(95%CI:1.10~4.14)及2.03(95%CI:1.11~3.71)倍;年龄每增加一个单位,患心血管的风险增加1.11倍(95%CI:1.07~1.14);退休前职业为机关或事业单位人员患心脑血管疾病的风险为退休前职业为工人或企业职员者2.00倍(95%CI:1.12~3.86)。老年人综合评估显示,患心脑血管疾病者的营养不良风险、跌倒风险、尿失禁风险、睡眠障碍风险以及骨质疏松风险与未患心脑血管疾病者差异均有统计学意义(P<0.05)。结论针对心脑血管疾病患者,应在综合评估的基础上,除积极治疗脑梗死、冠心病等原发症状外,同时进行营养支持、体重管理、抗抑郁治疗、心理疏导等,提高患者健康水平的同时提升患者的生活质量。更多还原

【Abstract】 Objective To comprehensively estimate the health status of patients with cardio-cerebrovascular diseases among elderly population with physical examination,and to analyze the related influencing factors. Methods A total of 532 elders aged ≥ 60 years who had physical examination in Health Management Center,Jiangsu Provincial Official Hospital from January to December in 2016 were enrolled in this study. Their demographic characteristics,distribution features of cardiovascular and cerebrovascular diseases and health status were investigated by a demographic survey,Activity of Daily Living Scale,Nutritional Risk Screening 2002( NRS 2002),Fall Risk Assessment Scale,the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form( ICIQ-UI-SF),Athens Insomnia Scale and Osteoporosis Self-assessment Tool for Asians. Results Among the 532 elders surveyed,there were 122( 22.93%) patients with cardiovascular diseases,71( 13.35%) patients with coronary heart disease and 48( 9.02%) patients with cerebral infarction. The prevalence rate increased gradually with the increasing age( Trend χ~2= 54.52,P<0.001). There were statistically significant differences in age,pre-retirement occupation,the proportion of combining with hypertension or diabetes,the levels of diastolic blood pressure,total cholesterol and low-density lipoprotein cholesterol and the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol between patients with cardio-cerebrovascular diseases and elders without cardio-cerebrovascular diseases( all P<0.05). Multivariate logistic analysis showed that the risk of suffering from cardio-cerebrovascular diseases in the elders with obesity and ones complicated with diabetes was respectively 2.13 times( 95%CI: 1.10-4.14) and 2.03 times( 95%CI: 1.11-3.71) those of the elders with normal BMI and ones without diabetes. The risk of suffering from cardio-cerebrovascular diseases in the retirees from government organizations and public institutions was double( 95%CI: 1.12-3.86) that of the retirants from factories and enterprises. The comprehensive assessment of health status of the elderly indicated that the risk of suffering from malnutrition,falls,urinary incontinence,sleep disorders and osteoporosis showed statistically significant differences between the elders with and without cardio-cerebrovascular diseases( all P<0.05).Conclusions As for the elderly patients with cardio-cerebrovascular diseases,we should actively treat stroke,coronary heart disease and other primary symptoms and simultanously implement nutrition support,weight management,antidepressant treatment and psychological counseling based on the comprehensive assessment of health status so as to improve health level of the patients and promote their quality of life at the same time.更多还原