【摘要】 背景 由于工作特殊性,护理人员长期处于高度精神紧张状态,易导致血压增高,且男性与女性在组织、细胞、分子水平调节血压稳态方面存在明显差异,其高血压影响因素可能有所不同,探讨不同性别护理人员的高血压影响因素对于制定针对性防控策略具有参考意义。目的 调查河北省不同性别护理人员高血压流行现状并进行影响因素对比分析,为不同性别护理人员制定个性化防控措施提供依据。方法 本研究采用普查方法,于2016年11月—2018年7月对河北省11个地市所有医院的128 009名护理人员进行高血压现况及影响因素调查。对男性和女性护理人员高血压的公认影响因素进行倾向性评分匹配,基于匹配后数据采用多因素Logistic回归分析探讨不同性别护理人员高血压的影响因素。结果 男性护理人员高血压患病率(20.36%,1 115/5 476)高于女性护理人员(6.26%,7 669/122 533)(P<0.001)。匹配后年龄[>25～35岁(OR=2.182)、>35～45岁(OR=3.560)、>45～55岁(OR=7.406)、>55～65岁(OR=13.339)]、体质指数[24.0～<28.0 kg/m~2(OR=1.591)、≥28.0 kg/m~2(OR=2.739)]、医院所在地[沧州(OR=1.431)、衡水(OR=1.834)、唐山(OR=1.408)]、高脂血症年限[>0～5年(OR=3.399)、>5～10年(OR=4.451)]、高血压家族史(OR=1.225)是男性护理人员发生高血压的影响因素(P<0.05);年龄[>25～35岁(OR=1.382)、>35～45岁(OR=4.125)、>45～55岁(OR=6.510)、>55～65岁(OR=5.616)]、体质指数[24.0～<28.0 kg/m~2(OR=1.749)、≥28.0 kg/m~2(OR=3.111)]、所在科室[儿科(OR=1.570)、医技科室(OR=1.779)]、高脂血症年限[>0～5年(OR=2.863)、>5～10年(OR=3.713)]、糖尿病年限[>0～5年(OR=3.126)、>5～10年(OR=2.947)、>10年(OR=9.743)]、高血压家族史(OR=1.243)、月经情况[不规律(OR=1.358)、已绝经(OR=1.689)]、妊娠高血压疾病[否(OR=0.486)、无妊娠史(OR=0.507)]是女性护理人员发生高血压的影响因素(P<0.05)。结论 河北省男性护理人员高血压患病率高于女性护理人员。年龄、体质指数、高脂血症年限、高血压家族史是男性、女性护理人员发生高血压的影响因素;所在科室为儿科或医技科室、糖尿病、月经不规律、已绝经、有妊娠高血压疾病仅对女性高血压患病风险产生影响,相关部门可采取针对性防控措施;另外,医院所在地是男性护理人员高血压的影响因素,应关注相关地市男性护理人员血压状况;应积极采取预防措施,最大限度地降低护理人员高血压患病风险。更多还原

【Abstract】 Background Long-term high level of mental tension induced by nursing work may be associated with increased blood pressure in nurses. The factors influencing hypertension may differ by sex,since there are sex-specific differences in the regulation of blood pressure in molecules,cells and tissues. So exploring influencing factors for hypertension in male and female nurses is significant for formulating targeted prevention and control strategies. Objective To examine the prevalence and influencing factors of hypertension among male and female nurses in Hebei Province,providing a basis for developing sex-based hypertension prevention and control measures for nurses. Methods A census survey method was used. The prevalence and influencing factors of hypertension were investigated among 128 009 nurses in all hospitals in 11 cities of Hebei Province from November 2016 to July 2018. The recognized factors influencing hypertension were matched between male and female nurses by propensity score matching. Based on the matched data, multivariate Logistic regression was used to explore the factors influencing hypertension among male and female nurses. Results The prevalence of hypertension was higher in male nurses than in female nurses[20.36%(1 115/5 476) vs 6.26%(669/122 533),P<0.001]. After propensity score matching,age[>25-35 years old(OR=2.182),>35-45 years old(OR=3.560),>45-55 years old(OR=7.406),>55-65 years old(OR=13.339)],BMI[24.0-<28.0 kg/m~2(OR=1.591),≥ 28.0 kg/m~2(OR=2.739)],location of hospital[Cangzhou(OR=1.431),Hengshui(OR=1.834),Tangshan(OR=1.408)],years of hyperlipidemia[>0-5 years(OR=3.399),>5-10 years(OR=4.451)],family history of hypertension(OR=1.225)were influencing factors of hypertension for male nurses(P<0.05). Age[>25-35 years old(OR=1.382),>35-45 years old(OR=4.125),>45-55 years old(OR=6.510),>55-65 years old(OR=5.616)],BMI[24.0-<28.0 kg/m~2(OR=1.749), ≥ 28.0 kg/m~2(OR=3.111)],department[paediatrics(OR=1.570),medical technology department(OR=1.779)],years of hyperlipidemia[>0-5 years(OR=2.863),>5-10 years(OR=3.713)],years of diabetes[>0-5 years(OR=3.126),>5-10 years(OR=2.947),>10 years(OR=9.743)],family history of hypertension(OR=1.243),menstrual condition[irregular(OR=1.358),menopause(OR=1.689)],pregnancy hypertension[no(OR=0.486),no history of pregnancy(OR=0.507)]were influencing factors of hypertension for female nurses(P<0.05). Conclusion The prevalence of hypertension was higher in male nurses than in female nurses. Age,BMI,years of hyperlipidemia,and a family history of hypertension are influencing factors of hypertension for both male and female nurses. Working at the pediatric or medical technology department,irregular menstruation,menopause,or gestational hypertension only affected the risk of hypertension in female nurses. These factors associated with hypertension can inform targeted prevention and control measures. In addition,the location of hospital was influencing factors of hypertension only for male nurses.更多还原