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目的评估慢性病综合防控示范区建设效果,为推进示范区建设提供决策依据。方法利用2013年11月至2014年5月开展的慢性病及危险因素调查数据,比较示范区与非示范区成年人吸烟、饮酒、膳食摄入、运动等慢性病相关的行为指标以及高血压与糖尿病患病率、知晓率、管理率与治疗率、血脂异常患病率等指标。应用SPSS 19.0软件进行χ~2检验和多因素logistic回归分析。结果示范区与非示范区分别调查了18岁及以上居民2 398人与2 996人,示范区居民吸烟率(27.06%)、红肉摄入过多的比例(67.51%)均低于非示范区(分别为30.24%、73.11%),差异均有统计学意义(χ~2值分别为6.55与19.99,P<0.01)。示范区有休闲性身体活动(17.60%)、1周内身体活动充分的比例(91.78%)高于非示范区(分别为14.95%、86.18%),差异均有统计学意义(χ~2值分别为6.89、41.63,P<0.01)。示范区居民高血压患病率(40.66%)、血脂异常的比例(17.82%)低于非示范区居民(分别为46.53%、21.17%),差异均有统计学意义(χ~2值分别为18.63、9.41,P<0.01)。示范区高血压知晓率(50.46%)、管理率(63.62%)、治疗率(77.64%)均高于非示范区(分别为39.89%、47.30%和70.63%),差异均有统计学意义(χ~2值分别为26.02、28.07和6.65,P<0.01)。示范区糖尿病知晓率(37.89%)与管理率(66.90%)均高于非示范区(分别为28.63%、45.45%),差异均有统计学意义(χ~2值分别为8.18和12.94,P<0.01)。多因素logistic回归分析结果显示,示范区建设对于现在吸烟(OR=1.57,95%CI:1.32~1.88)、红肉摄入过多(OR=1.16,95%CI:1.03~1.32)、蔬菜水果摄入不足(OR=0.61,95%CI:0.54~0.68)、1周内身体活动充分(OR=1.63,95%CI:1.36~1.95)、高血压知晓情况(OR=1.45,95%CI:1.23~1.72)、高血压管理情况(OR=1.89,95%CI:1.47~2.43)、高血压治疗情况(OR=1.52,95%CI:1.15~2.02)、糖尿病知晓情况(OR=1.39,95%CI:1.04~1.87)、糖尿病管理情况(OR=2.51,95%CI:1.52~4.14)、高血压患病情况(OR=0.85,95%CI:0.75~0.95)、血脂异常患病情况(OR=0.81,95%CI:0.71~0.94)是独立的影响因素。结论慢性病综合防控示范区建设可以明显促进居民健康行为的形成,降低主要慢性病患病率。
Objective To evaluate the effect of comprehensive prevention and control of chronic disease demonstration area and provide decision-making basis for promoting the construction of demonstration area. Methods According to the survey data of chronic diseases and risk factors from November 2013 to May 2014, the behavioral indexes related to chronic diseases such as smoking, alcohol consumption, dietary intake and exercise in demonstration area and non-demonstration area were compared between hypertension and diabetes Disease rate, awareness rate, management rate and treatment rate, the prevalence of dyslipidemia and other indicators. SPSS19.0 software was used forχ ~ 2 test and multivariate logistic regression analysis. Results There were 2 398 and 2 996 residents aged 18 and over in the demonstration and non-demonstration areas respectively. The smoking rate of residents in demonstration area (27.06%) and the excessive intake of red meat (67.51%) were all lower than those of non-demonstration (30.24% and 73.11% respectively), the difference was statistically significant (χ ~ 2 values were 6.55 and 19.99, P <0.01). The demonstration area had recreational physical activities (17.60%), and the percentage of physical activity within one week (91.78%) was higher than that of non-demonstration areas (14.95% and 86.18% respectively) (χ ~ 2 Respectively, 6.89,41.63, P <0.01). The prevalence rate of hypertension (40.66%) and dyslipidemia (17.82%) in residents in demonstration area were lower than those in non-demonstration area residents (46.53% and 21.17% respectively) (χ ~ 2 values were 18.63, 9.41, P <0.01). The awareness rate of hypertension (50.46%), management rate (63.62%) and treatment rate (77.64%) in the demonstration area were higher than those in non-demonstration area (39.89%, 47.30% and 70.63% respectively) χ ~ 2 values were 26.02,28.07 and 6.65 respectively, P <0.01). The awareness rate (37.89%) and management rate (66.90%) of diabetes in demonstration area were higher than those in non-demonstration area (28.63% and 45.45% respectively), with significant differences (χ ~ 2 values of 8.18 and 12.94, P <0.01). Multivariate logistic regression analysis showed that smoking in the demonstration area (OR = 1.57, 95% CI: 1.32-1.88), excessive intake of red meat (OR = 1.16, 95% CI: 1.03-1.32) (OR = 1.63, 95% CI: 1.36-1.95), knowledge of hypertension (OR = 1.45, 95% CI: (OR = 1.89, 95% CI: 1.47-2.43), hypertension treatment (OR = 1.52, 95% CI: 1.15-2.02), and the prevalence of diabetes (OR = 1.39,95 % CI: 1.04-1.87), management of diabetes (OR = 2.51, 95% CI: 1.52-4.14), prevalence of hypertension (OR = 0.85, 95% CI: 0.75-0.95), prevalence of dyslipidemia OR = 0.81, 95% CI: 0.71 ~ 0.94) were independent influencing factors. Conclusion The construction of integrated prevention and control of chronic diseases can significantly promote the formation of residents’ health behaviors and reduce the prevalence of major chronic diseases.