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目的了解夷陵区成年人高血压、糖尿病患病现状及其危险因素流行情况,为政府制定公共卫生政策、采取干预措施,做好高血压、糖尿病健康管理提供依据。方法于2014年10-12月在夷陵区12个乡镇(街道办事处)总人口520 261名居民中采取多阶段整群随机抽样方法,按总人口规模大小乘以5.2%比例抽样,随机抽取8个乡镇34个行政村,对夷陵山区2 598名18岁以上常住居民进行问卷调查和体格检查。用SPSS 19.0软件进行χ2检验,对高血压和糖尿病的影响因素用多因素非条件logistic回归分析。结果宜昌市夷陵区18岁以上人群高血压患病率为26.60%(标化率为24.39%),糖尿病患病率为9.85%(标化率为9.03%),超重、肥胖率分别为34.33%、6.46%,男性吸烟率为25.29%、饮酒率为23.71%,食用盐、油超标率分别为54.66%、53.50%,每周体力活动不足(<20 h/周)占36.64%,休闲性体育活动参与率为25.87%,有高血压家族史占34.88%,有糖尿病家族史占22.62%。不同年龄、文化程度、婚姻状况、职业、家庭月均收入、休闲性体育活动、每周体力活动时间、食盐量、食油量、体质指数(BMI)、是否患糖尿病、是否有高血压家族史人群的高血压患病率差异均有统计学意义(P<0.01),不同性别、年龄、文化程度、婚姻状况、职业、家庭月均收入、食盐量、食油量、水果摄入、BMI、是否患高血压、是否有高血压家族史与糖尿病家族史人群糖尿病患病率差异均有统计学意义(P<0.05,P<0.01)。多因素logistic回归分析结果显示,年龄、文化程度、婚姻、职业、体力活动、超重与肥胖、患糖尿病、高血压家族史是高血压的影响因素(OR值分别为4.603、11.338、0.505、2.960、0.625、0.689、2.857、1.508和1.480),性别、年龄、家庭月均收入、进食水果、超重与肥胖、患高血压、高血压家族史及糖尿病家族史是糖尿病发病的影响因素(OR值分别为1.431、2.320、3.900、0.546、1.531、1.786、1.610、1.539和2.251)。结论夷陵区18岁及以上人群高血压特别是糖尿病患病率高,影响因素多,应采取综合干预措施,降低高血压、糖尿病发病率,并提高高血压、糖尿病管理效果,提高居民健康水平。
Objective To understand the prevalence of hypertension and diabetes mellitus in adults and the prevalence of risk factors among adults in Yiling District, and to provide basis for the government to formulate public health policies, take interventions and do a good job of hypertension and diabetes health management. Methods From October to December 2014, a multistage cluster random sampling method was adopted among 520 261 residents of 12 townships (subdistrict offices) in Yiling District. Samples were taken according to the total population size multiplied by 5.2%, and randomly selected 34 administrative villages in 8 townships and 2 598 permanent residents over the age of 18 in Yiling Mountain area were surveyed and physically examined. The χ2 test was performed using SPSS 19.0 software, and the influencing factors on hypertension and diabetes were analyzed by multivariate non-conditional logistic regression analysis. Results The prevalence of hypertension in Yiling District of Yichang City was 26.60% (standardization rate was 24.39%), the prevalence of diabetes was 9.85% (standardized rate was 9.03%), the overweight and obesity rates were 34.33 % And 6.46% respectively. The male smoking rate was 25.29% and the drinking rate was 23.71%. The excessive rates of edible salt and oil were 54.66% and 53.50% respectively. The physical activity was less than 36.64% (<20 h / week) The participation rate of sports activities was 25.87%, family history of hypertension was 34.88%, family history of diabetes was 22.62%. Age, education level, marital status, occupation, family monthly income, recreational sports activities, weekly physical activity time, salt content, cooking oil amount, body mass index (BMI), whether or not suffering from diabetes, whether there is a family history of hypertension (P <0.01). There were significant differences in the prevalence of hypertension (P <0.01), gender, age, education level, marital status, occupation, family monthly income, salt intake, cooking oil intake, BMI, Hypertension, whether there is a family history of hypertension and family history of diabetes, diabetes prevalence differences were statistically significant (P <0.05, P <0.01). Multivariate logistic regression analysis showed that age, education, marriage, occupation, physical activity, overweight and obesity, diabetes and family history of hypertension were the influencing factors of hypertension (OR values were 4.603, 11.338, 0.505, 2.960, 0.625, 0.689, 2.857, 1.508 and 1.480). The factors affecting the incidence of diabetes were gender, age, monthly household income, fruit consumption, overweight and obesity, hypertension, family history of hypertension and family history of diabetes 1.320, 3.900, 0.546, 1.531, 1.786, 1.610, 1.539 and 2.251). Conclusion The prevalence of hypertension, especially diabetes, is very high in 18-year-olds and above in Yiling District, and there are many influencing factors. Comprehensive interventions should be taken to reduce the incidence of hypertension and diabetes, improve the management of hypertension and diabetes, and improve the health of residents .