论文部分内容阅读
探讨心血管病的社区人群综合性防治对农村人群心血管病危险因素的影响。方法 1991～1999年对北京郊区农村12万自然人群，按整群抽样的方法分为干预区和对照区，在干预区采取以健康教育和高血压防治为主的综合干预措施。于1991、1995和1999年分别采用随机抽样的方法分析干预区和对照区心血管病危险因素的变化，评价干预效果。研究的危险因素包括：收缩压、舒张压、体重指数、吸烟、饮酒、血清胆固醇、甘油三酯和高密度脂蛋白胆固醇。结果 1991～1999年，干预区人群收缩压、舒张压、吸烟率和饮酒率出现下降趋势，其中男性收缩压下降1.6mmHg(P＞0.05)，舒张压下降1.1 mmHg(P＞0.05)，吸烟率下降14.5％(P＜0.01)，饮酒率下降3.7％(P＞0.05)；女性收缩压下降4.8mmHg(P＜0.01)，舒张压下降3.2mmHg(P＜0.01)；对照区人群收缩压、舒张压和吸烟率也有小幅度下降。干预和对照社区人群体重指数、血清胆固醇和甘油三酯水平都有所上升，高密度脂蛋白胆固醇有所下降。1991～1999年，干预区人群多数危险因素有净下降。结论以健康教育为主的一级预防以及人群高血压筛查、管理、指导治疗等干预措施对降低群体血压水平和吸烟、饮酒率有一定效果，但体重指数和血脂的改变尚未达到预期的结果。“,”Objective To study the changes of risk factors of cardiovascular disease in the rural community population after intervention. Methods The Beijing Fangshan cardiovascular prevention program was a community-based comprehensive intervention study which was launched from 1991 and ended in 2000 in five communities including three as intervention communities (IC) and two as control communities (CC) in Fangshan, Beijing suburb. The intervention measures were focused on health education and hypertension control. The changes of risk factors of cardiovascular disease in IC and CC were analyzed using random sample in the year 1991, 1995 and 1999, respectively. The risk factors include systolic and diastolic blood pressure(SBP and DBP), body mass index(BMI), serum total cholesterol(TC), triglyceride(TG),high-density lipoprotein cholesterol(HDL), smoking, and drinking. Results From the year 1991 to 1999, the risk factors of cardiovascular disease such as SBP, DBP, smoking rate and drinking rate were reduced in the population of IC. For male in IC, the decline of SBP, DBP, smoking rate, and drinking rate were 1.6 mmHg, 1.1 mmHg, 14. 5% ( P ＜ 0. 01) and 3.7%, respectively. For female of IC, SBP and DBP declined 4.8 mmHg ( P＜0.01) and 3.2 mmHg ( P ＜0. 01), respectively. SBP, DBP and smoking rate in the population of CC had a little reduction while BMI, TC and TG increased in both IC and CC. During the period of 1991 to 1999, most cardiovascular risk factors in the population of IC had net reduction compared to that of CC. Conclusions Except for BMI and lipids, rural community intervention, as focused on health education and hypertension control, has resulted in the reduction of most risk factors of cardiovascular disease.