本文選題：高血壓 + 農村地區(qū)　； 參考：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的旨在對安徽省若干個農村地區(qū)老年人高血壓、超重和肥胖的流行狀況進行描述,并探索BMI及腰圍與血壓的關聯(lián)。為更好的反映超重、肥胖及中心性肥胖狀況對于高血壓患病的作用,同時為制定農村地區(qū)老年人群高血壓、超重及肥胖狀況的預防控制策略和措施提供科學依據。方法根據安徽省地理位置采用多階段整群抽樣方法,保證樣本代表性及抽樣的可行性原則。第一階段,選取宿州、蚌埠、馬鞍山、銅陵、池州五個地級市作為代表,在選取的5個市中再各自抽取1個或2個縣/區(qū),第二階段在抽取的縣/區(qū)中隨機抽取若干個行政村,對抽取的所有行政村中的4234名年齡在60歲及以上的老年人進行問卷調查及體格檢查。問卷調查及體格測量內容包括:一般情況調查(性別、年齡、文化程度、生活方式等)、體格測量(身高、體重、腰圍及血壓的測量)及慢性病患病情況。采用c2檢驗、t檢驗和方差分析進行單因素檢驗,均數間的兩兩比較采用Bonferroni檢驗,采用二分類Logistic回歸分析和多重線性回歸對高血壓的潛在影響因素進行分析。結果調查對象中的男性為1861人(44.0%),女性為2372人(56.0%),男女性之比為1:1.27。調查對象身高、體重和腰圍的平均值分別為(157.23±8.56)cm、(57.24±10.39)kg和(84.73±12.35)cm,體質指數平均值為(23.11±3.74)kg/m2,收縮壓和舒張壓的平均值分別為(133.20±20.17)mmHg和(80.12±11.32)mmHg。安徽省農村老年人高血壓患病率為57.0%,血壓正常高值檢出率為14.6%,超重檢出率為27.7%,肥胖檢出率為9.6%。男性腹型肥胖者的比例低于女性,差異有統(tǒng)計學意義(57.3%vs.63.0%,P0.01)。二分類Logistic回歸分析結果顯示,校正性別、年齡、文化程度、婚姻狀況、吸煙狀況及飲酒狀況后,以正常BMI/正常腰圍組為參照組,正常BMI/腹型肥胖、非正常BMI/正常腰圍、非正常BMI/腹型肥胖皆為患高血壓病的危險因素,OR值(95%CI)分別為1.40(1.20-1.64),2.06(1.44-2.95),2.60(2.23-3.03)。安徽省農村地區(qū)老年人平均動脈壓的多重線性回歸分析結果顯示,在校正了性別、年齡、文化程度、婚姻狀況、飲酒狀況和吸煙狀況后,模型1中BMI的標準偏回歸系數為0.243,模型2中腰圍的標準偏回歸系數為0.205,BMI值和腰圍值對平均動脈壓都有影響。結論安徽省農村地區(qū)老年人高血壓患病率較高,超重、肥胖率呈快速上升趨勢,兩者之間關系密切。因此,評估老年人中超重、肥胖、腹型肥胖對高血壓患病狀況的影響,具有重要的公共衛(wèi)生學意義。老年人的BMI對于平均動脈壓的影響略大于腰圍對于平均動脈壓的影響,關注并控制農村老年人的BMI是預防農村老年人高血壓的重要且有效的措施。
[Abstract]:Objective to describe the prevalence of hypertension, overweight and obesity among the elderly in some rural areas of Anhui Province, and to explore the relationship between BMI, waist circumference and blood pressure. In order to better reflect the role of overweight, obesity and central obesity on the prevalence of hypertension, and provide scientific basis for the formulation of prevention and control strategies and measures of hypertension, overweight and obesity among the elderly in rural areas. Methods according to the geographical location of Anhui Province, multi-stage cluster sampling method was adopted to ensure the representativeness of the sample and the feasibility principle of sampling. In the first stage, five prefecture-level cities, including Suzhou, Bengbu, Ma'anshan, Tongling and Chizhou, were selected as representatives, and one or two counties / districts were selected from each of the five selected cities. In the second stage, a number of administrative villages were randomly selected from the selected counties and districts. A questionnaire survey and physical examination were conducted among 4234 people aged 60 and above in all administrative villages. Questionnaires and physical measurements include general survey (sex, age, education, lifestyle, etc.), physical measurement (height, weight, waist circumference and blood pressure) and chronic disease. Single factor test was carried out by using C _ 2 test and variance analysis, Bonferroni test was used to compare the mean numbers, and potential influencing factors of hypertension were analyzed by two-classification Logistic regression analysis and multiple linear regression. Results there were 1861 males and 2372 females, and the ratio of male to female was 1: 1.27. The average height, weight and waist circumference of the subjects were 57.24 鹵10.39)kg and 84.73 鹵12.35 cm respectively, the average body mass index was 23.11 鹵3.74 kg 路m ~ (2), the mean systolic and diastolic blood pressure were 133.20 鹵20.17)mmHg and 80.12 鹵11.32 mm / g, respectively. The prevalence rate of hypertension, normal blood pressure, overweight and obesity were 57.0, 14.6, 27.7and 9.6 respectively. The proportion of male patients with abdominal obesity was lower than that of females, and the difference was statistically significant (57.3vs.63.0). The results of Logistic regression analysis showed that after adjusting sex, age, education, marital status, smoking status and drinking status, normal BMI/ normal waist circumference group was used as reference group, normal BMI/ abdominal obesity group, abnormal BMI/ normal waist circumference group. The odds ratio (OR) of abnormal BMI/ abdominal obesity was 1.40V 1.20-1.64% 2.064-2.95% 2.60,2.23-3.03g respectively. Multiple linear regression analysis of the mean arterial pressure of the elderly in rural areas of Anhui Province showed that after sex, age, education, marital status, drinking status and smoking status were adjusted, The standard partial regression coefficient of BMI in model 1 was 0.243, and the standard partial regression coefficient of waist circumference in model 2 was 0.205. Conclusion the prevalence of hypertension in the elderly in rural areas of Anhui Province is high, the prevalence of overweight and obesity is rising rapidly, and there is a close relationship between the two. Therefore, it has important public health significance to evaluate the influence of overweight, obesity and abdominal obesity on the prevalence of hypertension in the elderly. The influence of BMI on mean arterial pressure in the elderly is slightly greater than that of waist circumference on the mean arterial pressure. It is an important and effective measure to pay attention to and control the BMI of the rural elderly to prevent hypertension in the rural elderly.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R544.1;R589.2

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