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目的:比较三峡库区移民人群与非移民人群、移民人群与安置地人群及移民人群移民前后生活方式、生存环境及心血管事件发生情况的变化,评价迁移对移民的心血管健康的影响。方法:于2005-07-18/21选择在重庆市云阳县开展此次流行病学现况调查。采用整群抽样的方法对重庆市云阳县库区拟移居人群(南溪镇)及非移居人群(栖霞镇)各50人进行调查。该人群平均年龄(53±13)岁,男性占30%,女性占70%,67%为45岁及以上中老年人。受教育程度为未上学和小学的占77%。采用面对面的访问,填写问卷,体检,入户调查,生活环境的调查等方式了解库区居民的生活环境、生活方式及与心血管疾病相关的危险因素情况。内容包括:①问卷调查:包括一般情况、生活环境、生活方式、既往疾病史、家族史等。②体检:测身高、体质量、腰围、臀围及血压。③抽空腹静脉血3mL:测血清总胆固醇、血清三酰甘油、血清高密度脂蛋白胆固醇及血糖。结果:共调查100人,均获得完整资料,全部进入结果分析。①两组人群除了舒张压的差别有显著性意义(P=0.0014)外,年龄、收缩压、血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、血糖、性别、婚姻状况、受教育情况的差异均无显著性意义(P>0.05)。②移居组人均年收入2000元,对照组为1000元,差异具有显著性意义(P<0.05)。③移居组和对照组男性吸烟率(69%,43%)、饮酒率(13%,36%)差异均有显著性意义(P<0.05);饮食习惯差异无显著性意义(P>0.05)。④居民房屋建筑材料,73%为全砖及水泥结构,有独立厨房者占85%,55%的家庭使用自来水。58%的家庭以煤炭为做饭的主要燃料,厕所为蹲坑式的占75%。⑤移居组和对照组平均收缩压与舒张压分别为(109.67±14.13),(71.00±9.08);(115.33±20.80),(79.33±11.20)mmHg(1mmHg=0.133kPa);高血压检出率为19%,血脂异常检出率37%;不同类型的血脂异常检出率为:高胆固醇血症5%,高三酰甘油血症32%,低高密度脂蛋白血症11%;糖尿病检出率为6%;超体质量率为22%。移居组各项指标检出率仅高三酰甘油血症高于对照组(42%,22%,P<0.05)。结论:能找到合适的对象(库区移民),当地移民局与卫生局均支持、合作,拟定目标方案具有良好的可行性;被调查对象高血压、血脂异常及糖尿病检出率较高,开展三峡库区居民生活方式变化与心血管健康关系的研究是十分必要的。
Objective: To compare the changes of lifestyle, living environment and cardiovascular events before and after the immigrant and immigrant groups and immigrant groups in the Three Gorges Reservoir Area, and to evaluate the impact of migration on the cardiovascular health of immigrants. Methods: The survey of epidemiological status in Yunyang County of Chongqing Municipality was conducted at 2005-07-18 / 21. A cluster sampling method was used to survey 50 people each of migrant population (Nanxi Town) and non-migrant population (Qixia Town) in Yunyang County of Chongqing Municipality. The average age of the population (53 ± 13) years, 30% of men, women 70%, 67% of 45 years of age and older. Educational attainment is 77% for non-attendance and primary school. Face-to-face visits, questionnaires, physical examinations, household surveys, and living environment surveys were used to understand the living environment, life style and risk factors associated with cardiovascular diseases in the reservoir area. The contents include: ① Questionnaire: Including the general situation, living environment, lifestyle, past disease history, family history and so on. ② physical examination: height measurement, body mass, waist circumference, hip circumference and blood pressure. ③ pumping fasting venous blood 3mL: serum total cholesterol, serum triglyceride, serum high-density lipoprotein cholesterol and blood glucose. Results: A total of 100 people were surveyed, all obtained complete information and all entered the result analysis. ① There were significant differences in diastolic blood pressure between the two groups (P = 0.0014), age, systolic blood pressure, serum total cholesterol, triglyceride, high density lipoprotein cholesterol, blood glucose, sex, marital status, education status There was no significant difference (P> 0.05). ② The average annual income of migrant group was 2,000 yuan, while that of the control group was 1,000 yuan, the difference was significant (P <0.05). (3) There were significant differences in smoking prevalence (69%, 43%) and drinking rate (13%, 36%) among immigrant group and control group (P <0.05) . ④ Resident housing construction materials, 73% of all brick and cement structure, with independent kitchen accounted for 85%, 55% of households using tap water. 58% of households use coal as the main fuel for cooking, and toilets account for 75% of squatting pitches. (5) The average systolic and diastolic blood pressure of the migrating group and the control group were (109.67 ± 14.13), (71.00 ± 9.08), (115.33 ± 20.80) and (79.33 ± 11.20) mmHg respectively (1mmHg = 0.133kPa) Was 19%, the detection rate of dyslipidemia was 37%. The detection rate of different types of dyslipidemia was 5% of hypercholesterolemia, 32% of hypertriglyceridemia and 11% of low-density lipoproteinemia. The rate was 6%; the super body mass rate was 22%. The detection rate of each index of migrant group was only higher than that of the control group (42%, 22%, P <0.05). Conclusion: It is feasible to find a suitable target (immigrants from the reservoir area), both local immigration authorities and health bureau to support, cooperate and formulate the target plan. Hypertension, dyslipidemia and diabetes mellitus were higher in the investigated subjects The study on the relationship between lifestyle changes and cardiovascular health in the Three Gorges Reservoir area is very necessary.