中国人群2002年慢性非传染性疾病二级预防措施的执行情况

Implementation of second prevention measures on Chronic Diseases in Chinese, 2002

目的描述2002年调查样本人群中肿瘤、心脑血管疾病二级预防措施(血压、血脂、乳腺和宫颈细胞的定期检测)情况。方法使用8个指标,利用2002年普查人口进行加权计算不同类别人群高血压、高血脂对健康的影响,对目标人群定期每年测量血压、血脂及临床乳腺检查和宫颈细胞涂片检查的情况。结果调查人群对高血压、高血脂对健康影响的正确认识比例很低,仅占22%和5%。虽然知道应该定期测量血压、血脂,但实际得到测量的比例低于人们的认识。对乳腺癌筛查的目标人群应该是50岁以上人群,但是不同年龄女性乳腺临床检查的比例显示,50岁以上女性临床乳腺检查的比例低于年轻女性。结果还显示教育水平高、白领阶层、东部地区人群接受这些筛查试验的比例高于教育水平低、蓝领阶层以及在西部地区的人群。同时是否享受医疗保险,以及享受的医疗保险类别都与调查人群得到的二级预防服务的比例有关。结论筛查是重要的二级预防措施,在降低疾病的严重性和并发症方面有重要的作用,通过对样本人群接受四类筛查的现状描述,表明除血压测量外,接受筛查的比例都不高,不同地区、教育、职业和享受医疗保险的类别的人群,在接受筛查的比例有明显的差异。其次调查还显示有关筛查的目标人群定位不清,需要改进筛查政策,以指导筛查工作的执行。

Objective To describe the implementation of secondary prevention measures （blood pressure measure, test of blood lipid, and screening test for breast cancer and cervix uteri） on chronic diseases in different populations. Methods The indicators on proportion of receiving blood pressure measurement, tests on blood lipid, screening of breast cancer and cervix uteri in research samples, as well as awareness of the risk of hypertension and hyper lipid were calculated based on results from IBRFS questionnaire by weight on age structures from 2000 census. Results 22% and 5% of people under research understood the risk of hypertension and hyper lipid on their health. In addition, proportion of receiving these screening tests in sample populations were low. Secondly, the main target population including females over 50 years old but the proportion of screening breast cancer among those females over 50 years old was lower than that in females over 25 years old. Besides educational, occupational and geographic factors, the types of medical insurance for people also were important factors affecting the proportion of receiving screening tests. Conclusion Screening tests were important second prevention measures for reducing severity of the diseases. Except blood pressure tests among people over 35 years old, proportions of receiving other screening tests were very low. There were significant differences of receiving these screening tests in people by education occupation, geographic areas and types of medical insurance. In addition, the policy of screening was not clear on target orientation. It is necessary for developing guideline of screening to guide the screening programs.