烟台市3个区老年人健身运动状况与常见5种慢性疾病的流行病学调查

Epidemiological study on the status of physical exercises and five common chronic diseases among aged people living in three districts of Yantai city

目的:了解参加健身运动老年人高血压、冠心病、糖尿病、脑卒中、恶性肿瘤等5种慢性疾病的患病情况。方法:采用随机抽样的现况调查方法,于2004-07/08随机抽取烟台市芝罘区、福山区、莱山区的老年居民1500人作为调查对象。采用自行设计的统一调查问卷对老年居民进行调查,问卷内容包括运动情况,高血压、冠心病、糖尿病、脑卒中、恶性肿瘤等5种慢性疾病患病情况。慢性疾病诊断标准:高血压以1999年WHO的定义和分类标准,将收缩压≥140mmHg或舒张压≥90mmHg(1mmHg=0.133kPa)以及有高血压病史且近两周内服降压药者均列为患高血压;其他疾病均以县级及以上医院的诊断为准。患1种及以上慢性病视为患病。运动情况包括开始运动的年龄、主要运动方式、运动频率及每次运动时间等。运动频率分为偶尔运动且无规律、每周运动1～3次、每周运动3次以上。每次运动时间分为<20min,20～30min,>30min。将所调查人群分为运动组和非运动组,其中既往无运动史或偶尔运动且无规律为非运动组;每周运动1-3次或每周运动3次以上,持续5年以上者为运动组。结果:发出调查表1500份,收回合格问卷1428份,有效率95.20%。运动组1013人,非运动组415人,有规律健身运动参与率70.94%(1013/1428)。5种慢性疾病总患病人数602人,总患病率42.16%(602/1428)。①运动组5种慢性疾病的总患病率为41.56%(421/1013),非运动组为43.6%(181/415)。两组无差异。其中高血压的患病率运动组显著低于非运动组(29.32%,34.70%,χ2=3.99,P<0.05),而两组冠心病、糖尿病、脑卒中、恶性肿瘤4种慢性病的患病率相近。②随着年龄的增长,参与健身的人数逐渐增加,30岁前仅有7.50%(76/1013)的人开始参与健身运动,79.07%(801/1013)的人是在40岁以后才参与健身运动的,35.74%(362/1013)的人是在60岁后开始参与健身运动的。参与健身运动的年龄越晚,慢性疾病患病率越高(28.95%～48.07%,χ2=16.85P<0.01)。每周运动1-3次的人群慢性疾病患病率显著高于每周运动3次以上者(47.70%,35.55%,χ2=15.41P<0.01)。每次运动<20min者患病率最高达53.80%。而每次运动20～30min与每次运动>30min间无统计学差异(χ2=0.53P>0.05)。多数老年人选择了步行和传统体育类项目,但不同运动方式间的患病率无差异。结论:①开始健身运动的年龄影响老年个体慢性疾病的患病情况。②有较高频率的运动者可在一定程度上降低老年期慢性疾病的发生。③5种慢性疾病中,高血压的患病与个体的运动行为有关。

AIM： To investigate the prevalences of 5 chronic diseases of hypertension, coronary heart disease, diabetes mellitus, stroke and cancer in aged people, who participate in exercises or not. METHODS： Between Ju.ly and August 2004, 1 500 aged residents in the Zhifu, Fushan and Laishan urban districts of Yantaicity were randomly selected, and were investigated with the self-desigend questionnaire, the contents consisted of physical exercises status, the prevalenees of the 5 chronic diseases of hypertension, coronary heart disease, diabetes mellitus, stroke and cancer. The diagnostic standards of chronic diseases were as follows： According to the standard set by WHO in 1999 that systolic pressure ≥ 140 mm Hg or diastolic pressure ≥90 mm Hg （1 mm Hg=0.133 kPa）, those with history of hypertension and took drugs for decreasing blood pressure within two weeks were diagnosed to have hypertension; other diseases were according to the diagnosis of hospital of county and above. Having one and more chronic diseases was taken as a patient. Physical exercises status included the age of starting to do exercises, main exercise way, frequency and duration. Exercises frequency was divided into occasionally and irregularly, 1 to 3 times every week, more than 3 times every week. Duration was divided into less than 20 minutes, 20 to 30 minutes, more than 30 minutes. All the subjects were divided into exercise group （doing exercise at least once every week and had lasted for 5 years and more） and non-exercise group （without exercise history or doing exercise occasionally）. RESULTS： Totally 1 500 questionnaires were sent out, 1 428 qualified ones were collected back, and the effective rate was 95.20%. There were 1 013 and 415 cases in the exercise group and non-exercise group, respectively, the participating rate of regular exercise was 70.94% （1 013/1 428）. ①A total of 602 cases suffered from one or more of the 5 chronic diseases, and the total prevalence rate was 42.16% （602/1 428）. The total preva- lence rate of 5 chronic diseases was 41,56% （421/1 013） in the exercise group and 43.6% （181/415） in the non-exercise group, and there was no difference between the two groups. The prevalence rate of hypertension was significantly lower in the exercise group than in the non-exercise group （29.32%, 34.70%, X^2=3.99, P 〈 0.05）, but the rates of coronary heart disease, diabetes mellitus, stroke and cancer were close. ②The number of people who participated in exercise increased gradually with age. Only 7.50% （76/1 013） of the subjects started to do exercise before 30 years old, 79.07% （801/1 013） started after 40 years old, and 35.74% （362/1 013） started after 60 years old. The later the exercises started, the higher the prevalence of the chronic diseases （28.95% to 48.07%, X^2=16.85, P 〈 0.01）. ③The prevalence rate was significantly higher in the subjects, who participated in exercises for 1 to 3 times every week than in those, who partici pated in exercises for more than 3 times （47.70%, 35.55%, X^2=15.41, P 〈 0.01）. The prevalence rate was the highest （53.80%） in the subjects who exercised for less than 20 minutes each time, and there was insignificant difference between those exercised for 20 to 30 minutes each time and more than 30 minutes （ X^2=0.53, P 〉 0.05）. Most of the aged people selected walking and traditional physical exercises, the prevalence rate among different exercise ways was not significance. CONCLUSION： ①The age of starting to do exercises influences the prevalence rate of chronic diseases in aged people. ②Higher exercise frequency may lower the incidence of chronic diseases in aged people. ③Of the5 chronic diseases, the prevalence of hypertension is related to individual exercises behavior.