健康管理降低功能社区人群心血管病危险因素的研究

Health management reduces risk factors of cardiovascular diseases in community residents

目的研究健康管理对功能社区人群心血管病危险因素的影响。方法选取在我院健康管理中心做体检的一个功能社区共208名，随机分为对照组（n=104）和健康管理组（n=104），于入组当时和研究结束后分别测量血糖、血脂、血压等指标，并进行心血管病危险因素问卷调奄。对照组给以体检及问卷评估结果和建议，管理组应用签约式健康管理模式。随访1年观察心血管病危险因素的变化。应用SPSS13．0软件包进行数据统计分析，计数资料采用x2检验，计量资料采用t检验。结果两组基线数据比较差异无统计学意义。通过1年时间的健康管理，健康管理组研究后的10年缺血性心血管病发病绝对危险、危险因素个数、对个人健康状况的满意率、人均年请病假天数、日均蔬菜摄入量、日均体力活动时间、血压等指标均较研究前改善，差异有统计学意义（P均〈0．05），对照组变化差异无统计学意义（P均〉0．05）。健康管理组研究后的10年缺血性心血管病发病绝对危险、危险因素个数、年请病假天数[（0．8±0．4）、172，118d（人均1．13d）]显著低于同期对照组[（1．3±0，5）、283，264d，（人均2．54d）]，差异有统计学意义（P均〈0．05）。健康管理组研究后的对个人健康状况的满意度、蔬菜日均摄入量、日均体力活动时间[83．7％（87／104），520．5g，1．2h]显著改善于同期对照组[52．9％（55／104），348．3g，0．3h]，差异有统计学意义（P均〈0．05）。结论应用签约式健康管理模式可以降低功能社区人群缺血性心血管病发病绝对危险。

Objective To investigate the effects of health management on risk factors of cardiovascular diseases in community residents. Methods A total of 208 adults from one single community who visited our health check-up center were randomly assigned to the control group （receiving routine consuhation,n = 104） and health management group （receiving health management intervention,n = 104）. At 1-year follow-up, fasting blood glucose （ FBG ） , lipid profiles, and blood pressure （ BP ） were measured and risk factors of cardiovascular were surveyed, t or X2 test was used for data analysis. Results No difference of clinical data was found between the two groups at baseline. Follow-up results indicated that absolute risk of cardiovascular diseases, number of risk factors, health satisfaction, sick leave, daily vegetables intake and physical exercise, and BP were significantly improved in the health management group. Ten-year absolute risk of cardiovascular diseases （ 0. 8 ± 0.4 vs 1.3±0. 5 ） , number of risk factors （ 172 vs 283 ） , and sick leave per year （ 118 d vs 264 d） were significantly decreased in the health management group when compared to the control group （ all P 〈 0. 05 ） . Furthermore, health satisfaction （ 83.7% （ 87/104 ） vs 52.9% （55/104）） ,and daily vegetables intake （520. 5 g vs 348. 3 g） and physical exercise （1.2 h vs 0. 3 h） were significantly improved in the health management group （ all P 〈 0. 05 ）. Conclusion Health management may be effective in decreasing risk factors of cardiovascular diseases in community residents.