北京市社区无社会保障老年女性居民健康状况分析

Health Status of Elderly Female Residents without Social Insurance in Beijing

目的了解2009—2012年北京市社区无社会保障老年女性居民躯体健康指标变化趋势,为在该人群中开展健康管理服务,提高其健康水平提供参考依据。方法分别于2009—2012年在北京市海淀区永定路街道选取60岁以上无社会保障老年女性居民,其中2009年为518名,2010年为455名,2011年为449名,2012年为504名。收集调查对象健康体检资料,躯体健康指标来自于北京市海淀区统一的＂无社会保障老年人体检表＂,包括年龄、腰围、收缩压、舒张压、脂肪肝、糖尿病、空腹血糖受损（IFG）、超重、肥胖、肝囊肿、肾囊肿、胆囊结石、眼动脉硬化和代谢综合征等。结果 2009—2012年,无社会保障老年女性居民脂肪肝、糖尿病、超重、肝囊肿、肾囊肿、胆囊结石、眼动脉硬化患病率比较,差异无统计学意义（P〉0.05）。2009—2012年,无社会保障老年女性居民年龄、腰围、收缩压、舒张压比较,差异有统计学意义（P〈0.05）;高血压、IFG、肥胖、代谢综合征患病率呈下降趋势（P〈0.05）。将调查对象按照年龄分为60~64岁,65~69岁,70~74岁和〉74岁;2009—2012年,高血压发生率在60~64岁、65~69岁、70~74岁中呈下降趋势（P〈0.05）,IFG患病率在60~64岁、70~74岁、〉74岁中呈下降趋势（P〈0.05）,肝囊肿患病率在70~74岁中呈下降趋势（P〈0.05）,胆囊结石患病率在〉74岁中呈下降趋势（P〈0.05）,代谢综合征患病率在65~69岁、70~74岁中呈下降趋势（P〈0.05）。将调查对象按照体质指数（BMI）分为体质量偏低、体质量正常、超重和肥胖;2009—2012年,脂肪肝患病率在体质量正常和超重人群中呈上升趋势（P〈0.05）,高血压患病率在体质量偏低和超重人群中呈下降趋势（P〈0.05）,IFG、眼动脉硬化患病率在体质量正常和超重人群中呈下降趋势（P〈0.05）,代谢综合征患病率在肥胖人群中呈下降趋势（P〈0.05）。结论北京市无社会保障老年女性居民腰围呈现逐年增大趋势,中心性肥胖患病率逐年增高;但超重、肥胖、脂肪肝、高血压、糖尿病、IFG、代谢综合征患病率呈现总体下降趋势;考虑可能与健康体检发现问题后采取一定的健康干预措施有关。但是,该人群慢性疾病防控形势仍然比较严峻,建议加强健康管理干预措施。

Objective To investigate the change trend of physical health indicators of elderly female residents without social insurance in Beijing from 2009 to 2012,to provide a basis for health management services for them and improve their health levels. Methods From 2009 to 2012, in Haidian District of Beijing, over- 60- year- old female residents without social insurance（ 518 residents in the year of 2009,455 in 2010,449 in 2011,504 in 2012） were enrolled. This stusy collected their physical examination information, physical health indicators including age, waist circumference（ WC）, systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,fatty liver（ FL）,diabetes,impaired fasting glucose（ IFG）,overweight,obesity,liver cysts（ LC）, renal cysts（ RC）, gallstones（ GS）, eye atherosclerosis（ EA）, metabolic syndrome（ MS）,etc. Results There was no significant difference in prevalence of FL,diabetes,overweight,LC,RC,GS,EA between the years of 2009,2010,2011,2012 in elderly females without social insurance（ P〈0. 05）,there was in age,WC,SBP,DBP（ P〈0. 05）; the prevalence of hypertension,IFG,obesity,MS was on a declining curve（ P〈0. 05）. The residents were divided,according age,into groups A（ 60- 64 years old）,B（ 65- 69 years old）,C（ 70- 74 years old）,D（ over 70 years old）. The prevalence of hypertension decreased in groups A,B,C（ P〈0. 05）,that of IFG in groups A,C,D（ P〈0. 05）,that of LC in group C（ P〈0. 05）,that of GS in group D（ P〈0. 05）,that of MS in groups B,C（ P〈0. 05）. The residents were divided, according to BMI, into groups a（ with low BM）, b（ with normal BM）, c（ overweight）, d（ obesity）. The prevalence of FL increased in groups b,c（ P〈0. 05）,that of hypertension decreased in groups a,c（ P〈0. 05）,that of IFG,EA decreased in groups a,c（ P〈0. 05）,that of SM decreased in group d（ P〈0. 05）. Conclusion In elderly females without social insurance,WC is on a rising curve,the prevalence of central obesity increases year by year,but that of overweight,obesity,FL,hypertension,diabetes,IFG,SM is generally on a declining curve,which may be related to the health interventions after physical examinations. However,the situation of chronic disease prevention and control remains grim in these people. Health management intervention is proposed to be strengthened.