农村社区高血压人群钠盐摄入水平及限盐行为的影响因素

An analysis on factors influencing salt-restriction behavior of hypertension in rural communities

目的了解农村社区高血压人群钠盐摄入水平及限盐行为的影响因素。方法采用随机整群抽样方法,选取临海市小芝镇2个农村社区的200名高血压患者和高危人群,开展为期一年的限盐行为干预,并在干预前后分别进行基线和终末调查,内容包括钠盐与高血压病知识、3 d氯化钠(NaCl)摄入量调查和尿钠检测等;分析限盐行为与NaCl摄入量的相关性;采用多因素Logistic回归分析限盐行为的影响因素。结果 173名调查对象在终末调查时每日NaCl摄入量的中位数(四分位数间距)为6.72(5.18)g,主要来源为食盐4.74(3.36)g/d和酱油0.04(0.63)g/d;每日尿钠排出量为90.10(62.28)mmol/24 h。拥有限盐勺152人(87.86%),正在使用108人(71.05%),能正确使用53人(49.07%);限盐勺使用频率与NaCl摄入量,及正确使用限盐勺与24 h尿钠排出量均呈负相关(P<0.05);家庭年均收入水平高(OR=2.75,95%CI:1.16~6.53)、知晓每人每日6 g盐(OR=5.43,95%CI:1.22~24.07)、经常进食蔬菜(OR=9.35,95%CI:1.17~75.01)和主动采取控盐措施(OR=5.05,95%CI:1.19~21.45)的居民更倾向于使用限盐勺,饮酒(OR=0.13,95%CI:0.02~0.84)的居民不倾向于使用限盐勺。结论应针对NaCl摄入量高且不采取限盐行为的农村社区高血压人群开展钠盐知识健康教育,进一步推广限盐支持性工具的使用。

Objective To learn the salt intake level of residents with hypertension in rural community and the influencing factors of salt restriction behavior. Methods We used random cluster sampling method to extract two rural communities.A total of 200 residents with hypertension or high- risk of hypertension were selected as the subjects. We conducted general information questionnaire,hypertension knowledge,attitudes and behavior questionnaire,3- day salt intake survey and urine sodium detection to evaluate the level of sodium intake. We used multivariate logistic regression equation modeling to predict influencing factors of salt restriction behavior. Results After the completion of the investigation,M（ QR） for daily sodium intake of 173 cases in the intervention group was 6. 72（ 5. 18） g,and the main route were through the salt,monosodium glutamate,soy sauce,pickles. Daily 24 hours urinary sodium excretion amount was 90. 10（ 62. 28）mmol /24 h and 152 cases（ 87. 86%） of respondents had salt- restriction- spoon,and 108 cases（ 71. 05%） use the salt- restriction- spoon,but only 53 cases（ 49. 07%） used the spoon correctly. The frequency of spoon for salt restriction and sodium intake was negatively correlated（ P〈0. 05）,whether spoon for salt restriction was used correctly and 24- hour urinary sodium excretion was negatively correlated（ P〈0. 0 5）. By multivariate logistic regression analysis,those people who had high level of the average annual household income（ OR = 2. 75,95% CI： 1. 16- 6. 53）,identified 6 g of salt a day（ OR = 5. 43,95% CI： 1. 22- 24. 07）,regular consumption of vegetables（ OR = 9. 35,95% CI： 1. 16- 75. 01）and initiative to take measures to control salt（ OR = 5. 05,95% CI： 1. 19- 21. 45） were more likely to use salt-restricted spoons. Residents of drinking（ OR = 0. 13,95% CI： 0. 02- 0. 84） did not tend to use salt- restricted spoons.Conclusion For people with high NaCl intake and no restriction behavior,the level of health knowledge,especially the knowledge of sodium salt,should be improved and the good dietary habits including salt- limited support tools and correct methods should be promoted.