云南省农村居民四种慢性病的流行现状及其对生命质量的影响研究

Prevalence of Four Major Chronic Diseases and Their Impact on Quality of Life among Rural Residents in Yunnan Province

目的调查云南省农村居民高血压、糖尿病、冠心病和脑卒中4种慢性病的流行现状,并分析其对生命质量的影响。方法 2015年1—9月,采用多阶段分层随机抽样方法,抽取云南省12个行政村符合纳入标准的农村居民5 040例作为调查对象,分别进行体格检查和一对一面访调查。问卷内容包括人口学特征(性别、年龄、文化程度、家庭人均年收入、婚姻情况)、肥胖情况(全身性肥胖、中心性肥胖)、生命质量〔采用健康调查简表(SF-36)评价,包括8个维度(生理功能、生理职能、躯体疼痛、总体健康、生命力、社会功能、情感职能、精神健康)得分和2个综合得分(躯体健康综合得分、精神健康综合得分)〕,高血压、糖尿病、冠心病、脑卒中患病情况;并采用多元线性回归分析农村居民生命质量的影响因素。结果共发放问卷5 040份,回收有效问卷4 979份,回收有效率为98.8%。4 979例农村居民中,高血压患者1 757例(35.3%),糖尿病患者491例(9.9%),冠心病患者191例(3.8%),脑卒中患者83例(1.7%),健康者2 911例(58.5%)。高血压患者生理功能、生理职能、躯体疼痛、总体健康、社会功能、情感职能得分及躯体健康综合得分、精神健康综合得分均低于健康人群(P<0.05);糖尿病患者生理功能、生理职能、躯体疼痛、总体健康、生命力、情感职能得分及躯体健康综合得分均低于健康人群(P<0.05);冠心病、脑卒中患者生理功能、生理职能、躯体疼痛、总体健康、生命力、社会功能、情感职能、精神健康得分及躯体健康综合得分、精神健康综合得分均低于健康人群(P<0.05)。性别、年龄、文化程度、家庭人均年收入、患高血压、患糖尿病、患冠心病、患脑卒中是农村居民躯体健康综合得分的影响因素(P<0.05);性别、文化程度、家庭人均年收入、肥胖、患冠心病、患脑卒中是农村居民精神健康综合得分的影响因素(P<0.05)。结论云南省农村居民4种慢性病中高血压患病率最高,其次是糖尿病和冠心病,且慢性病患者生命质量较健康人群明显下降,因此,需加强慢性病患者的疾病干预和健康管理,改善其生命质量。

Objective To study the prevalence of four chronic diseases（ hypertension,diabetes,coronary heart disease and stroke） in rural residents of Yunnan and analyze their impact on quality of life（ QOL） of the residents. Methods From January to September in 2015,a multistage stratified random sampling method was used to select 5 040 rural residents who met the inclusion criteria from 12 administrative villages in Yunnan province as the research objects. Physical examination and one- to- one interview questionnaire survey were carried out respectively. The questionnaire survey included the demographic characteristics（ gender,age, educational level, family income per capita, marital status）, obesity（ generalized obesity,central obesity） and quality of life（ SF- 36 scale was used to evaluate, the scores of 8 dimensions including physiological function,physiological role,bodily pain,general health,vitality,social function,emotional function and mental health,2comprehensive scores including comprehensive scores of physical health and mental health）, prevalence of the four chronic diseases; and multiple linear regression was used to analyze the influencing factors of quality of life of rural residents. Results A total of 5 040 questionnaires were sent out and 4 979 valid questionnaires were returned. The total effective response rate was98. 8%. Of the 4 979 residents,there were 1 757（ 35. 3%） with hypertension,491（ 9. 9%） with diabetes,191（ 3. 8%）with coronary artery disease,83（ 1. 7%） with stroke and 2 911（ 58. 5%） healthy people. The scores of physiological function,physiological role,bodily pain,general health,social function,emotional function,and the comprehensive scores of physical health and mental health of patients with hypertension were lower than those of healthy people（ P〈0.05）. The scores of physiological function,physiological role,physical pain,overall health,vitality,emotional function and comprehensive scores of physical health of diabetic patients were lower than those of healthy people（ P〈0.05）. The scores of physiological function,physiological role, physical pain, overall health, vitality, social function, emotional function and mental health and comprehensive scores of physical health and mental health of patients with coronary heart disease and stroke were lower than those of healthy people（ P〈0.05）. Gender,age,educational level,family income per capita,developing hypertension,diabetes mellitus,coronary heart disease and stroke were influencing factors of comprehensive scores of physical health of rural residents（ P〈0.05）. Gender,educational level,family income per capita,obesity,developing coronary heart disease and stroke were influencing factors of comprehensive scores of physical health of rural residents（ P〈0.05）. Conclusion The prevalence rate of hypertension is the highest,followed by diabetes mellitus and coronary heart disease among the four chronic diseases in rural residents in Yunnan province,and the quality of life of patients with chronic diseases significantly declines compared with that of the healthy people. Therefore,we need to strengthen the intervention and health management of patients with chronic diseases,and improve their quality of life.