基于结构方程模型的云南农村60岁及以上人群常见慢性病患病现状及影响因素分析

Status quo of common chronic diseases and influencing factors analysis among population aged≥60 years old in rural areas of Yunnan Province based on structure equation model

目的探讨基于结构方程模型(SEM)的云南省农村60岁及以上人群5种常见慢性病[高血压、糖尿病、冠心病、卒中和慢性阻塞性肺疾病(COPD)]的患病现状及影响因素。方法采用多阶段分层随机抽样方法在云南省3个县6个乡18个村中抽取农村60岁及以上人群5004名老年人进行问卷调查和体格检查。采用SEM的最大似然法分析调查人群中慢性病患病数量的影响因素。结果共收回4833份有效问卷,调查人群中,高血压、糖尿病、冠心病、卒中和COPD的患病率分别为50.59%(2445/4833)、10.20%(493/4833)、5.61%(271/4833)、6.50%(314/4833)和5.50%(266/4833);慢性病患病数量为1、2、3、4、5种的患病率分别是43.41%(2098/4833)、13.49%(652/4833)、2.36%(114/4833)、0.14%(7/4833)、0.06%(3/4833)。SEM分析结果显示,慢性病家族史、社会经济地位(受教育水平、家庭财产和医疗服务可及性)、生活行为因素(吸烟、饮酒)和性别对慢性病患病数量起到直接和间接效应,其总路径系数分别为0.25、-0.12、0.22和0.02;体型、缺乏体力活动和睡眠质量对慢性病患病数量只有直接效应,其路径系数分别为0.24、0.08和-0.09;年龄和民族对慢性病患病数量只有间接效应,其路径系数为0.08和0.04。结论慢性病家族史、生活行为因素、体型和缺乏体力活动是60岁及以上人群5种慢性病患病数量的主要影响因素。

Objective To study the prevalence status quo and influencing factors of 5 kinds of common diseases[hypertension,diabetes,coronary heart disease(CHD),stroke and chronic obstructive pulmonary disease(COPD)]and influencing factors among the population aged≥60 years old in the rural areas of Yunnan Province based on the structure equation model(SEM).Methods The multi-stage stratified random sampling method was adopted to extract 5004 elderly people aged≥60 years old in 18 villages,6 towns and 3 counties of Yunnan Province.Then the questionnaire survey and physical examination were conducted.The maximum likelihood method of SEM was adopted to analyze and survey the influencing factors in the number of chronic diseases among surveyed population.Results Total 4833 effective questionnaires were recovered.The prevalence rates of hypertension,diabetes,CHD,stroke and COPD among the surveyed population were 50.59%(2445/4833),10.20%(493/4833),5.61%(271/4833),6.50%(314/4833)and 5.50%(266/4833)respectively.The prevalence rates in the respondents with 1,2,3,4,5 kinds of chronic diseases were 43.41%(2098/4833),13.49%(652/4833),2.36%(114/4833),0.14%(7/4833)and 0.06%(3/4833)respectively.The SEM analytical results indicated that the family history of chronic diseases,socioeconomic status(education level,household property and medical service accessibility),living behavior factors(smoking and drinking)and gender had the direct and indirect effects on the number of chronic diseases with the total path coefficients of 0.25,-0.12,0.22 and 0.02 respectively;the body type,lacking physical activity and sleep quality only had the direct effects on the number of chronic diseases,and their path coefficients were 0.24,0.08 and-0.09 respectively;the age and nationality only had the indirect effects on the number of chronic diseases,and their path coefficients were 0.08 and 0.04 respectively.Conclusion The family history of chronic diseases,life behavior factors,body type and lacking physical activity are the main influencing factors in five kinds of common chronic diseases among elderly people aged≥60 years old.