浙江省原发性高血压和2型糖尿病社区管理指标与重大慢性病早死概率的相关性分析

Analysis of correlation of community management index of essential hypertension and type 2 diabetes with probability of premature mortality caused by major non-communicable diseases in Zhejiang Province

目的:探索原发性高血压和2型糖尿病社区管理指标与重大慢性病早死概率的相关性。方法:从2016—2018年浙江省慢性病社区综合防控工作情况年度报表获取原发性高血压和2型糖尿病社区管理数据源,从浙江省慢性病信息管理系统获取各年度慢性病死亡数据,从浙江省公安机关人口报表获取各年度人口数据。描述2016—2018年浙江省原发性高血压、2型糖尿病社区管理情况和浙江省慢性病死亡情况,其中重大慢性病包括心血管疾病、恶性肿瘤、糖尿病和慢性呼吸系统疾病等。采用Spearman相关分析和线性回归模型进行原发性高血压和2型糖尿病社区管理与重大慢性病早死概率的相关性分析。结果:2016—2018年浙江省原发性高血压患者的规范管理例数、血压控制例数和规律用药例数分别由2016年的312.73万、281.15万和356.97万上升至2018年的335.90万、315.18万和401.06万;2型糖尿病患者的规范管理例数、血糖控制例数和规律用药例数分别由2016年的80.55万、68.75万和91.34万上升至2018年的91.26万、79.87万和106.48万。2016—2018年浙江省慢性病标化死亡率由2016年的403.07/10万降至2018年的380.07/10万,慢性病早死比例由2016年的28.39%降至2018年的26.90%。重大慢性病的死亡占全部慢性病死亡的比例由2016年的90.96%降至2018年的90.69%;早死概率由2016年的10.68%降至2018年9.67%。Spearman相关分析显示:血压控制和糖尿病患者规律用药与重大慢性病早死概率呈负相关(r值分别为-0.367和-0.392,P值分别为0.035和0.024)。线性回归模型分析显示:高血压控制例数和2型糖尿病规律用药每增加10万例,慢性病早死概率分别下降为0.47%(95%CI:0.39%,0.54%)和1.31%(95%CI:1.12%,1.50%)。结论:2016—2018年浙江省居民原发性高血压控制和2型糖尿病患者规律用药例数与重大慢性病早死概率呈负相关。

Objective To evaluate the correlation of community management index of essential hypertension and type 2 diabetes with the probability of premature mortality of major chronic diseases.Methods From 2016 to 2018,the management of essential hypertension and type 2 diabetes were obtained from annual report of comprehensive prevention and control of chronic diseases in communities of Zhejiang province.The death data of chronic diseases were obtained from Information Management System of Chronic Diseases of Zhejiang province and annual population data were obtained from Public Security Bureau of Zhejiang Province.The management of essential hypertension and type 2 diabetes in communities of Zhejiang Province from 2016 to 2018 was described.The death status of major chronic diseases,including cardiovascular diseases,malignant tumors,diabetes and chronic respiratory diseases,in the same period was also described.Spearman correlation analysis and linear regression model were used to explore the correlation of community management of essential hypertension and type 2 diabetes with the probability of premature mortality of major chronic diseases.Results The number of essential hypertension patients under standardized management,blood pressure control and regular medication increased from 3.1273,2.8115 and 3.5697 million in 2016 to 3.3559,3.1518 and 4.0106 million in 2018,respectively.The number of type 2 diabetes patients with standardized management,blood glucose control and regular medication increased from 0.8055,0.6875 and 0.9134 million in 2016 to 0.9126,0.7987 and 1.0648 million in 2018,respectively.The standardized mortality rate of chronic diseases decreased from 403.07/100000 in 2016 to 380.07/100000 in 2018.The proportion of premature deaths of chronic diseases decreased from 28.39%in 2016 to 26.90%in 2018.The proportion of deaths from major chronic diseases in all chronic diseases decreased from 90.96%in 2016 to 90.69%in 2018.The probability of premature mortality decreased from 10.68%in 2016 to 9.67%in 2018.The spearman correlation analysis showed that the blood pressure control and regular drug use were negatively correlated with the probability of premature death of major chronic diseases(r values were-0.367 and-0.392;P values were 0.035 and 0.024).According to the linear regression model analysis,with increase of 100000 of essential hypertension control cases or regular medication use cases of type 2 diabetes,the probability of premature death of major chronic diseases decreased by 0.47%(95%CI:0.39%,0.54%)or 1.31%(95%CI:1.12%,1.50%),respectively.Conclusion From 2016 to 2018,the community management of essential hypertension and type 2 diabetes was negatively correlated with probability of premature death of major chronic diseases in Zhejiang province.