三级及社区医院医护人员缺血性心血管疾病10年发病风险评估分析及比较

Analysis and comparison of the 10-years’risk assessment of ischemic cardiovascular disease among the medical staff in tertiary and community hospitals

目的调查广西柳州市三级医院及社区医院医护人员心血管疾病及危险因素的流行情况,分析并比较两者未来10年缺血性心血管病(ICVD)的发病风险。方法选取在广西柳州市某医院进行体检的年龄>35岁三级医院及社区医院医护人员2423例。对受检者进行问卷调查、体格及生化检查,对其中35~59岁人群采用"国人ICVD 10年发病危险度评估表"评估10年ICVD发病风险。结果三级医院≥55岁年龄构成多于社区医院,而40~44岁,45~49岁的占比少于社区医院(P<0.001)。三级医院女性医护人员多于社区医院(P<0.01)。三级医院医护人员的体质量、BMI、收缩压、舒张压、TC、FBG及10年患病危险度水平,高胆固醇血症及高血压患病率均高于社区人员(P<0.001)。三级医院35~39岁,40~44岁,45~49岁,50~54岁及≥55岁的高血压、高胆固醇血症及10年ICVD发病风险均高于社区医院(P<0.001)。45~49岁年龄段三级医院女性医护人员的高血压及高胆固醇血症患病率高于社区医院(P<0.05)。三级医院50~54岁年龄段极低危风险人群占比低于社区医院(P<0.001),同时,性别比较差异有统计学意义(P<0.05)。而≥55岁年龄段极低危风险人群三级医院和社区医院性别构成比较差异有统计学意义(P<0.001)。在低危,中危,高危和极高危分组中,三级医院在各年龄段的绝对发病人数均高于社区人员,但差异无统计学意义。结论广西柳州市三级医院医护心血管危险因素患病率高,35~59岁人群10年ICVD发病风险较大,应加强对危险因素的干预。

Objective To investigate the prevalence of cardiovascular diseases and risk factors among the medical staff in the tertiary and community hospitals in Liuzhou,Guangxi,and to analyze and compare the 10-years’risk of ischemic cardiovascular disease(ICVD).Methods 2423 doctors and nurses were selected from a hospital in Liuzhou City,Guangxi.Questionnaire survey,physical examination and biochemical examination were carried out for the subjects,among them,the 10-years’risk of ICVD was assessed by"10-year risk assessment of ICVD in China".Results The age composition of tertiary hospitals over 55 years old was more than that of community hospitals,while that of 40-44 years old and 45-49 years old was less than that of community hospitals(P<0.001).The number of female medical staff in tertiary hospitals was higher than that in community hospitals(P<0.01).The body weight,BMI,systolic blood pressure,diastolic blood pressure,TC,FBG and 10-year risk level,hypercholesterolemia and hypertension of the medical staff in the tertiary hospital were higher than those in the community(P<0.001).The risk of hypertension,hypercholesterolemia and 10-year ICVD in tertiary hospitals aged 35-39,40-44,45-49,50-54 and≥55 years old was higher than that in community hospitals(P<0.001).The prevalence of hypertension and hypercholesterolemia of female medical staff in the third level hospital in the 45-49 age group was higher than that in community hospital(P<0.05).The proportion of extremely low-risk population in the age group of 50-54 years old in the tertiary hospital was lower than that in the comparative community hospital(P<0.001),and there was gender difference(P<0.05).There was a significant difference in gender composition between tertiary hospitals and community hospitals in the very low-risk groups of≥55 years old(P<0.001).In the groups of low risk,medium risk,high risk and high risk,the absolute incidence of tertiary hospitals in all age groups was higher than that of community personnel,but there was no significant statistical significance.Conclusion The prevalence of cardiovascular risk factors for tertiary hospitals in Liuzhou City,Guangxi is high especially in people aged 35-59 years.The intervention of risk factors should be strengthened.