新冠疫情下上海远郊社区签约居民血脂异常现状调查

Investigation on the status of dyslipidaemia among contracted residents in Shanghai suburban communities during COVID-19 epidemic

目的通过收集和分析因2019新型冠状病毒疫情原因而居家不出的上海远郊社区的签约居民的血脂异常情况,为进一步开展社区全科工作提供意见和建议。方法通过HIS系统调阅2020年1月15日-4月24日间于上海市浦东新区凌桥社区卫生服务中心就诊且在中心或医联体上海第七人民医院进行生化检验的573例签约患者的数据,筛选出居家不出期间未增加调脂药物、未接受运动指导的血脂异常患者31例。比较居家不出前后,在第0周和第12周时总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及肝功能检测指标谷丙转氨酶(ALT)、谷草转氨酶(AST)和肾功能检测指标血肌酐(Scr)、尿素氮(BUN)水平。结果签约居民居家不出12周后,TG、TC、LDL-C水平[(3.057±1.837)、(5.236±1.141)、(1.824±0.353)mmol/L]高于0周时[(2.034±1.009)、(4.625±1.213)、(2.629±1.167)mmol/L],差异有统计学意义(均P<0.05);HDL-C、ALT、AST、Scr、BUN前后差异无统计学意义(均P>0.05)。结论居家不出影响血脂异常管理效果,因此,社区全科工作应关注签约居民中诸如居家不出的特殊人群;应引进新技术手段来发展"互联网+"慢病健康宣教工作;同时,急需培养"体医结合型、科普人才型"的复合型社区全科医生。

Objective By collecting and analysing situations of dyslipidaemia in contracted residents who were house-bound because of the COVID-19 epidemic in Shanghai suburban communities.Comments and suggestions were provided for further development of communities'general practice.Methods Data were retrieved through the HIS system from January 15 to April 24,2020.Thirty-one housebound patients with dyslipidaemia who did not increase lipid-lowering drugs and receive exercise direction during the housebound time were screened out of the 573 contracted patients who visi-ted the Lingqiao Community Health Service Center.Biochemical tests were performed in the Lingqiao Community Health Service Center and the Seventh People's Hospital of Shanghai.The urea nitrogen(BUN)levels of patients before and af-ter housebound were compared.The levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein choles-terol(LDL-C),high-density lipoprotein cholesterol(HDL-C),glutamic-pyruvic transaminase(ALT),glutamic-oxaloa-cetic transaminase(AST)and renal function test indicators serum creatinine(Scr)and urea nitrogen(BUN)of house-bound patients were compared between week 0 and week 12.Results After 12 weeks of housebound,the levels of TG,TC and LDL-C(3.057±1.837,5.236±1.141 and 1.824±0.353)were higher than those at week 0(2.034±1.009,4.625±1.213 and 2.629±1.167),with statistical significance(all P<0.05).However,the levels of HDL-C and liver and kidney function test indicators ALT,AST,Scr and BUN showed no significant difference before and after follow-up(all P>0.05).Conclusion Housebound affects the effect of management for patients with dyslipidaemia.Commu-nities'general practice should focus on special groups in contracted residents such as housebound people.In addition,new scientific and technological means should be introduced to gradually develop the"Internet+"chronic disease health education work.At the same time,the composite of general practitioners should integrate talents specialising on sports,medicine and popular science.