上海市中老年残疾人慢性病共病现状及相关因素的多重对应分析

Multiple correspondence analysis of the status and related factors of chronic disease comorbidity in middle-aged and elderly residents with disabilities in Shanghai

目的 了解上海市45岁及以上中老年残疾人慢性病共病现状及关联因素,为残疾人健康管理政策的制定提供依据。方法 收集2018年2—12月同济大学附属养志康复医院6 530名45岁及以上残疾人员信息和健康体检数据。采用SPSS 20.0统计软件进行t检验、χ^(2)检验或Fisher精确检验。选用R 4.0.5软件venn包绘制韦恩图描述慢性病共病情况,采用多重对应分析探索中老年残疾人慢性病共病的相关因素。结果 6 530名残疾人中,7种慢性病中检出率最高的是脂肪肝(3 253人,49.8%);共病检出率为51.7%(3 379人),占比最高的共病组合是高血压和脂肪肝组合(442人,6.8%)。多重对应分析结果显示,男性、肢体残疾、65岁及以上、超重与共病检出数紧密关联;肢体残疾与高血压、糖尿病、冠心病存在关联。结论 上海市中老年残疾人慢性病共病现状严峻,男性、老年、肢体残疾、超重影响慢性病共病情况,对残疾人慢性病管理需推行精准管理模式。

Objective To understand the status and related factors of chronic disease comorbidity among middle-aged and elderly people with disabilities in Shanghai,and provide the evidence for healthcare management policies in people with disabilities.Methods A total of the information of 6 530 middle-aged and elderly people with disabilities and their physical examination information from February to December 2018 in Shanghai Yangzhi Rehabilitation Hospital were collected.The t test,χ^(2)test and Fisher exact test were used to analyze the data.The used software was SPSS 20.0.The venn package of R 4.0.5 software was used to draw the venn diagram to describe the situation of chronic disease comorbidity.Multiple correspondence analysis was used to explore the related factors of chronic disease comorbidity of middle-aged and elderly people with disabilities.Results The disease with the highest detected rate in seven chronic diseases among 6 530 people with disabilities was fatty liver (3 253 cases,49.8%),and the detected rate of comorbidity was 51.7%(3 379 cases),and the highest proportion of comorbidity was the combination of hypertension and fatty liver(442 cases,6.8%).Multiple correspondence analysis showed that male,physical disability,≥65 years old,overweight were closely associated with the number of comorbidity;the physical disability was associated with hypertension,diabetes,and coronary heart disease.Conclusion The comorbidity of chronic diseases in middle-aged and elderly people with disabilities in Shanghai is serious.The factors of male,elderly age,physical disability and overweight should be considered reasonably to implement a precise management mode for reducing the prevalence of chronic disease comorbidity.