上海市浦东新区某社区老年人群体检结果及5年随访分析

Healthy examination results and 5-year follow-up analysis of the elderly in a community of Pudong New Area,Shanghai

目的分析65岁及以上老年人健康体检结果及慢性病发生率的动态变化,为制定区域内老年人健康管理方案提供参考。方法选取上海市浦东新区某社区2014年1月—2019年12月连续每年参加健康体检的年龄≥65岁老年人2846例为研究对象,并排除恶性肿瘤及严重的血液系统疾病和肝、肾疾病者。所有研究对象采集标本前1 d保持清淡饮食,在采集标本前24 h不进行剧烈运动,并在采集标本前禁食12 h后于清晨空腹采血。由专业体检医师测量身高、体重和血压,计算BMI,采集一般资料、生化指标及腹部超声检查资料后进行对比分析。结果与2014年相比,2846例老年人2019年血压、血糖、糖化血红蛋白、低密度脂蛋白、甘油三酯、总胆固醇及血尿酸水平均明显升高(均P<0.05)。此外,2846例老年人2019年高血压、高甘油三酯血症、高胆固醇血症及高尿酸血症检出率(33.1%、28.3%、24.2%、23.8%、28.4%)均较2014年(22.6%、18.1%、15.1%、14.9%、19.2%)显著增加(均P<0.05)。结论浦东新区社区65岁及以上老年人群代谢指标水平及高血压、糖尿病、高脂血症和高尿酸血症的检出率呈现出上升的动态变化,提示需对社区老年人群高血压和糖脂代谢异常进行早期干预和健康宣教。

Objective To investigate dynamic changes in the results of healthy examination and incidence of chronic diseases in the elderly aged 65 and then to provide a reference for the formulation of regional health management plan for the elderly.Methods A total of 2846 elderly people over 65 in a community of Pudong New Area in Shanghai who continued to participate in healthy examination from January 2014 to December 2019 were selected as the research subjects.Subjects with malignant tumours,serious blood system diseases and liver and kidney diseases were excluded.All subjects maintained a bland diet one day before sample collection,did not undergo strenuous exercise 24 hours before sample collection and fasted for 12 hours before sample collection.Blood samples were obtained while their stomachs were empty in the morning.Height,weight,body mass index and blood pressure were measured by professional physical examination doctors,and general data were collected.Biochemical indexes and abdominal ultrasound examination data were collected and analysed.Results The blood pressure,blood glucose,glycosylated haemoglobin,low-density lipoprotein,triglyceride,total cholesterol and blood uric acid levels in the elderly people in 2019 significantly increased relative to those in 2014(all P<0.05).In addition,the detection rates of hypertension,diabetes,hyperlipidaemia,hyperuricaemia and hyperuricemia in 2846 elderly people in 2019(33.1%,28.3%,24.2%,23.8%,28.4%)were significantly higher than those in 2014(22.6%,18.1%,15.1%,14.9%,19.2%,all P<0.05).Conclusion The levels of metabolic indexes and the detection rates of hypertension,diabetes,hyperlipidaemia and hyperuricaemia in the community aged over 65 in Pudong New Area show an upward dynamic change.These results suggeste that early intervention and health education for hypertension and abnormal glucose and lipid metabolism should be carried out in community elderly.