某综合医院心血管病研究所医务人员心血管病危险因素的调查分析

Investigation and analysis of cardiovascular risk factors among medical staff of cardiovascular institute in a general hospital

目的 探讨某综合医院心血管病研究所医务人员心血管病危险因素的现状,重视这类人群心血管病危险因素的预防和健康管理。方法 采用便利抽样方法,对心血管专科医务人员的心血管病相关危险因素进行问卷调查。主要内容包括一般人口学资料、工作生活方式、心血管疾病既往史,焦虑自评量表(self-rating anxiety scale,SAS)和知觉压力量表(perceived stress scale,PSS)等。结果 研究对象工作科室涵盖心内科、心外科、心脏重症监护室、心脏手术室、导管室及心脏辅助检查科室,年龄为(35.43±9.17)岁,其中男性167人(46.5%),女性192人(53.5%);医生201人(56.0%),护士151人(42.1%),技师7人(1.9%)。心血管病危险因素占比由高到低分别为缺乏运动264人(73.5%),压力大109人(30.4%),血糖异常100人(27.9%),吸烟29人(8.1%),高血压22人(6.1%),血脂异常21人(5.8%),心血管病史18人(5.0%),肥胖17人(4.7%)。SAS评分原始分为(54.14±3.28)分,轻度焦虑3人(0.8%),中度焦虑240人(66.9%),重度焦虑116人(32.3%)。PSS评分为(37.92±7.45)分,压力较低48人(13.4%),压力适中202人(56.3%),压力较高108人(30.1%),压力非常高1人(0.3%)。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评估年龄和体质量指数(body mass index,BMI)对血糖、血脂和血压异常的预测效果。糖代谢异常的人群中,年龄预测效果的曲线下面积(area under the curve,AUC)为0.751(P<0.001),截断值为32岁;BMI的AUC为0.646(P=0.025),截断值为23.6 kg/m^(2)。血脂代谢异常的人群中,年龄预测效果的AUC为0.710(P<0.001),截断值为36岁;BMI的AUC为0.671(P<0.001),截断值为23.4 kg/m^(2)。高血压人群中,年龄预测效果的AUC为0.784(P<0.001),截断值为37岁;BMI的AUC值为0.728(P<0.001),截断值为21.3 kg/m^(2)。结论 心血管专科医务人员心血管病危险因素复杂,缺乏运动、压力大、血糖异常等占比较大,应引起高度关注,亟需采取有效措施,提高心血管专科医务人员的健康状况。

Objectives To investigate the risk factors of cardiovascular diseases among medical staff in the institute of cardiovascular diseases of a general hospital,and to pay attention to the comprehensive prevention and treatment of cardiovascular diseases in this population. Methods A questionnaire survey was conducted on cardiovascular related risk factors among cardiovascular medical staff by convenience sampling method. The main contents include general demographic data,working and life style,past history of cardiovascular diseases,self-rating anxiety scale(SAS)and perceived stress scale(PSS). Results A total of 359 cardiovascular specialists,including cardiology department,cardiac surgery department,cardiac intensive care unit,cardiac operating room,catheterization room and cardiac auxiliary examination department,with an average age of(35.43±9.17)years,including 167 males(46.5%)and 192 females(53.5%),participated in the study. There were 201 doctors(56.0%),151 nurses(42.1%)and 7 technicians(1.9%).The frequency of cardiovascular risk factors in descending order were as follows:264 cases(73.5%)of physical inactivity,109 cases(30.4%)of stress,100 cases(27.9%)of abnormal blood glucose,29 cases(8.1%)of smoking,22 cases(6.1%)of hypertension,21 cases(5.8%)of dyslipidemia,18 cases(5.0%)of cardiovascular history,and 17 cases(4.7%)of obesity. The original SAS score was 54.14±3.28,with 3 cases(0.8%)of mild anxiety,240 cases(66.9%)of moderate anxiety,and 116 cases(32.3%)of severe anxiety. The PSS score was 37.92±7.45,with 48 cases(13.4%)of mild stress,202 cases(56.3%)of moderate stress,108 cases(30.1%)of severe stress,and 1 case(0.3%)of very severe stress. Receiver operating characteristic curve(ROC)was used to evaluate the predictive effects of age and body mass index(BMI)on abnormal blood glucose,dyslipidemia and hypertension. In the population with abnormal glucose metabolism,the area under the curve(AUC)value of age prediction effect was 0.751(P<0.001),the cut-off value was 32 years old,and the AUC value of BMI was 0.646(P=0.025),the cut-off value was 23.6 kg/m^(2). In the population with dyslipidemia,the AUC value of age prediction was 0.710(P<0.001),the cut-off value was 36 years old,and the AUC value of BMI was 0.671(P<0.001),the cut-off value was 23.4 kg/m^(2). In population with hypertension,the AUC value of age prediction effect was 0.784(P<0.001),the cut-off value was 37 years old,and the AUC value of BMI was 0.728(P<0.001),the cut-off value was 21.3 kg/m^(2). Conclusions Cardiovascular risk factors of medical staff in cardiovascular specialty are complex,physical inactivity,hypertension,abnormal blood glucose,etc.,which should be paid high attention to,and effective measures are urgently needed to improve the health status of medical staff in cardiovascular specialty.