社区老年人高尿酸血症相关因素分析及知信行模式干预研究

Analysis of the related factors of hyperuricemia in the elderly in the community and the intervention effect of knowledge,belief and practice model

目的探讨本市社区老年人高尿酸血症(HUA)相关因素分析及知信行模式的干预效果。方法于2021年11月至2022年6月对我市青浦区盈浦社区3021名老年人进行流行病学调查,观察老年人群HUA发生率,通过单因素和多因素分析影响HUA发生率的风险因素。将通过流行病学调查的患者采用随机数字表法分为对照组和研究组,对照组给予一般健康指导,研究组给予知信行模式干预,观察2组患者干预前后血尿酸水平和健康行为合格率。结果本研究3021例受试者中,共663例检测符合HUA标准,HUA发生率21.95%。HUA和非HUA患者年龄、性别、文化程度、BMI、吸烟、饮酒、喜食动物内脏、喜食海鲜类、喜食红肉、喜食甜食、饮食习惯、运动情况、收缩压(SBP)、空腹血糖、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)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血肌酐(Scr)相比较差异均有统计学意义(P<0.05),HUA和非HUA患者DBP差异无统计学意义(P>0.05)。多因素Logistic分析,结果显示,年龄≥75岁、男性、体质指数(BMI)≥28 kg/m^(2)、饮酒(有害、危险)、抽烟(现在吸烟)、饮食习惯(异常、有害)、TG异常、SBP异常、空腹血糖异常、Scr异常是影响HUA的风险因素(P<0.05),经常运动是HUA的保护性因素(P<0.05)。2组患者干预后血尿酸水平均较干预前降低(P<0.05),研究组干预后血尿酸水平低于对照组(P<0.05)。干预后研究组患者健康行为合格率均高于对照组(P<0.05)。结论明确影响HUA患病率的因素,给予知信行模式干预,有助于本市社区老年人群HUA的控制。

Objective To study the related factors of hyperuricemia(HUA)among the elderly in the community of our city and the intervention effect of the knowledge,belief and practice mode.Methods From November 2021 to June 2022,an epidemiological survey was conducted among 3021 elderly people in 12 communities in our city to observe the incidence of HUA in the elderly population.The risk factors affecting the incidence of HUA were analyzed by single-factor and multi-factor analysis.The patients who passed the epidemiological survey were divided into the control group and the research group by random number table method.The control group was given general health guidance,and the research group was given the intervention of knowledge,belief and practice mode.The blood uric acid level and the qualified rate of health behavior before and after the intervention were observed in the two groups.Results Among the 3021 subjects in this study,663 cases met the HUA standard,and the incidence of HUA was 21.95%.The age,sex,education level,body mass index(BMI),smoking,drinking,eating animal viscera,eating seafood,eating red meat,eating sweets,eating habits,exercise,systolic blood pressure(SBP),fasting blood glucose,total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),ALT,AST,serum creatinine(Scr)of patients with HUA and non-HUA were statistically significant(P<0.05),while diastolic blood pressure(DBP)of patients with HUA and non-HUA was not statistically significant(P>0.05).Multivariate Logistic analysis showed that age≥75,male,BMI≥28 kg/m^(2),drinking(harmful,dangerous),smoking(smoking now),eating habits(abnormal,harmful),abnormal TG,abnormal SBP,abnormal fasting blood glucose,and abnormal Scr were risk factors affecting HUA(P<0.05),and regular exercise was a protective factor for HUA(P<0.05).The level of serum uric acid in the two groups after the intervention was significantly lower than that before the intervention(P<0.05).The level of serum uric acid in the study group was lower than that in the control group after intervention(P<0.05).After the intervention,the eligible rate of health behavior in the study group was significantly higher than that in the control group(P<0.05).Conclusion Identifying the factors that affect the incidence rate of HUA and giving the intervention of the knowledge,trust and practice mode will help to control the elderly in the community of our city.