2017—2022年河南省某肿瘤医院体检人群健康状态及其恶化的影响因素

Health Status and the Factors Affecting the Deterioration of the Medical Examination Population in a Cancer Hospital in Henan Province from 2017 to 2022

目的探索体检人群健康状态及其恶化的影响因素。方法基于河南省某肿瘤医院体检中心2017—2022年的个体健康体检横断面数据,将体检项目分为4类:实验室检查(28项)、影像学检查(21项)、肿瘤标志物筛查(14项)和血压,并按类别分别计算个体的异常项目个数和异常率。使用限制性立方样条拟合体重指数(BMI)与各类异常体检结果的关系曲线。使用线性回归或logistic回归模型,探索各类异常体检结果的影响因素,并基于重复体检人群数据分析首次体检时年龄、性别、BMI和体检结果与末次体检结果恶化的关联。结果本研究共纳入5844例体检个体作为研究对象,其中重复体检人群316例。高龄、男性、BMI异常均是异常体检结果的影响因素,且体检结果异常程度随着BMI的升高而增加。首次体检时超重会增加末次体检中肿瘤标志物筛查结果恶化的风险(OR=2.62,95%CI:1.29~5.32),而首次体检实验室检查(OR=0.50,95%CI:0.41~0.62)、影像学检查(OR=0.64,95%CI:0.56~0.74)和血压测量(OR=0.12,95%CI:0.07~0.23)异常结果的检出可降低末次体检中上述指标恶化的风险。结论BMI异常会增加个体异常健康状态和恶化的风险。异常体检结果的及时检出有助于之后个体健康状态的改善。

Objective To explore risk factors of health examination results and worsening health status.Methods Based on cross-sectional data of population once received health examinations in a cancer hospital in Henan Province during 2017 to 2022.The physical examination items were divided into four categories:laboratory test(28 items),imaging test(21 items),tumor marker test(14 items)and measuring blood pressure,and the number of abnormal items and abnormal rate of individual were calculated according to the category.The relationship curves between body mass index(BMI)and abnormal physical examination results were fitted with restricted cubic splines.Linear regression or logistic regression model was used to explore the influencing factors of various abnormal physical examination results,and the association between age,sex,body mass index and physical examination results at the first physical examination and the deterioration of the results at the last physical examination was analyzed based on the data of the repeated physical examination population.Results A total of 5844 physical examination individuals were included in this study,including 316 repeated physical examination groups.Elderly,male,unhealthy BMI were risk factors of abnormal test results,and the risk could be higher as BMI increased.The first health examination with the overweight result could increase the risk of worsening tumor marker result of the last time(OR=2.62,95%CI:1.29-5.32),while successfully detected the initial abnormal results of laboratory(OR=0.50,95%CI:0.41-0.62),imaging examination(OR=0.64,95%CI:0.56-0.74)and blood pressure tests(OR=0.12,95%CI:0.07-0.23)could decrease the risk of worsening results of those tests at the last time.Conclusion Unhealthy BMI will increase the risk of abnormal and worsening health status.Timely detecting the abnormal test results will help improve later health status.