Analysis of Perinatal Outcomes of Twin Pregnancy in a Referral Hospital for High Risk

Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.

Risk factors of morbidity after pulmonary resection for lung cancer in patients older than 70 years

Objective This study is to analyse the clinical feature and risk factors of morbidity after pulmonary resection for lung cancer in patients older than 70 years. Methods The clinical records of 222 patients older than 70 years who had undergone pulmonary resection for their lung cancer were reviewed. The patients were divided into 3 groups,group I including the patients who had

ApoE基因多态性与高水平Hcy的协同作用对妊娠高血压的影响

目的为探究载脂蛋白E(ApoE)基因多态性与同型半胱氨酸(Hcy)的协同作用对妊娠高血压发病的影响。方法选取2021年1月至2021年12月新疆维吾尔自治区人民医院收治的200例妊娠期高血压孕妇作为研究组,同期非妊娠高血压孕妇200例作为对照组,检测两组孕妇ApoE基因多态性以及Hcy水平。结果研究组蛋白尿、水肿、胎儿生长受限、羊水过少的发生率均显著高于对照组(χ^(2)值介于10.751~34.783之间,P<0.01),且血中Hcy水平显著高于对照组(t=3.210,P<0.05)。研究组ε2ε3、ε3ε3基因型频率以及ε2、ε3等位基因频率均显著低于对照组,ε3ε4、ε4ε4基因型频率以及ε4等位基因频率均显著高于对照组(χ^(2)值介于4.624~32.172之间,P<0.05),ε2ε2、ε2ε4基因型频率略高于对照组但无显著性差异(χ^(2)值分别为1.309、0.069,P>0.05)。研究组E3、E4 AopE表型孕妇的Hcy水平均显著高于对照组(t值分别为4.009、2.609,P<0.05),且研究组E4表型孕妇的Hcy水平显著高于E2、E3(F值为4.118,P<0.05)。E4表型中研究组孕妇的高Hcy比例显著高于对照组(χ^(2)=4.650,P<0.05),而E2、E3表型中两组孕妇的高Hcy比例均无显著性差异(χ^(2)值分别为3.678、3.432,P>0.05)。结论ApoE基因多态性和高水平Hcy在妊娠期高血压疾病发病中存在协同作用,ApoE基因ε4等位基因的存在与高Hcy水平之间的相互作用会增加妊娠期高血压疾病发生的风险。

阻塞性睡眠呼吸暂停综合征患者糖代谢情况分析

目的分析男性阻塞性睡眠呼吸暂停综合征(OSAS)患者糖代谢情况,探究OSAS患者糖代谢异常的影响因素。方法连续选取2020年4—12月就诊于新疆维吾尔自治区人民医院高血压诊疗研究中心的男性患者224例,纳入人群均完成多导睡眠呼吸监测、糖耐量-胰岛素释放试验。根据呼吸暂停低通气指数(AHI)分为无OSAS组(59例)、轻度OSAS组(55例)、中度OSAS组(54例)、重度OSAS组(56例)。结果筛查出OSAS患者165例,OSAS组患者血糖异常患病率高于无OSAS组患者,差异有统计学意义(P<0.05)。四组间糖化血红蛋白及各时段血糖水平差异均有统计学意义(P<0.05);重度OSAS组患者糖化血红蛋白水平高于其余各组,差异有统计学意义(P<0.05),重度OSAS组患者空腹、0.5 h、1 h、2 h、3 h血糖水平高于无OSAS组患者,差异有统计学意义(P<0.05),重度OSAS组患者3 h血糖高于轻度OSAS组、2 h血糖高于中度OSAS组,差异有统计学意义(P<0.05)。无、轻度OSAS患者Matsuda指数高于中、重度OSAS患者,HOMA-IR低于中、重度OSAS患者,差异均有统计学意义(P<0.05);无OSAS患者葡萄糖处置指数高于其他各组患者,差异均有统计学意义(P<0.05)。logistic回归发现在校正相关因素后AHI、年龄、颈围和腹围为OSAS患者糖代谢异常的危险因素(P<0.05)。结论本研究结果显示男性OSAS患者合并糖代谢异常的患病率及血糖水平相关参数明显升高,这可能与AHI、年龄、颈围及腹围等危险因素有关。

社会网络视域下2型糖尿病管理研究进展

从糖尿病管理理论框架、社会网络特征及其主要评估工具、社会网络视域下的糖尿病管理(社会网络与糖尿病发病风险,并发症,预防及照护方法)等方面进行综述,为有效管理2型糖尿病提供参考。

肌少症不同分级与10年动脉粥样硬化性心血管病发病风险的相关性研究

目的:探究肌少症不同分级与10年动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)发病风险的相关性,为肌少症不同时期干预降低ASCVD发生风险提供依据。方法:研究对象取自2021年1月—2022年6月在北京市中关村医院完成“65岁及以上老年人体检项目”的1072例老年人,其中男性408例,女性664人例。对受试者进行信息采集、体格检查、生化检测、身体成分测试和功能体适能测试。根据握力、5次起坐试验时间和四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)综合判定肌少症分级,将研究对象分为肌少症可能组、肌少症前期组、肌少症组和对照组。比较四组受试者的临床特点,并采用二元logistic回归分析肌少症不同分级与10年ASCVD发病风险之间的关系。结果:本研究肌少症患病率为10.6%,肌少症可能和肌少症前期检出率分别为16.1%和15.1%。男性肌少症前期[OR:95%Cl=3.63(1.03—12.78),P=0.04]和肌少症组[OR:95%Cl=8.90(1.15—68.86),P=0.04]与ASCVD 10年发病高风险相关,女性肌少症组[OR:95%Cl=5.05(1.49—17.13),P=0.009]与ASCVD 10年发病高风险明显相关。结论:男、女肌少症患者和男性肌肉质量下降人群的10年ASCVD发病风险较高,且肌少症严重程度和ASCVD发病风险正相关,这对于早期预防心血管疾病具有重要意义。

Risk assessment in patients undergoing liver resection

BACKGROUND:Liver resection is still a risky procedure with high morbidity and mortality.It is significant to predict the morbidity and mortality with some models after liver resection.DATA SOURCES:The MEDLINE/PubMed,Web of Science,Google Scholar,and Cochrane Library databases were searched using the terms "hepatectomy" and "risk assessment" for relevant studies before August 2012.Papers published in English were included.RESULTS:Thirty-four original papers were included finally.Some models,such as MELD,APACHE II,E-PASS,or POSSUM,widely used in other populations,are useful to predict the morbidity and mortality after liver resection.Some special models for liver resection are used to predict outcomes after liver resection,such as mortality,liver dysfunction,transfusion,or acute renal failure.However,there is no good scoring system to predict or classify surgical complications because of shortage of internal or external validation.CONCLUSION:It is important to validate the models for the major complications after liver resection with further internal or external databases.

Maternal Risk Factors and Short Term Outcome of Prematurity: A Descriptive Study at a Secondary Care Hospital

Background: Approximately 15 million babies are born premature (before 37 weeks of gestation) and 1 million babies die due to prematurity complications every year. Less is known about risk factors of prematurity in middle and low-income countries. The prevalence of prematurity ranges from 5% - 18%. Objective: To determine the prevalence of premature births and to assess the rate of survival, along with the morbidity, among preterm newborns. Furthermore, to document our experience with different gestational age groups of preterm births;and to analyze the association among these strata and their clinical outcomes. Study Design: A descriptive study. Place and Duration of Study: The Aga Khan Maternal and Childcare Centre Hyderabad, Pakistan, from 1st January 2017 to 31st December 2018. Methodology: All pregnant women registered at the obstetric clinic before 24 weeks of gestation having at least three subsequent visits at the same clinic were included in the study. The women who were lost to follow up before completing three visits were excluded from the study. All un-booked women were also excluded from the study. Demographic profile was recorded including maternal age, parity, no of visits at the clinic, gestational age, mode of delivery, birth weight and pregnancy outcome. Newborns were subsequently followed at nursery or well-baby till discharge. Further subgroups were made for gestational age to assess the frequency of various morbidities in each group. Results: One thousand and ninety-one (1091) women were included in the study period that fulfilled the inclusion criteria. Two pregnancies were terminated before 24 weeks due to major congenital malformations. The prevalence of prematurity was recorded as 13.4% (146/1089). Perinatal mortality rate (no of stillbirths plus the number of early neonatal death/1000 live birth) was 17 (15.6/1000 live births) out of them, 12 were still births and 5 were early neonatal death. Out of the total preterm babies born, 59.5% (87/146) were admitted to the nursery. In the study group (2%/3146) were extreme preterm, while 7.5% were severe preterm (11/146). Moderate preterm was 11.6% (17/146) and the majority were late preterm accounting for 78.7% (115/146). Though the incidence of birth asphyxia were noted more in late preterm babies i.e. 10 as the number of these babies are also high in our study but the overall percentage was low (8.7%) as compared with the babies of extreme prematurity (100%) and moderate late prematurity (23.5%) respectively. In pregnancy outcome, 12 were still births in which six (50%) were in the late preterm group. Total of 17 newborns suffered from birth asphyxia in which ten newborns (58.8%) were in late preterm group. Overall, it was noted that the decreasing gestational age was directly correlated to morbidity and mortality. Conclusion: Among the different strata, the late preterm group has been observed to be associated with greater morbidity and mortality. Prior awareness of the morbidities associated with late preterm babies is helpful for the health care providers to anticipate and manage potential complications in preterm infants.

Prevalence of Depression and Anxiety Disorders in Peri-Natal Sudanese Women and Associated Risks Factors

The purpose of this study was to estimate a point prevalence of depression and anxiety disorders among Sudanese peri-natal women attending ant-natal and postnatal clinics in the capital city of Sudan. Simultaneously, to examine the associated risks factors. Participants were 945 peri-natal women in two main women antenatal and post natal clinics in the Capital City of Sudan screened consecutively. They were divided into two groups. The first group was of, Four Hundreds eighty (480) women in their third trimester, and the second group consisted of Four Hundreds Sixty Five (465) women in the first 10 week of postnatal period. All participants were screened, using Beck Depression Inventory (BDI), Hospital Anxiety and Depression scale (HADS), and Personal information Questionnaire (PIQ) for collecting socio-demographic, personal, medical, social and family history data. Routine urine and blood results were recorded. Results: 59% of prenatal and 46% of postnatal women suffered from high levels of distress in the form of mixed anxiety and depressive symptoms. However, only 20.9% of peri-natal women suffered of moderate to severe depression. Over 90% of the depressed women were not formally diagnosed or received psychiatric help. Poor marital relationship, physical co-morbidity, positive family history and past psychiatric history of depression were the main significant risk factors associated with perinatal depression and anxiety. Conclusion: Contrary to the commonly held views that perinatal women are mainly plighted with depression as the main mental illness, this study confirms initial findings that, anxiety disorder is far more prevalent and more distressing to this vulnerable group. Moreover, psychiatric morbidities in both prenatal and postnatal periods attract high prevalence rates in low income countries. Maternal health policies in low income countries must incorporate routine screening for mental health status, basic support and interventions for mental illnesses in perinatal women. Depression and emotional disorders in perinatal women should be seen as important public health priority.

Risk Factors and Outcome of Preterm Admissions in a Special Care Baby Unit of a Tertiary Hospital in North Central Nigeria

The main objective of this study was to determine the prevalence of preterm births, risk factors and the outcome in a Tertiary Hospital in North Central Nigeria. Setting and Methods: The study was based on the data of records of all preterm admissions over a three-year period at Benue State University Teaching Hospital (BSUTH), Makurdi, Benue State. Results: During this period, a total of 778 neonates were admitted out of which 95 (12.0%) were preterm with gestational ages ranging from 21 - 36 weeks with an average mean gestational age 31.27 weeks (±3.2) and birth weights from 500 - 2490 g with a mean of 1440 g (±0.45). There were 48 males and 47 females (M: F 1.02). 76 ??(80.0%) were delivered by spontaneous vaginal delivery while 19 (20.0%) were delivered by caesarean section. 37 (39.0%) were delivered in BSUTH while 58 (61.0%) were delivered elsewhere and referred or brought into Special Care Baby Unit (SCBU). The duration of hospital stay ranged from 1 - 90 days, with a mean duration of 17 days (±15.2 days). The commonest risk factor for prematurity was premature rupture of membrane followed by multiple pregnancy and lack of Ante natal care (ANC). The commonest morbidity in the patients in the present study was sepsis followed by respiratory problems and jaundice. Of the 95 preterm, 60 (63.2%) were discharged, 27 (28.4%) died, while 8 (8.4%) were discharged against medical advice (DAMA). Conclusion: Prematurity remains a major cause of morbidity and mortality in our SCBU. There is urgent need for the establishment of a neonatal intensive care unit with adequate manpower and appropriate equipment so as to improve the survival rates of this vulnerable group of patients.

非肥胖人群基线空腹血糖水平与急性胰腺炎发病风险的关系:前瞻性队列研究

背景研究表明肥胖人群急性胰腺炎(AP)的发病风险增加,而肥胖患者常伴有空腹血糖(FPG)异常,FPG是否独立增加AP的发病风险尚存在争议,且国内外关于非肥胖人群FPG与AP发病风险的关系鲜见报道。目的探究开滦研究队列中非肥胖人群基线FPG水平与AP发病风险的关联。方法采用前瞻性队列研究方法,选取2006—2009年首次在开滦总医院及其下属10家医院完成体检的开滦研究队列非肥胖人群102512例为研究对象。收集研究对象的流行病学资料、人体测量学数据、实验室检查指标等资料,将研究对象按FPG四分位数分为4组:第一分位组(Q1组,FPG≤4.66 mmol/L,n=25929),第二分位组(Q2组,4.66 mmol/L≤FPG<5.10 mmol/L,n=25797),第三分位组(Q3组,5.10 mmol/L≤FPG<5.67 mmol/L,n=25162),第四分位组(Q4组,FPG≥5.67 mmol/L,n=25624)。采用Kaplan-Meier法绘制非肥胖人群新发AP的生存曲线图,计算不同FPG水平分组非肥胖人群AP累积发病率,并采用Log-rank法进行组间检验。采用Cox比例风险回归模型分析非肥胖人群新发AP的影响因素及不同FPG水平分组与非肥胖人群新发AP的相关性。结果本研究中位随访时间为(12.8±2.4)年,累计发生AP 320例,AP的发病密度为2.44例/万人年,4组非肥胖人群AP累积发病率比较,差异有统计学意义(χ^(2)=13.96,P<0.001)。Cox比例风险回归模型分析结果显示,高龄〔HR=1.02,95%CI(1.01,1.03),P=0.001〕、高三酰甘油(TG)水平〔HR=1.22,95%CI(1.13,1.30),P<0.001〕、有胆石症病史〔HR=2.79,95%CI(1.88,4.13),P<0.001〕是非肥胖人群新发AP的危险因素;受教育年限≥9年〔HR=0.65,95%CI(0.47,0.90),P<0.001〕是非肥胖人群新发AP的保护因素;Q4组新发AP的HR为1.40〔95%CI(1.02,1.92),P=0.038〕。剔除应用降糖药人群后,结论未发生改变,Q4组新发AP的HR为1.40〔95%CI(1.02,1.92),P=0.036〕。结论高龄、高TG水平、有胆石症病史是非肥胖人群新发AP的危险因素;受教育年限≥9年是非肥胖人群新发AP的保护因素。在非肥胖人群中,当FPG≥5.67 mmol/L时AP的发病风险会增加。

结直肠癌的危险因素及筛查方法的新进展

结直肠癌(Colorectal cancer,CRC)是消化系统常见的恶性肿瘤之一,在中国的癌症中CRC发病率居第2位,死亡率居第5位。了解结直肠癌的危险因素,开展CRC筛查工作对CRC癌前病变及早期CRC的早发现、早诊断、早治疗有重要的临床价值。近年来,新发现多种危险因素与CRC相关,如肠道微生态、饮食习惯等。现常用筛查指标仍为粪便潜血检测,但其特异度、灵敏度均较低。多靶点粪便DNA作为一项高灵敏度、高特异度的非侵入性检查逐渐走入CRC早筛队列,其他相关CRC筛查方法也已有更多的证据支持,本文就结直肠癌危险因素及相关筛查方法的新进展进行综述。

产后妇女孕产疾患症状及相关因素分析

目的调查产后妇女孕产疾患症状情况,探讨产后孕产疾患躯体症状与生活功能损伤、焦虑、抑郁之间的关系。方法于2020年11月—2021年12月选取在复旦大学附属妇产科医院产后门诊完成42天复查的771例产后妇女进行问卷调查。采用中文版孕产疾患测量工具(WOICE产后问卷)调查产后妇女的躯体症状、生活功能损伤及心理状态,并绘制孕产疾患躯体症状网络图。结果771例研究对象自报的产后孕产疾患躯体症状涉及13大类共62个症状,平均症状数为(8.20±6.35)个,其中乳房症状(72.24%,557/771)、全身症状(61.61%,475/771)、运动系统症状(61.48%,474/771)的发生率最高。产后孕产疾患躯体症状数量是导致产后妇女心理状态改变和生活功能损伤的风险因素,高症状组(≥10个)发生产后抑郁、焦虑的风险分别是无症状组的19.986倍(95%CI:2.685~148.784)和11.693倍(95%CI:2.737~49.950);中症状组(5~9个)出现生活功能损伤的风险是无症状组的2.864倍(95%CI:1.452~5.649),且随着数量的增加,风险递增。结论孕产疾患躯体症状数量是产后妇女出现生活功能损伤和焦虑、抑郁心理的共同危险因素。

早产儿视网膜病变患儿致病危险因素及不同分期发病率的探究

目的:分析早产儿视网膜病变(retinopathy of prematurity,ROP)的致病危险因素及不同分期发病率,为临床预防ROP提供参考。方法:回顾性分析2019年10月—2021年1月信阳市眼科医院收治的130例早产儿临床资料,将出生胎龄为30~36周的早产儿设置为A组(n=89),将出生胎龄小于30周的早产儿设置为B组(n=41);结合眼底筛查结果对比不同胎龄早产儿ROP发病率及不同分期的对应人数,分析早产儿ROP发病率的影响因素。结果:眼底筛查结果显示,A组ROP检出率低于B组,差异有统计学意义(χ^(2)=32.865,P<0.05),B组ROP患儿纤维形成期(Ⅰ度、Ⅱ度、Ⅲ度)人数占比高于A组,差异有统计学意义(Z=8.402,P<0.05);多因素分析结果显示,早产儿胎龄(OR=3.620)、出生体质量(OR=4.421)、氧疗时长(OR=1.229)是早产儿ROP发病的危险因素。结论:早产儿胎龄短、出生体质量过轻、氧疗时间过长是ROP的危险因素,且胎龄可对ROP患儿分期结果产生影响,临床应对存在这部分危险因素的早产儿采取积极的治护措施以降低ROP发生风险。

北京城区2万查体人群大肠息肉发病情况调查

目的 :调查北京城区查体人群大肠息肉发病情况。方法 :对北京城区部分查体人群普查大肠肿瘤发病情况 ,人数为 1 9852 ,30岁以上均接受化学法粪隐血试验 ,阳性者再接受免疫法粪隐血试验。所有普查对象均填表登记 ,符合 7个所列条件为高危人群。免疫法粪隐血试验阳性或高危人群接受全结肠镜检查。结果 :72 3例患者接受全结肠镜检查 ,共有 2 0 5(2 8.35 % )例发现大肠息肉 ,包括男 1 36名 ,女 69名 ,平均年龄 58.61±1 4 .2 5岁 ,显著高于非息肉患者平均年龄 48.53± 1 4 .2 6岁 (P <0 .0 1 ) ,男性所占比例显著高于非息肉患者 (P<0 .0 5)。结肠镜息肉检出率随年龄递增而升高 ,50岁以上检出率达 40 %。 2 0 5例大肠息肉患者中 ,包括腺癌 1 4例 (6 .83 % ) ,良性息肉 1 91例 (93 .2 0 % )。在明确息肉具体分类的 61例良性息肉中 ,包括增生性息肉 3例 (4.92 % ) ,炎性息肉 1 7例 (2 7.87% ) ,腺瘤性息肉 41例 (67.2 1 % )。对大肠息肉患者及结肠镜检查未发现异常者 ,经Logistic回归分析 ,大肠息肉的二个独立危险因素为年龄 >50岁 (OR :2 .886 ,95 %CI :1 .972 -4 .2 2 2 ,P <0 .0 1 )及大肠息肉病史 (OR :2 .92 9,95 %CI:1 .664 - 5 .1 55 ,P <O .0 1 )结论 :查体人群接受结肠镜检查者中大肠息肉检出高达 2

上海市黄浦区老年高血压人群同型半胱氨酸流行特征及心脑血管疾病风险分析

目的探讨黄浦区社区老年高血压人群同型半胱氨酸(HCY)升高的流行现状及其心脑血管疾病风险。方法采用简单随机抽样方法,在黄浦区社区高血压患者管理系统中抽取1 160例,年龄≥60岁的原发性高血压患者进行患病情况问卷调查和相关指标检测,采用描述性流行病学方法分析H型高血压患病情况及该人群心脑血管疾病危险因素聚集暴露情况。结果有效调查1 082例,检出H型高血压904例,检出率为83.5%。男性患病率为87.0%,高于女性的79.9%(P<0.05);患病率随着年龄增长而呈升高趋势(P<0.05)。Logistic回归提示糖尿病、吸烟、饮酒及肥胖更可能导致HCY的升高(P<0.05)。H型高血压患者比单纯高血压患者有更高的心脑血管疾病危险因素聚集(具有≥3项心脑血管疾病危险因素)暴露率(P<0.05);男性患者的平均暴露个数高于女性(P<0.05)。结论黄浦区老年H型高血压患病率高,心脑血管疾病危险因素聚集差异显著,应针对H型高血压患者开展个性化的社区慢性病健康教育,改变患者的生活行为模式,降低心脑血管疾病风险,提高其生活质量。

山西省城乡居民超重和肥胖流行病学调查

目的了解山西省城乡居民超重和肥胖的患病情况及危险因素,为制定相应的干预措施提供科学依据。方法以整群随机抽样方法,抽取山西省太原、大同、晋中、运城等9个地、市的41个街道居委会和村镇作为调查点,对每个调查点的15岁以上长住居民进行超重和肥胖患病情况及相关因素调查。结果共调查10 792人,其中男性4 721人,女性6 071人。超重患病率男性为25.7%,女性为27.8%,总患病率为26.8%。肥胖患病率男性为3.5%,女性为4.9%,总患病率为4.3%。男女之间超重和肥胖患病率差异均有统计学意义(χ2=5.99和χ2=12.24,P<0.05)。经多元逐步回归分析发现,年龄、饮食习惯、职业、性别、饮酒、吸烟等与体质指数(BMI)有相关性,其中吸烟为负相关。结论山西省居民超重和肥胖患病率较高,应采取综合性预防措施,以降低超重和肥胖的患病率,提高人民生活质量。

广州市25岁以上居民高血压患病情况调查

目的调查广州市高血压发病情况及影响因素。方法 按统一方法抽样调查广州市荔湾区 2 5岁以上居民10 0 2 1人 ,了解血压血脂、血糖及体重指数等情况。结果 高血压患病粗率 2 5 .87%,标化患病率 2 0 .34 %,随着增龄高血压患病率增加 ,45岁以上人群增加幅度很大 ,单纯收缩期高血压患病率 16 .6 4%,6 5岁以上老年人单纯收缩期高血压患病率明显增加、血脂异常率、超重肥胖发生率及血糖异常率 ,高血压组明显高于正常血压组。高血压知晓率6 2 .19%,治疗率 37.40 %,控制率 2 4.0 0 %。结论 广州地区从全国高血压患病率最低的省份之一 ,上升为全国高血压病率高发区之一 ,患病率增加的原因与经济发展 ,工作紧张程度 ,生活方式 ,肥胖血脂血糖代谢异常有关 ,高血压知晓率、治疗率控制率高于全国调查水平 ,但低于先进国家水平。

中国汉族人群原发性高血压危险因素横断面调查

目的探讨与原发性高血压(EH)有关的危险因素,为高血压高危人群风险预测提供科学依据和方法。方法采用横断面调查方法,对开滦(集团)有限责任公司1 224例员工进行体格检查和问卷调查。采用聚合酶链反应(PCR)检测ACE基因的Alu I/D多态性;采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)的方法测定血管紧张素原(AGT)基因型和血管紧张素Ⅱ的1型受体(AT1R)基因型;全自动生化仪测定生化指标。结果不同性别、年龄人群的原发性高血压患病率不同(P<0.001);胆固醇、三酰甘油、血尿酸及体重指数异常者,原发性高血压患病率高(P<0.001);打鼾、吸烟、饮酒者、有原发性高血压家族史者患病率高(P<0.001);不同AGT、ACE基因型人群的原发性高血压患病率不同(P<0.001,P=0.027)。不同AT1R基因型人群的原发性高血压患病的差异无显著性(P>0.05)。结论 AGT基因CC基因型、年龄、性别、体重指数、家族史、血尿酸、三酰甘油及打鼾是原发性高血压患病的独立危险因素。

儿童反复呼吸道感染发病影响因素的Logistic回归分析

目的探讨儿童反复呼吸道感染(RRTI)的发病率及其影响因素。方法参照文献方法设计调查问卷,以临床流行病学调查研究结果统计RRTI的发病率;采集出生抚育、生长发育和既往病史等基本信息,以单因素和多因素分析,归纳RRTI发病的影响因素。结果对上海地区517例适龄儿童的临床调查显示,儿童RRTI的社区患病率为8.9%,且年龄越小患病率越高,但性别间无显著差异。年龄、剖宫产儿、过期产儿、始行月龄、过敏史、哮喘/咳嗽变异性哮喘史、湿疹/荨麻疹史、厌食及营养不良史、胃食管反流表现等均为RRTI发病的影响因素。结论必须重视上海地区儿童RRTI的预防和诊治,基于大样本临床流行病学调查的各影响因素可供临床诊断、治疗及其预防参考。