云南省农村老年人五种常见慢性病及共病的流行现状及与社会经济地位的关系

李潇; 蔡乐; 王旭明; 崔文龙; 吕思齐; 何建辉

doi:10.16462/j.cnki.zhjbkz.2019.06.003

云南省农村老年人五种常见慢性病及共病的流行现状及与社会经济地位的关系

doi: 10.16462/j.cnki.zhjbkz.2019.06.003

1.
650500 昆明, 昆明医科大学公共卫生学院
2.
650032 昆明, 昆明医科大学第一附属医院呼吸科

基金项目:

国家自然科学基金资助项目 71663035

云南省科技厅-昆明医科大学联合专项重点项目 2017FE467(-002)

云南省高校科技创新团队支持计划 2018(134)

昆明医科大学科技创新团队 CXTD201706

详细信息

通讯作者:
蔡乐, E-mail: caile002@hotmail.com

中图分类号: R181
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出版历程
- 收稿日期: 2018-10-29
- 修回日期: 2019-01-15
- 刊出日期: 2019-06-10

The prevalence of five common chronic diseases and multi-morbidity and its relationship with socioeconomic position among rural older adults in Yunnan Province

1.
School of Public Health, Kunming Medical University, Kunming 650500, China
2.
Department of Respiratory, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China

Funds:

Grants from the National Natural Science Fundation of China 71663035

The Major Specific Project Fund of the Yunnan Provincial Department of Science and Technology and Kunming Medical University 2017FE467(-002)

Program for Innvative Research Team(in sciecnce and technology) in University of Yunnan Province 2018(134)

Science and Technology Innovation Team of Kunming Medical University CXTD201706

More Information

Corresponding author: CAI Le, E-mail: caile002@hotmail.com

摘要

摘要: 目的分析云南省农村老年人高血压、糖尿病、脑卒中、冠心病、慢性阻塞性肺疾病(chronic obstructive pneumonia diseases，COPD)及共病的流行现状及与社会经济地位的关系。方法采用多阶段分层随机抽样的方法抽取云南省4 833名60岁及以上农村老年人进行问卷调查和体格检查，采用主成分分析法构建社会经济地位。结果云南农村老年人高血压、糖尿病、脑卒中、冠心病、COPD和共病的患病率分别为50.6%、10.2%、6.4%、5.5%、5.4%和16.1%。女性高血压和糖尿病的患病率均高于男性(均有P < 0.05)，而男性COPD的患病率高于女性(χ²=5.499，P=0.019)；高血压、冠心病、脑卒中、COPD和共病的患病率均随年龄的增长而增加(均有P < 0.05)；少数民族高血压、冠心病、COPD和共病的患病率均高于汉族(均有P < 0.05)。多因素Logistic回归分析结果显示，社会经济地位越低的老年人，其患高血压、冠心病、脑卒中、COPD和共病的风险越高(均有P < 0.05)。结论云南省农村老年人五种慢性病及共病的患病存在明显的社会经济差异，低社会经济地位的老年人是慢性病防控的重点人群。
- 慢性病 /
- 农村 /
- 老年人 /
- 社会经济地位 /
Abstract: Objective To analyze the relationship between socioeconomic position and prevalence of hypertension, diabetes, coronary heart disease, stroke, chronic obstructive pulmonary diseases (COPD) and multi-morbidity among older adults in rural Yunnan Province. Methods A total of 4 833 older adults aged 60 years and over were selected by multi-stage stratified random sampling method in rural Yunnan Province. Information was acquired from questionnaire and health examination. Principal component analysis was used to construct the socioeconomic comprehensive score. Results The prevalence of hypertension, diabetes, stroke, coronary heart disease, COPD and multi-morbidity in target persons was 50.6%, 10.2%, 6.4%, 5.5%, 5.4% and 16.1% respectively. The prevalence of hypertension and diabetes was much higher in female compared with male (both P < 0.05), in contrast the prevalence of COPD was much higher in male than female(χ²=5.499, P=0.019)The prevalence of hypertension, stroke, coronary heart disease, COPD and multi-morbidity was increased with age(all P < 0.05);Minority ethnic were more likely to develop hypertension, coronary heart disease, COPD and multi-morbidity than Han ethnic(all P < 0.05). The results of multivariate logistic regression analysis showed that older adults with lower socioeconomic position had higher probability of suffering from hypertension, coronary heart disease, stroke, COPD and multi-morbidity (all P < 0.05). Conclusions There are significant socioeconomic differences between socioeconomic position and prevalence of five major chronic diseases and multi-morbidity among older adults in rural Yunnan province. Older adults with low socioeconomic position should be key population for future prevention and control of chronic diseases.
- Chronic diseases /
- Multi-morbidity /
- Rural area /
- Older adults /
- Socio-economic position

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表 1 云南农村老年人常见慢性病患病及共病情况[n(%)]

Table 1. Prevalence of common chronic non-communicable diseases and multi-morbidity among older adults in rural Yunnan Province[n(%)]

特征	高血压	糖尿病	冠心病	脑卒中	COPD	共病
性别
男	1 047(47.6)	203(9.2)	111(5.1)	151(6.9)	139(6.3)^a	334(15.2)
女	1 400(53.1)^b	291(11.0)^a	158(6.0)	161(6.1)	126(4.8)	442(16.8)
年龄(岁)
60~	591(44.6)	129(9.7)	61(4.6)	61(4.6)	56(4.2)	166(12.5)
65~	649(50.5)	137(10.7)	71(5.5)	98(7.6)	60(4.7)	218(17.0)
70~	562(53.7)	116(11.1)	64(6.1)	74(7.1)	64(6.1)	192(18.3)
≥75	645(54.8)^a	112(9.5)	73(6.2)^b	79(6.7)^b	85(7.2)^a	200(17.0)^b
民族
汉族	2 007(49.9)	418(10.4)	199(4.9)	257(6.4)	200(5.0)	613(15.2)
少数民族	440(54.5)^a	76(9.4)	70(8.7)^b	55(6.8)	65(8.1)^a	163(20.2)^b
合计	2 447(50.6)	494(10.2)	269(5.6)	312(6.5)	265(5.5)	776(16.1)
注：^aP＜0.05，^bP＜0.01。

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表 2 云南省农村老年人按性别、年龄和民族的社会经济地位分布情况[n(%)]

Table 2. The distribution of social economic position among the older adults in rural Yunnan Province by sex, age and ethnicity[n(%)]

特征	社会经济地位分组
特征	低	中	高
性别
男	339(15.4)	794(36.1)	1 065(48.5)^a
女	695(26.4)	1 070(40.6)	870(33.0)
年龄(岁)
60~	262(19.8)	489(36.9)	575(43.4)^a
65~	227(17.7)	492(38.3)	565(44.0)
70~	190(18.1)	385(36.8)	472(45.1)
≥75	355(30.2)	498(42.3)	323(27.5)
民族
汉族	772(19.2)	1 543(38.3)	1 711(42.5)^a
少数民族	262(32.5)	321(39.8)	224(27.8)
合计	1 034(21.4)	1 864(38.6)	1 935(40.0)
注：^aP＜0.01。

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表 3 云南省农村老年人5种慢性病及共病的患病与社会经济地位关系的的多因素分析

Table 3. Multilevel logistic regression analysis of the relationship between prevalence of five common chronic diseases and multi-morbidity with social economic position

因素	β	s_x	Wald值	P值	OR(95%CI)值
高血压
社会经济地位
低			9.416	0.009	1.000
中	-0.245	0.081	9.131	0.003	0.783(0.668~0.917)
高	-0.197	0.083	5.675	0.017	0.821(0.699~0.917)
糖尿病
社会经济地位
低			0.455	0.797	1.000
中	-0.086	0.129	0.449	0.503	0.917(0.712~1.181)
高	-0.063	0.131	0.236	0.627	0.938(0.726~1.213)
冠心病
社会经济地位
低			33.238	< 0.001	1.000
中	-0.719	0.154	21.711	< 0.001	0.487(0.360~0.659)
高	-0.843	0.162	27.153	< 0.001	0.431(0.314~0.591)
脑卒中
社会经济地位
低			21.582	< 0.001	1.000
中	-0.453	0.147	9.512	0.002	0.636(0.477~0.848)
高	-0.715	0.156	21.123	< 0.001	0.489(0.361~0.664)
COPD
社会经济地位
低			7.335	0.026	1.000
中	-0.32	0.16	4.003	0.045	0.726(0.531~0.993)
高	-0.441	0.167	6.957	0.008	0.644(0.464~0.893)
共病
社会经济地位
低			34.289	< 0.001	1.000
中	-0.524	0.103	26.097	< 0.001	0.592(0.485~0.724)
高	-0.554	0.105	27.735	< 0.001	0.575(0.468~0.706)

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