太原市老年人多重慢病患病现状及影响因素

杨娟; 郑晓; 候丽红; 薛雅卿; 李咪咪; 邹嘉瑜2; 郑建中; 张持晨

doi:10.16462/j.cnki.zhjbkz.2021.01.015

太原市老年人多重慢病患病现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2021.01.015

杨娟¹,
郑晓³,
候丽红²,
薛雅卿²,
李咪咪²,
邹嘉瑜2²,
郑建中^1, ,,
张持晨^{2, 3, ,}

1.
030001 太原，山西医科大学公共卫生学院社会医学教研室
2.
030001 太原，山西医科大学管理学院卫生管理学教研室
3.
510515 广州，南方医科大学卫生管理学院卫生管理学系

基金项目:

国家自然科学基金 71874104

中国博士后科学基金面上项目 2019M652133

山西省哲学社会科学规划课题 2018B205

山西省高等学校人文社会科学重点研究基地项目 201801019

详细信息

通讯作者:
张持晨，E-mail：zhangchichen@sina.com

郑建中，E-mail：zjzhong4183@163.com

中图分类号: R181.22
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- 文章访问数: 890
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- 被引次数: 0
出版历程
- 收稿日期: 2020-07-27
- 修回日期: 2020-09-19
- 刊出日期: 2021-01-10

The prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan

1.
Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan 030001, China
2.
Department of Health Management, School of Management, Shanxi Medical University, Taiyuan 030001, China
3.
Health Services Management, School of Health Services Management, Southern Medical University, Guangzhou 510515, China

Funds:

National Natural Science Foundation of China 71874104

China Postdoctoral Science Foundation Project 2019M652133

Planning Project of Shanxi Philosophy and Social Science founded by Shanxi Philosophy and Social Science Planning Office 2018B205

Program for the Philosophy and Social Sciences Key Research Base of Higher Learning Institutions of Shanxi 201801019

More Information

Corresponding author: ZHENG Jian-zhong, E-mail: zjzhong4183@163.com; ZHANG Chi-chen, E-mail: zhangchichen@sina.com

摘要

摘要: 目的了解太原市老年人多重慢病患病现状及其影响因素，为提升老年人健康水平、优化慢性病防治和管理提供参考。方法采用多阶段整群随机抽样的方法，在山西省太原市抽取3 637名年龄≥60岁的老年人，进行面对面问卷调查。采用χ²检验进行组间比较、多分类Logistic回归分析模型分析影响因素。结果 3 637名调查对象中，慢性病患病率为68.8%，多重慢病患病率为21.0%；常见的二元疾病组合为：高血压+糖尿病、高血压+冠心病、高血压+类风湿性关节炎；常见的三元疾病组合为：高血压+糖尿病+冠心病、高血压+糖尿病+类风湿性关节炎、高血压+糖尿病+眼病。高龄、常住地为农村、低强度体力活动、有家族病史、超重或肥胖、饮食不规律(均有P < 0.05)的老年人是多重慢病高发人群。结论 60岁及以上老年人慢性病患病率较高，多重慢病患病情况不容乐观，应针对患病特点和危险因素采取综合性的干预措施。
- 老年人 /
- 多重慢病 /
- 影响因素 /
- 健康管理
Abstract: Objective To investigate the prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan, so as to provide references for improving the health level of the elderly and optimizing the prevention and management of chronic diseases. Methods Using multi-stage cluster random sampling method, 3 637 elderly persons aged 60 years or older were selected from Taiyuan City, Shanxi Province for face-to-face questionnaire survey. Chi-square test was used for comparison between groups and multinomial Logistic regression model was used to analyze the influencing factors. Results Among the 3 637 respondents, the prevalence of chronic diseases was 68.8%, and the prevalence of multiple chronic diseases was 21.0%; common dual disease combinations are: hypertension + diabetes, hypertension + coronary heart disease, hypertension + rheumatoid; common three disease combinations are: hypertension + diabetes + coronary heart disease, hypertension + diabetes + rheumatoid, hypertension + diabetes + eye disease. The elderly, who live in rural areas, with a family history, overweight or obesity, and an irregular diet (all P < 0.05), have a high incidence of multiple chronic diseases. Conclusions The prevalence of chronic diseases in the elderly aged 60 and above is relatively high, and the prevalence of multiple chronic diseases is not optimistic. Comprehensive intervention measures should be taken according to the characteristics of the disease and risk factors.
- Elderly /
- Multiple chronic diseases /
- Influencing factors /
- Health management

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图 1 太原市老年人常见慢性病构成比情况

Figure 1. Composition of common chronic diseases among the elderly in Taiyuan

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表 1 太原市不同性别老年人慢性病患病情况[n (%)]

Table 1. The prevalence of chronic diseases among the elderly of different genders in Taiyuan[n(%)]

慢性病种类	男		女		总计
慢性病种类	患病人数	顺位	患病人数	顺位	患病人数	顺位
高血压	722(38.7)	1	687(38.7)	1	1 409(38.7)	1
糖尿病	227(12.2)	2	254(14.3)	2	481(13.2)	2
类风湿性关节炎^a	88(4.7)	6	138(7.8)	3	226(6.2)	3
冠心病	128(6.9)	3	95(5.4)	7	223(6.1)	4
听力障碍	112(6.0)	4	101(5.7)	5	213(5.9)	5
眼病	90(4.8)	5	109(6.1)	4	199(5.5)	6
骨质疏松症^b	65(3.5)	7	98(5.5)	6	163(4.5)	7
胃炎	54(2.9)	8	60(3.4)	8	114(3.1)	8
肥胖症^b	41(2.3)	10	60(3.4)	8	102(2.8)	9
支气管哮喘	47(2.5)	9	30(1.7)	9	77(2.1)	10
注：表格中仅列出总患病率>2.00%的慢性病；^a表示不同性别比较，P < 0.001；^b表示不同性别比较，P < 0.05。

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表 2 不同人口学资料分组的老年人多重慢病患病情况[n (%)]

Table 2. The prevalence of multiple chronic diseases in the elderly in different demographic data groups [n(%)]

变量	未患病(n=1 133)	单一慢性病(n=1 742)	多重慢病(n=762)	χ²值	P值
性别				3.83	0.147
男	595(52.5)	902(51.8)	367(48.2)
女	538(47.5)	840(48.2)	395(51.8)
年龄(岁)				48.35	< 0.001
60~	651(57.4)	844(48.5)	321(42.1)
70~	362(32.0)	638(36.6)	315(41.3)
≥80	120(10.6)	260(14.9)	126(16.6)
婚姻状况				47.13	< 0.001
在婚	925(81.6)	1 410(80.9)	566(74.3)
未婚	36(3.2)	49(2.8)	20(2.6)
丧偶	147(13.0)	270(15.5)	172(22.6)
离异	25(2.2)	13(0.8)	4(0.5)
空巢情况				2.45	0.294
空巢	528(46.6)	837(48.0)	383(50.3)
非空巢	605(53.4)	905(52.0)	379(49.7)
文化程度				55.99	< 0.001
小学及以下	377(33.3)	634(36.4)	365(47.9)
初中	319(28.1)	507(29.1)	206(27.0)
高中	265(23.4)	384(22.0)	110(14.5)
大学及以上	172(15.2)	217(12.5)	81(10.6)
退休前职业				47.04	< 0.001
公务员	98(8.7)	150(8.6)	44(5.8)
企业及事业单位	459(40.5)	710(40.8)	264(34.6)
农民	280(24.7)	465(26.7)	286(37.5)
自由职业	247(21.8)	339(19.5)	130(17.1)
无业	49(4.3)	78(4.4)	38(5.0)
常住地				44.36	< 0.001
农村	396(35.0)	734(42.1)	383(50.3)
城市	737(65.0)	1 008(57.9)	379(49.7)
家庭人均月收入(元)				18.62	0.001
＜1 000	154(13.6)	280(16.1)	148(19.4)
1 000~	529(46.7)	773(44.4)	364(47.8)
≥3 000	450(39.7)	689(39.5)	250(32.8)
是否吸烟				0.31	0.856
是	286(25.2)	449(25.8)	201(26.4)
否	847(74.8)	1 293(74.2)	561(73.6)
是否饮酒				0.69	0.707
是	258(22.8)	374(21.5)	166(21.8)
否	875(77.2)	1 368(78.5)	596(78.2)
BMI(kg/m²)				14.02	0.007
＜18.5	89(7.9)	123(7.1)	53(7.0)
18.5~	676(59.7)	986(56.6)	398(52.2)
≥24	368(32.4)	633(36.3)	311(40.8)
家族病史				107.71	< 0.001
无	1 114(98.3)	1 561(89.6)	654(85.8)
有	19(1.7)	181(10.4)	108(14.2)
体力活动强度				37.95	< 0.001
低	245(21.6)	429(24.6)	222(29.1)
中	435(38.4)	735(42.2)	335(44.0)
高	453(40.0)	578(33.2)	205(26.9)
注重饮食搭配				26.75	< 0.001
否	195(17.2)	317(18.2)	176(23.1)
一般	231(20.4)	375(21.5)	197(25.9)
是	707(62.4)	1 050(60.3)	389(51.0)
三餐规律				33.24	< 0.001
否	129(11.4)	207(11.9)	138(18.1)
一般	234(20.6)	417(23.9)	192(25.2)
是	770(68.0)	1 118(64.2)	432(56.7)

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表 3 太原市老年人多重慢病的影响因素的多分类Logistic回归分析

Table 3. Multinomial Logistic regression analysis of influencing factors of multiple chronic diseases in the elderly in Taiyuan

变量	单一慢性病		多重慢性病
变量	OR(95% CI)值	P值	OR(95% CI)值	P值
年龄(岁)
60~	1.000		1.000
70~	1.352(1.138~1.605)	0.001	1.728(1.393~2.143)	< 0.001
≥80	1.764(1.363~2.281)	< 0.001	2.181(1.593~2.985)	< 0.001
婚姻状况
在婚	1.000		1.000
未婚	0.833(0.519~1.337)	0.449	0.804(0.435~1.484)	0.485
丧偶	0.976(0.765~1.245)	0.844	1.399(1.057~1.853)	0.019
离异	0.268(0.130~0.551)	< 0.001	0.201(0.066~0.611)	0.005
文化程度
大学及以上	1.000		1.000
小学及以下	1.264(0.946~1.689)	0.113	1.369(0.944~1.986)	0.980
初中	1.284(0.978~1.686)	0.072	1.126(0.787~1.609)	0.516
高中	1.083(0.829~1.416)	0.559	0.733(0.509~1.058)	0.097
退休前职业
无业	1.000		1.000
公务员	1.052(0.645~1.716)	0.839	0.846(0.451~1.586)	0.601
企业及事业单位	1.191(0.787~1.802)	0.408	1.284(0.770~2.139)	0.338
农民	0.951(0.635~1.424)	0.808	1.283(0.789~2.085)	1.283
自由职业	0.981(0.649~1.482)	0.926	0.934(0.561~1.555)	0.792
常住地
城市	1.000		1.000
农村	1.370(1.125~1.670)	0.002	1.458(1.140~1.863)	0.003
家庭人均月收入(元)
≥3 000	1.000		1.000
< 1 000	1.020(0.766~1.358)	0.893	0.944(0.667~1.336)	0.743
1 000~	0.944(0.786~1.133)	0.537	1.060(0.838~1.341)	0.628
BMI(kg/m²)
≥24	1.000		1.000
18.5~	0.870(0.737~1.027)	0.990	0.724(0.590~0.888)	0.002
＜18.5	0.737(0.539~1.008)	0.560	0.539(0.363~0.802)	0.002
家族病史
无	1.000		1.000
有	7.389(4.543~12.091)	< 0.001	11.329(6.794~18.893)	< 0.001
体力活动强度
低	1.000		1.000
高	0.831(0.672~1.028)	0.088	0.649(0.497~0.848)	0.002
中	1.069(0.869~1.314)	0.528	1.044(0.815~1.338)	0.733
注重饮食搭配
是	1.000		1.000
否	0.960(0.769~1.199)	0.722	1.163(0.890~1.520)	0.268
一般	0.987(0.803~1.214)	0.904	1.244(0.967~1.601)	0.090
三餐规律
是	1.000		1.000
否	1.147(0.888~1.483)	0.294	1.840(1.369~2.474)	< 0.001
一般	1.272(1.042~1.554)	0.018	1.385(1.080~1.776)	0.010

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太原市老年人多重慢病患病现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2021.01.015

通讯作者:
张持晨，E-mail：zhangchichen@sina.com

郑建中，E-mail：zjzhong4183@163.com

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The prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan

Corresponding author: ZHENG Jian-zhong, E-mail: zjzhong4183@163.com; ZHANG Chi-chen, E-mail: zhangchichen@sina.com

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太原市老年人多重慢病患病现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2021.01.015

通讯作者: 张持晨，E-mail：zhangchichen@sina.com 郑建中，E-mail：zjzhong4183@163.com

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The prevalence and influencing factors of multiple chronic diseases in the elderly in Taiyuan

Corresponding author: ZHENG Jian-zhong, E-mail: zjzhong4183@163.com; ZHANG Chi-chen, E-mail: zhangchichen@sina.com

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通讯作者:
张持晨，E-mail：zhangchichen@sina.com

郑建中，E-mail：zjzhong4183@163.com