Current status of cardiovascular health and its inprovement evaluation in Shangdong Province
-
摘要:
目的 了解山东省各市心血管健康现状及改善情况,为政府部门针对性制定心血管疾病防控策略提供依据。 方法 构建包含5个维度52个指标的山东省分市心血管健康指数(cardiovascular health index,CHI)体系,对各指标进行同向化、标准化、百分化及加权求和等处理,并计算各指标得分的加权合计总分,得分越高表明表现越好。 结果 从CHI总分来看,最高分为威海市(78.21分),最低分为聊城市(30.96分);威海市、青岛市、东营市、济南市和烟台市得分居前五位,人群心血管健康状况相对较好;聊城市、菏泽市、德州市、枣庄市和滨州市得分位居后五位,人群心血管健康状况相对较差。从单个维度来看,总分排名靠前的城市也有相对较弱的方面,比如排名靠前的济南市在D维度心血管病救治情况排名第11位,处于全省下游水平。从52个指标的得分排名来看,各市均有需要具体改善的方面,如青岛市冠心病早死概率(A03,第9位)、肥胖率(B06,第13名)、糖尿病患病率(B09,第10名)、血脂异常患病率(B10,第14名)、血压检测率(C01,第12位)、糖尿病控制率(C08,第12位)、心血管内科神经内科医生数量(D01,第11名)、导管室数量(D02,第16名)、危险因素干预药物的使用情况(E04,第15名)和疾控人员数(E07,第12名)等指标得分排名较为靠后。与2018年比较,威海市、烟台市、日照市、济宁市、临沂市和菏泽市6个市总分排名均有不同程度上升,其他地市排名有所下降或保持不变。 结论 山东省各地市心血管健康状况不尽相同,东中部地市整体好于鲁西北、鲁西南地区,各市在心血管疾病防控的每一个维度和指标均有进步的空间。 Abstract:Objective To understand the current status and improvement of cardiovascular health in Shandong Province, and to provide basis for government departments to formulate prevention and control strategies for cardiovascular diseases. Methods The system of cardiovascular health index (CHI) in Shandong Province was constructed, which contained 52 indicators in five dimensions. The indicators were homogenized, standardized, differentiated, and weighted summation, and the weighted total score was calculated. A higher score indicated a better performance. Results Regarding the CHI total score, Weihai city was the highest (78.21), while Liaocheng city was the lowest (30.96). Weihai, Qingdao, Dongying, Jinan and Yantai ranked the top five cities, where local cardiovascular health status was relatively well. Liaocheng, Heze, Dezhou, Zaozhuang, and Binzhou ranked the last five cities, where local cardiovascular health status was relatively inferior. For the single dimension, there were also relatively weak aspects of the cities with high CHI. For example, Jinan ranked the 11th in the D dimension in terms of the treatment of cardiovascular diseases, which was at the lower level in this province. For the score ranking of the 52 indicators, all cities had specific aspects that need to be improved. For instance, the premature death rate of coronary heart disease (A03, 9th), prevalence rate of obesity (B06, 13th), diabetes (B09, 10th), and dyslipidemia (B10, 14th), detection rate of blood pressure (C01, 12th), control rate of diabetes (C08, 12th), number of cardiovascular neurologists (D01, 11th), number of cardiac catheter room (D02, 16th), use of risk factor intervention drugs (E04, 15th), and number of disease control personnel (E07, 12th) of Qingdao ranked relatively lower. The total scores of Weihai, Yantai, Rizhao, Jining, Linyi and Heze had increased to varying degrees compared with those in 2018, while the ranking of other cities had decreased or remained unchanged. Conclusions The cardiovascular health status of different cities in Shandong Province is not the same. The status in eastern and central cities are better than that of the northwestern and southwestern cities in Shandong Province, and there is room for improvement in every dimension and index of cardiovascular disease prevention and control in each city. -
Key words:
- Index /
- Cardiovascular health /
- Evaluation
-
表 1 2021年山东省各市心血管健康指数得分情况
Table 1. Cardiovascular health index scores of cities in Shandong Province in 2021
地市 心血管病流行情况 危险因素暴露情况 危险因素防控情况 心血管病救治情况 公共卫生政策与服务能力 心血管健康指数 得分 排名 得分 排名 得分 排名 得分 排名 得分 排名 得分 排名 济南市 14.62 7 6.97 4 22.73 5 7.47 11 12.19 2 63.98 4 青岛市 19.10 3 7.99 3 29.38 1 10.46 7 9.64 4 76.58 2 淄博市 13.96 8 8.03 2 14.62 13 12.10 3 9.08 5 57.81 6 枣庄市 15.01 6 1.85 14 6.20 16 11.07 6 5.32 13 39.44 13 东营市 20.58 2 3.13 13 23.65 3 11.30 5 12.49 1 71.16 3 烟台市 17.50 4 6.17 6 15.17 12 12.34 2 6.78 9 57.96 5 潍坊市 10.39 10 4.65 8 24.86 2 9.48 8 7.52 7 56.89 7 济宁市 6.56 11 3.33 12 16.37 11 8.50 9 7.80 6 42.55 10 泰安市 3.49 13 6.53 5 18.66 8 11.65 4 5.13 14 45.46 8 威海市 20.67 1 8.46 1 23.31 4 14.17 1 11.60 3 78.21 1 日照市 15.08 5 4.48 9 10.97 15 8.07 10 5.84 10 44.44 9 临沂市 2.09 14 4.69 7 22.03 6 6.98 13 5.50 11 41.28 11 德州市 0.09 15 1.41 15 18.26 9 7.02 12 7.37 8 34.13 14 聊城市 0.00 16 4.25 11 19.11 7 5.51 16 2.09 16 30.96 16 滨州市 11.06 9 4.44 10 13.34 14 6.51 14 5.39 12 40.75 12 菏泽市 5.24 12 0.79 16 16.79 10 6.03 15 5.08 15 33.92 15 表 2 2021年山东省16市心血管健康指数得分排名与2018年比较
Table 2. Comparison of cardiovascular health index scores of 16 cities in Shandong Province in 2021 and 2018
地市 心血管疾病流行情况 危险因素暴露情况 危险因素防控情况 心血管病救治情况 公共卫生政策与服务能力 CHI总分 2021版 2018版 位次变化 2021版 2018版 位次变化 2021版 2018版 位次变化 2021版 2018版 位次变化 2021版 2018版 位次变化 2021版 2018版 位次变化 威海市 1 1 - 1 7 ↑6 4 9 ↑5 1 3 ↑2 3 3 - 1 5 ↑4 青岛市 3 4 ↑1 3 1 ↓2 1 1 - 7 7 - 4 4 - 2 1 ↓1 东营市 2 5 ↑3 13 12 ↓1 3 3 - 5 1 ↓4 1 1 - 3 2 ↓1 济南市 7 6 ↓1 4 4 - 5 2 ↓3 11 2 ↓9 2 2 - 4 3 ↓1 烟台市 4 3 ↓1 6 14 ↑8 12 14 ↑2 2 5 ↑3 9 5 ↓4 5 6 ↑1 淄博市 8 2 ↓6 2 6 ↑4 13 5 ↓8 3 4 ↑1 5 7 ↑2 6 4 ↓2 潍坊市 10 7 ↓3 8 13 ↑5 2 10 ↑8 8 8 - 7 6 ↓1 7 7 - 泰安市 13 13 - 5 10 ↑5 8 4 ↓4 4 6 ↑2 14 13 ↓1 8 8 - 日照市 5 8 ↑3 9 5 ↓4 15 11 ↓4 10 15 ↑5 10 15 ↑5 9 11 ↑2 济宁市 11 9 ↓2 12 2 ↓10 11 16 ↑5 9 12 ↑3 6 8 ↑2 10 14 ↑4 临沂市 14 12 ↓2 7 3 ↓4 6 15 ↑9 13 14 ↑1 11 9 ↓2 11 15 ↑4 滨州市 9 11 ↑2 10 9 ↓1 14 7 ↓7 14 9 ↓5 12 12 - 12 10 ↓2 枣庄市 6 10 ↑4 14 11 ↓3 16 8 ↓8 6 10 ↑4 13 11 ↓2 13 9 ↓4 德州市 15 15 - 15 15 - 9 6 ↓3 12 13 ↑1 8 14 ↑6 14 12 ↓2 菏泽市 12 14 ↑2 16 8 ↓8 10 13 ↑3 15 16 ↑1 15 16 ↑1 15 16 ↑1 聊城市 16 16 - 11 16 ↑5 7 12 ↑5 16 11 ↓5 16 10 ↓6 16 13 ↓3 -
[1] 《中国心血管健康与疾病报告2020》概述[J]. 中国心血管病研究, 2021, 19(7): 582-590. DOI: 10.3969/j.issn.1672-5301.2021.07.002.Key points of Report on Cardiovascular Health and Diseases in China 2020[J]. Chinese Journal of Cardiovascular Research, 2021, 19(7): 582-590. DOI: 10.3969/j.issn.1672-5301.2021.07.002. [2] 王妮, 吴炳义, 武继磊, 等. 2012年山东省心脑血管疾病死亡状况及去死因期望寿命研究[J]. 中华疾病控制杂志, 2017, 21(9): 917-920. DOI: 10.16462/j.cnki.zhjbkz.2017.09.014.Wang N, Wu BY, Wu JL, et al. Distribution of cardiocerebral vascular disease death and its life expectancy eliminating causes of death in Shandong Province in 2012[J]. Chin J Dis Control Prev, 2017, 21(9): 917-920. DOI: 10.16462/j.cnki.zhjbkz.2017.09.014. [3] Jiang Y, Mao F, Li Y, et al. Construction of China cardiovascular health index[J]. BMC Public Health, 2018, 18(1): 937. DOI: 10.1186/s12889-018-5647-7. [4] 张丙银, 陈先献, 毛凡, 等. 基于综合指数法评价山东省地市级心血管健康现状[J]. 现代预防医学, 2020, 47(13): 2410-2413, 2425. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202013026.htmZhang BY, Chen XX, Mao F, et al. Evaluation of cardiovascular health status in Shandong province based on comprehensive index method[J]. Mod Prev Med, 2020, 47(13): 2410-2413, 2425. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202013026.htm [5] 张丙银, 唐俊利, 鹿子龙, 等. 山东省各地市心血管疾病负担现状及应对情况评价[J]. 中国慢性病预防与控制, 2021, 29(9): 660-664. DOI: 10.16386/j.cjpccd.issn.1004-6194.2021.09.005.Zhang BY, Tang JL, Lu ZL, et al. Evaluation of the current status and countermeasures of cardiovascular disease burden in cities of Shandong Province[J]. Chin J Prev Contr Chron Dis, 2021, 29(9): 660-664. DOI: 10.16386/j.cjpccd.issn.1004-6194.2021.09.005. [6] 姜莹莹, 毛凡, 张岩, 等. 我国各省心血管疾病相关健康资源分布评价[J]. 疾病监测, 2020, 35(5): 387-393. DOI: 10.3784/j.issn.1003-9961.2020.05.006.Jiang YY, Mao F, Zhang Y, et al. Cardiovascular disease related health resources distribution provinces of China[J]. Dis Surveill, 2020, 35(5): 387-393. DOI: 10.3784/j.issn.1003-9961.2020.05.006. [7] 中国心血管病预防指南(2017)写作组, 中华心血管病杂志编辑委员会. 中国心血管病预防指南(2017)[J]. 中华心血管病杂志, 2018, 46(1): 10-25. DOI: 10.3760/cma.j.issn.0253-3758.2018.01.004.Task Force on Chinese Guidelines for the Prevention of Cardiovascular Diseases (2017), Editorial Board of Chinese Journal of Cardiology. Guidelines for prevention of cardiovascular diseases in China (2017)[J]. Chin J Cardiovl, 2018, 46(1): 10-25. DOI: 10.3760/cma.j.issn.0253-3758.2018.01.004. [8] 莫兴波, 张永红. 基于多组学的心血管疾病危险因素研究[J]. 中华疾病控制杂志, 2018, 22(9): 873-874, 879. DOI: 10.16462/j.cnki.zhjbkz.2018.09.001.Mo XB, Zhang YH. Cardiovascular disease risk factors based on multiple omics research[J]. Chin J Dis Control Prev, 2018, 22(9): 873-874, 879. DOI: 10.16462/j.cnki.zhjbkz.2018.09.001. [9] 费菲, 张清涵, 葛均波. 大数据下的医疗质量控制提升策略, 《中国心血管健康指数》告诉你[J]. 中国医药科学, 2018, 8(21): 3-5. DOI: 10.3969/j.issn.2095-0616.2018.21.002.Fei F, Zhang QH, Ge JB. Medical quality control and improvement strategy under big data, China Cardiovascular Health Index tells you[J]. China medicine and pharmacy, 2018, 8(21): 3-5. DOI: 10.3969/j.issn.2095-0616.2018.21.002. [10] Meng QY, Mills A, Wang LD, et al. What can we learn from China's health system reform?[J]. BMJ, 2019, 365(6): l2349. DOI: 10.1136/bmj.l2349. [11] 龙凌波, 佘倩楠, 孟紫琪, 等. 中国沿海地区大气污染特征及其聚类分析[J]. 环境科学研究, 2018, 31(12): 2063-2072. DOI: 10.13198/j.issn.1001-6929.2018.06.15.Long LB, She QN, Meng ZQ, et al. Characteristics and cluster analysis of air pollution in coastal areas of China[J]. Research of Environmental Sciences, 2018, 31(12): 2063-2072. DOI: 10.13198/j.issn.1001-6929.2018.06.15. [12] 马爱娟, 姜莹莹, 周脉耕, 等. 北京市人群心血管健康水平现状调查[J]. 疾病监测, 2020, 35(5): 376-380. DOI: 10.3784/j.issn.1003-9961.2020.05.004.Ma AJ, Jiang YY, Zhou MG, et al. Beijing population cardiovascular health status survey[J]. Dis Surveill, 2020, 35(5): 376-380. DOI: 10.3784/j.issn.1003-9961.2020.05.004.