内蒙古某旗县慢性病综合防控示范区建设效果评价

Evaluation of the construction effect of the comprehensive prevention and control demonstration area for chronic diseases in a banner county of Inner Mongolia

摘要:

目的 评价内蒙古某旗县国家级慢性病综合防控示范区建设效果，为深化示范区建设和完善制定慢性病防控策略和措施提供科学依据。方法 采用2015年和2018年内蒙古某旗县18岁及以上居民慢性病营养监测数据，对不同特征居民的主要慢性病患病率、知晓率、管理率与治疗率，健康行为生活方式变化进行对比分析。应用SPSS25.0软件进行数据统计，分类变量主要采用率、构成比进行描述，两年间各项指标率的比较采用c2检验，2015-2018年示范区的持续性建设与各项指标的统计学关联采用多因素logistic回归分析。检验水准为α=0.05。结果 2015年与2018年分别调查了18岁及以上居民621人与600人，2018年示范区居民糖尿病患病率（8.17%）、血脂异常患病率（28.13%）均低于2015年示范区居民（分别为 12.08%、54.91%），差异均有统计学意义（P＜0.05）。2018年示范区居民糖尿病知晓率（71.43%）、糖尿病治疗率（71.43%）、糖尿病管理率（38.78%）、血脂异常知晓率（51.50%），均高于2015年示范区居民（分别为42.67%、42.67%、13.33%、31.09%），差异均有统计学意义（P＜0.05）。2018年示范区居民现在吸烟率（20.83%）、一年内饮酒率（31.67%）、新鲜蔬菜摄入不足（51.00%）、食用盐摄入过多（47.83%）均低于2015年示范区居民（分别为30.43%、45.57%、71.18%、78.42%），差异均有统计学意义（P＜0.05）。多因素logistic回归分析结果显示，示范区的持续性建设与血脂异常（OR=0.31，95%CI：0.24-0.39）、糖尿病知晓（OR＝3.92，95%CI：1.68-9.12）、糖尿病治疗（OR=4.53，95%CI：1.75-11.70）、糖尿病管理（OR=5.82，95%CI：1.94-17.52）、血脂异常知晓（OR=1.57，95%CI：1.04-2.38）、现在吸烟（OR=0.60，95%CI：0.44-0.82）、一年内饮酒（OR=0.46，95%CI：0.35-0.61）、新鲜蔬菜摄入不足（OR=0.45，95% CI：0.35-0.58）有统计学关联（P＜0.05）。结论 国家级慢性病综合防控示范区建设可以明显降低内蒙古某旗县居民主要慢性病患病率，提高慢性病患者自我管理水平，促进健康行为生活方式养成。

Abstract:

Objective To evaluate the construction effect of a national comprehensive prevention and control demonstration area for chronic diseases in a banner county in Inner Mongolia, and to provide a scientific basis for deepening the construction of the demonstration area and improving the formulation of chronic disease prevention and control strategies and measures. Methods Using the chronic disease nutrition monitoring data of residents aged 18 and over in a banner county in Inner Mongolia in 2015 and 2018, the prevalence, awareness, and management and treatment rates of the main chronic diseases of residents with different characteristics, as well as the changes in healthy behaviors and lifestyles were compared and analyzed. SPSS25.0 software was used for data analysis. The classification variables were mainly described by rate and composition ratio. The comparison of rates of various indicators between the two years was performed using c2 test. Multivariate logistic regression analysis was used to analyze statistical correlation between the continuous construction of the demonstration area from 2015 to 2018 and the various indicators. The test level was α=0.05. Results In 2015 and 2018, 621 and 600 residents aged 18 and above were investigated respectively. The prevalence of diabetes (8.17%) and the prevalence of dyslipidemia (28.13%) of residents in the demonstration area in 2018 were lower than those in the demonstration area in 2015 (12.08% and54.91%, respectively), and the differences were statistically significant (P<0.05). In 2018, the diabetes awareness rate (71.43%), diabetes treatment rate (71.43%), diabetes management rate (38.78%), and dyslipidemia awareness rate (51.50%) of residents in the demonstration area were higher than those in the demonstration area in 2015 (42.67%, 42.67%, 13.33%, and 31.09%, respectively), and the differences were statistically significant (P<0.05). In 2018, the current smoking rate (20.83%) of residents in the demonstration area, the drinking rate within one year (31.67%), insufficient intake of fresh vegetables (51.00%), and excessive intake of edible salt (47.83%) were all lower than those of residents in the demonstration area in 2015 (30.43%, 45.57%, 71.18%, and 78.42%, respectively), and the differences were statistically significant (P<0.05). The results of multivariate logistic regression analysis showed that the continuous construction of the demonstration area was statistically correlated with dyslipidemia (OR=0.31, 95%CI: 0.24-0.39), diabetes awareness (OR=3.92, 95%CI: 1.68-9.12), diabetes treatment ( OR=4.53, 95%CI: 1.75-11.70), diabetes management (OR=5.82, 95%CI: 1.94-17.52), awareness of dyslipidemia (OR=1.57, 95%CI: 1.04-2.38), current smoking (OR =0.60, 95%CI: 0.44-0.82), drinking within one year (OR=0.46, 95%CI: 0.35-0.61), and insufficient intake of fresh vegetables (OR=0.45, 95% CI: 0.35-0.58). Conclusion The construction of a national demonstration zone for comprehensive prevention and control of chronic diseases can significantly reduce the prevalence of major chronic diseases among residents in a banner county in Inner Mongolia, improve the self-management level of patients with chronic diseases, and promote the development of healthy behaviors and lifestyles.