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目的探讨社会心理压力对冠心病发病的影响,引起人们对中老年人社会心理压力足够的重视。方法于2005年选取吉林省部分地区农村40~80岁的中老年人进行第1次基础调查建立研究队列,之后每年进行随访,随访至2014年8月。通过简式社会心理幸福指数调查问卷(PWI-SF)区分人群的社会心理压力程度,用Cox比例风险回归模型分析社会心理压力与冠心病事件发生之间的关联。结果人群社会心理压力高低在不同婚姻状况、民族、糖尿病患者与非糖尿病患者之间差异均有统计学意义(P<0.01)。未婚者或未同居者、朝鲜族居民、糖尿病患者具有高社会心理压力的几率大。Cox比例风险回归模型分析显示,冠心病发病在不同吸烟情况、体质指数(BMI)、总胆固醇水平人群之间差异均有统计学意义(P<0.01)。在调整了年龄、性别后(模型1),结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值(95%CI)为4.15(1.24~13.93);在模型1的基础上进一步调整婚姻状况、民族、糖尿病史等与社会心理压力有关的因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值(95%CI)为4.54(1.34~15.35);在模型1的基础上进一步调整吸烟史、BMI、总胆固醇等与冠心病发病有关的因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值(95%CI)为4.34(1.29~14.58);在模型1的基础上进一步调整婚姻状况、民族、糖尿病史、吸烟史、BMI、总胆固醇等与社会心理压力和冠心病发病有关的因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值(95%CI)为4.69(1.38~15.93);在模型1的基础上调整所有因素,结果显示,高社会心理压力人群与心理健康人群比较,冠心病发病的HR值(95%CI)为4.76(1.39~16.26)。结论社会心理压力与冠心病发病密切相关,降低中老年人社会心理压力,有利于减少冠心病发病危险。
Objective To explore the impact of social psychological pressure on the incidence of coronary heart disease, causing people to pay enough attention to the social and psychological pressure on the elderly. Methods In 2005, select the middle-aged and elderly people aged 40 to 80 years in rural areas of Jilin Province to conduct the first basic survey to establish a research cohort, followed by annual follow-up until August 2014. The socio-psychological stress level of the population was differentiated by the Simplified Social Psychological Well-being Index Questionnaire (PWI-SF), and the association between social psychological pressure and the incidence of coronary heart disease was analyzed by Cox proportional hazards regression model. Results There was a significant difference in social psychological pressure between different marital status, ethnic groups, diabetic patients and non-diabetic patients (P <0.01). Unmarried or not cohabitants, Korean residents, diabetic patients with high social and psychological pressure of a large probability. Cox proportional hazards regression model analysis showed that the incidence of coronary heart disease in different smoking status, body mass index (BMI), total cholesterol levels were significantly different between groups (P <0.01). After adjusting for age and gender (model 1), the results showed that the HR value (95% CI) of CHD incidence was 4.15 (1.24 ~ 13.93) in the high social psychological stress population and the mental health population. Based on the model 1 The results showed that the HR (95% CI) of CHD incidence was 4.54 (1.34 ~ 15.35) when compared with the psychosocial factors in the population with high social psychological stress ). On the basis of model 1, the factors related to the incidence of coronary heart disease such as smoking history, BMI, total cholesterol and so on were further adjusted. The results showed that the HR of coronary heart disease (95% CI ) Was 4.34 (1.29 ~ 14.58). Factors such as marital status, ethnicity, history of diabetes mellitus, smoking history, BMI, total cholesterol and other factors related to social psychological stress and coronary heart disease were further adjusted on the basis of model 1. The results showed that high society The psychological stress population and mental health of the population, the incidence of coronary heart disease (95% CI) was 4.69 (1.38 ~ 15.93); based on the model 1 to adjust all the factors, the results showed that high social psychological stress and mental health populations ratio , CHD value HR (95% CI) 4.76 (1.39 - 16.26). Conclusion Social psychological pressure is closely related to the incidence of coronary heart disease, reducing social and psychological stress in the elderly, is conducive to reducing the risk of coronary heart disease.