【作者】 宋兆录；

【导师】 郑文贵； 翟慎永；

【作者基本信息】 山东大学 ， 公共卫生（专业学位）， 2013， 硕士

【摘要】 研究背景：高血压是以体循环动脉压增高为主要表现的临床综合征。高血压患者较正常血压者更容易合并其他心脑血管疾病,长期高血压可能成为多种心脑血管疾病的重要危险因素。随着全球工业化的发展,近代人类的疾病谱已经发生显著改变,脑卒中、冠心病已经成为威胁我国人民健康的重大疾病,而血压升高是脑卒中和冠心病的独立危险因素,高血压、糖尿病等慢性非传染疾病成为我国居民死亡的主要原因之一,给社会带来沉重的疾病负担和经济负担。2002年我国18岁以上成年人高血压患病率为18.8%,患病人口约为1.6亿,高血压患病率呈明显地逐年上升趋势。在中国高血压是造成40岁以上成年人死亡的首要可预防因素。由于人们生活水平的逐步提高,外界环境因素不断发生变化,铁路部门的工作日益紧凑,铁路职工的健康现况不容乐观,目前国内对铁路职工的高血压患病情况的调查不多。研究铁路职工目前的高血压患病状态及其影响因素,可以为高血压病的防治工作提供科学的依据。研究目的：本研究的主要目的是通过对2006年和2010年两个时间断面济南市铁路职工高血压患病情况的研究,了解济南市铁路职工高血压患病基本情况,分析其流行趋势及相关影响因素,为制定高血压防控策略提供科学依据。具体研究目的如下：1.了解济南市铁路职工血压水平及变动趋势；2.分析济南市铁路职工高血压流行病学特征；3.分析影响济南市铁路职工高血压患病的影响因素,为制定适合该人群的卫生政策和干预措施提供科学依据；研究方法：以济南市铁路职工为调查对象,收集2006年、2010年济南市铁路职工年龄大于18岁的人群作为调查对象进行流行病学研究,研究共收入20109例职工,其中男15633(77.7%)人,女4476(22.3%)人。将收集到的数据资料,利用Excel数据库进行整理,然后利用SPSS软件进行统计学处理和分析。主要研究结果：1.2006年、2010年济南市铁路职工血压水平男性均高于女性,其中年龄越大,血压水平越高；2010年各年龄段血压水平较2006年同年龄段增高。2.调查对象的高血压患病率随年龄增长而增高,男性的高血压患病率明显高于女性。2006年济南铁路职工高血压患病男性为27.7%,女性为9.8%;2010年济南铁路职工高血压患病男性33.6%,女性为14.3%。3.不同工种中,机务段组高血压患病率最高,达29.1%,客运段组高血压患病率最低,为22.3%,车辆段组高血压患病率升高最明显。与2006年相比,2010年不同分组人群高血压患病率增高。4.吸烟人群与不吸烟人群比较,吸烟者高血压患病率高。与2006年比较,2010年吸烟与不吸烟人群高血压患病率均较2006年高。饮酒者较不饮酒者高血压患病率高,2010年高血压患病率饮酒者人群与不饮酒者人群均高于2006年。5.调查人群中,高体重、高血糖、高甘油三酯、高胆固醇、脂肪肝是高血压患病率的重要危险因素,且在各组中,2010年高血压患病率都较2006年高。结论与建议：主要结论：1.济南铁路职工患慢性病病种多、患病率高,且呈增高趋势。铁路职工的健康状况不容忽视,仍需加大预防保健力度。2.2010年济南铁路职工高血压患病率高于2006年；其中高脂、高糖、高体重、年龄、吸烟、饮酒、脂肪肝等是影响高血压患病率的重要因素,合理科学的饮食搭配、健康的生活习惯是减少高血压对人体危害的关键。建议：1.积极宣传,提高认识,加强高血压的预防,遏制高血压的高发态势；2.改善工作环境,合理利用医疗卫生资源；3.合理膳食,均衡营养；4.定期体检,提前发现,提前治疗；5.调高对心理健康工作的重视,积极辅导治疗；6.积极认真开展健康调查,及时全面制定治疗方法。更多还原

【Abstract】 BackgroundHypertension is a clinical syndrome that arterial pressure increases as the main performance. Studies have shown that patients with high blood pressure are more easily to suffer the other cardiovascular diseases than the ones with normal blood pressure, long-term high blood pressure may give rise to an important danger in suffering from variety of cardiovascular diseases.Along with the progress of global industrialization, the disease spectrum of modern human has been notably changed, stroke is an important threat to our people’s health, elevation of blood pressure is the independent risk factor of stroke and coronary heart disease, the increasing rates of chronic non-infectious disease, such as high blood pressure, diabetes, have become one of the important leading causes to death of the residents in our country, which has been made our society suffer from heavy disease and economic burden. In the year of2002, the rate of hypertension in the adults above the age of eighteen in our country with hypertension was18.8%, the population reached about160million. Compared with the rate of1991, it has been increased58%during the certain11years. The number of the population of hypertension increases more than6million each year, it shows the rate of hypertension prevalence has an obvious increasing tendency per year. In china, hypertension is a chief death preventable factor above forty years old adults.Hypertension is a complicated disease, and it is affected by multiple factors. As people’s living standard increasing day by day, the environment factors are constantly changing, The railway departments’work has had an increasingly pace, but railway employees’health status has not got enough attention. At present there is a few investigation about the illness of hypertension in our country. This research, through a large scale survey, is aimed to explore the basic information of hypertension of Jinan railway employee and the following influencing factors, and then to provide the basis for the prevention of hypertension.AimsThe main aim of the study is to analyze the prevalence trend of hypertension in railway employees on the job in Jinan between2006and2010, learn about the relevant factors affecting the prevalence rate of hypertension, and thus provide basic information for prevention and control of hypertension. The specific research purposes are as follows:1. To learn about blood pressure level and variation tendency in employees of railway enterprise in Jinan between2006and2010;2. To analysize the epidemiological characteristics of hypertension in employees of railway enterprise in Jinan;3. To find out influence factors that can affect the prevalence of hypertension, and to formulate suitable political suggestions on prevention and provide the scientific basis for intervention measures.MethodsTaking Jinan railway employees as the research object, we have collected20109cases of Jinan railway employees in the year of2006and2010, whose age above eighteen years old, for epidemiological studies. And15633are men (77.7%) and4476are women (22.3%).The collected datas were arranged by using Excel database, and then were going to be processed and analysed by using the SPSS software. Main Results 1. Jinan railway female employees’blood pressure levels are both higher than the men’s in the year of2006and2010, and the older employees are, the higher blood pressure level the people get; level of blood pressure in each age groups of2010are higher than ones in2006.2. In the Survey, hypertension prevalence rate increases along with the age, male hypertension prevalence is obviously higher than that of the female. In the year of2006, the hypertension prevalence rate of male is27.7%, and that of the female is9.8%, however, the rate add to33.6%and14.3%in the year of2010.3. In the occupation group, the hypertension incidence of locomotive depot group was highest, which is29.1%; passenger traffic section group’s hypertension prevalence was the lowest, which is22.3%; car depot group is the highest blood pressure elevator among all the group. Compared with2006,2010people in different groups had a higher hypertension prevalence.4. Compared with the people who are not smoking, smoking people’s blood pressure is higher. Compared with the people who are not drinking, drinking people’s blood pressure is higher.5. In the survey, high weight, high blood sugar, high triglycerides, high cholesterol, and fatty liver disease are important risk factors for hypertension prevalence.Conclusion and Suggestion1. Jinan railway employees are in a condition that is surrounded with multiple chronic diseases, which their prevalence rates are higher than usual, and the rates shows rising tendency. Railway employees’health are not allow to be ignored, we still need to make much effort to strengthen health care.2. In2010, the prevelace rate of hypertension among Jinan railway employeesr are higher than that of2006. The high fat and hyperglycemia, high weight, aged, smoking, drinking alcohol, fatty liver disease are the important factors affecting the prevalence of high blood pressure, reasonable scientific diet collocation, healthy habits is a key to reduce the harm of blood pressure from human body.3. We have some opinion for the prevention and control of hypertension: Sugguestion1. Carry out publicity positively, and raise awareness of the important of prevention of hypertension, and strengthen the the prevention of hypertension, then to suppress the elevation of the incidence of hypertension; Sugguestion2. Improve the working environment, and make reasonable use of health resources; Sugguestion3. Keep the reasonable diet and balanced nutrition; Sugguestion4. Make a regular physical examination, to get early detection and early treatment; Sugguestion5. Make attention to the mental health work, and develop actively counseling treatment; Sugguestion6. Carry out the health survey actively and seriously, and develop treatment methods timely and comprehensive.更多还原