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云南省罗平县高血压的经济负担与烟草暴露的关系研究
作者:李淑娟 蔡乐 舒占坤 叶亚怀 冯锐 崔文龙 何建辉
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摘要:

   目的分析云南省罗平县高血压与烟草暴露的相关关系,测算归因于高血压的直接经济负担。方法采用按比例概率抽样法(PPS),于2011年4月在云南省罗平县12个乡镇中分别抽取当地18岁以上常住农村居民5000名,完成调查4611名。采用自行设计的调查问卷收集调查对象的一般情况、吸烟情况、因患高血压的门诊费、住院费、治疗费、药费、交通费、住宿费和营养费及健康相关行为等信息,测量其身高、体重、腰围、臀围和血压。同时计算高血压患者的直接经济负担。采用χ2检验比较性别间高血压患病率、吸烟及被动吸烟率的差异;采用t检验比较性别、是否吸烟及是否被动吸烟之间高血压直接经济负担的差异;采用多因素logistic回归模型分析高血压患病的影响因素。结果罗平县4611名调查对象的年龄为(4690±1674)岁,男性占498%(2294/4611),女性占502%(2317/4611);男性吸烟率[757%(1736/2294)]高于女性[16%(38/2317)](χ2=266921,P<001);男性被动吸烟率[100%(230/2294)]低于女性[462%(1070/2317)](χ2=74427,P<005);男性非烟草暴露率[143%(328/1537)]低于女性[522%(1209/1537)](χ2=74437,P<005)。吸烟和被动吸烟者患高血压的风险均高于非烟草暴露者[OR(95%CI)值分别为141(115~171)、131(107~163)(P值均<005)]。高血压患者人均直接经济负担为(344409±306783)元,其中,烟草暴露者的人均直接经济负担为(455246±318905)元,高于非烟草暴露[(190771±138394)元](t=-381,P<005),吸烟者为(695171±342287)元,高于被动吸烟者[(312809±208317)元](t=319,P<005),男性为(582739±324050)元,高于女性[(263303±256901)元](t=322,P<005)其中归因于吸烟和被动吸烟的经济负担分别为041亿元和038亿元。结论吸烟和被动吸烟对云南省罗平县高血压患病率及经济负担造成了影响。

关键词:高血压;吸烟;烟草烟污染;经济负担;农村

Abstract:

   ObjectiveTo analyze the association between hypertension and tobacco exposure Luoping county of Yunnan province and estimate the direct cost attributable to hypertension  MethodsUsing Probability proportional to size (PPS) sampling method, 5000 rural residents aged over 18 years were selected from 12 townships in Luoping county, Yunnan province in April 2011, from which 4611 subjects completed the survey Selfdesigned questionnaires were used to collect general information, smoking status, costs for outpatient consultation, inpatient, treatment, medication, travel, accommodation and extranutrition caused by hypertension as well as the information of healthrelated behavior Their height, weight, waist circumference, hip circumference and blood pressure were measured The direct economic burden of hypertension was calculated Chisquare (χ2) test was used to compare gender differences of hypertension prevalence, smoking and passive smoking. And t test was used to compare the differences of direct economic burden of hypertension among different gender, smoking and passive smoking statusMultivariable logistic regression model was used to analyze the influence factors of hypertension ResultsAmongthe 4611 subjects, the age was(4690±1674)years old Male accounted for 498%(2294/4611)and female 502%(2317/4611) The smoking rate was higher in males (757% (1736/2294))  than in females(16% (38/2317)) (χ2= 266921, P<001) The passive smoking rate was lower in males (100% (230/2294)) than in females (462% (1070/2317)) (χ2= 74427, P<005) Nontobacco exposure rate in males (143% (328/1537)) was lower than in females (522% (1209/1537))(χ2=74437,P<005) The risk of hypertension in smokers and passive smokers were higher than those without tobacco exposure, OR(95%CI)was 141(115-171)(P<005) and 131(107-163)(P<005)respectively The per capita direct cost of hypertension was (344409±306783) Yuan Of this, tobacco exposure (455246±318905)Yuan was higher than  nontobacco exposure(190771±138394)Yuan(t=-381,P<005)Moreover, smokers were (695171±342287)Yuan higher than passive smokers(312809±208317)Yuan(t=319,P<005) and males(582739±324050)Yuan were higher than females(263303±256901)Yuan(t=322,P<005) The total direct costs of hypertension attributable to smoking and SHS was 41 million and 38 million, respectively ConclusionBoth smoking and SHS had significant impact on prevalence and economic burden of hypertension in Luoping county Implementing effective strategies to control tobacco exposure is useful to reduce the economic burden of hypertension in the study region

Key words: Hypertension;Smoking;Tobacco smoke pollution;Economic burden;Rural area

发表日期:2013/10

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参考文献:

[1]刘红艳,彭辉,刘奥博,等.中国人原发性高血压危险因素Meta 分析.中国心血管杂志, 2009,14(3):205209.
[2]李镒冲,王丽敏,姜勇,等.2010年中国成年人高血压患病情况.中华预防医学杂志,2012,46(5):409413.
[3]骆文书,郭志荣,胡晓抒,等.腰围和体质指数动态变化对高血压发病的影响.中华预防医学杂志,2011,45(11):10121016.
[4]刘立生.中国高血压防治指南.3版.北京:人民卫生出版社,2010:3536.
[5]中华人民共和国卫生部疾病预防控制司.中国成人超重和肥胖症预防控制指南北京:人民卫生出版社,2006.
[6]杨功焕,马杰民,刘娜,等. 中国人群2002 年吸烟和被动吸烟的现状调查.中华流行病学杂志,2005,26(2):7783.
[7]宋桂德. 吸烟归因死亡及经济损失研究方法. 中国慢性病预防与控制,1996,4(6):270272.
[8]程晓明.卫生经济学.北京:人民卫生出版社,2012:455456.
[9]向全永, 潘晓群, 吕淑荣, 等.吸烟与高血压相关关系研究.中国预防医学杂志,2010,11(11):11291131.
[10]周超, 雷燕, 杨春霞, 等.饮酒、吸烟和嗜盐等生活方式与高血压发病关联的Meta 分析.现代预防医学,2006,33(4):488490.
[11]Rodgers A,Ezzati M,Vander Hoom S , et al. Distribution of major health risks: findings from the Global Burden of Disease study. PLoS Med 2004,1(1):e27.
[12]李玲,陈秋霖, 贾瑞雪,等. 我国的吸烟模式和烟草使用的疾病负担研究. 中国卫生经济, 2008,27(1):2630.
[13]云南省统计局,国家统计局云南调查总队.云南统计年鉴2011.北京:中国统计出版社,2011:526527.
[14]涂洪谊,吴晶.不同等级医院医保老年患者住院费用分析.中国公共卫生,2009,25(8):10151016.
[15]Druss BG, Marcus SC, Olfson M, et al. Comparing the national economic burden of five chronic conditions. Health Aff (Millwood) ,2001,20(6):233241.
[16]陈杨,肖义泽,杨永芳,等.云南省居民高血压疾病负担. 中华预防医学杂志,2010,44(2):169170.

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