文章摘要
李贤,刘庭明,张建新,阎丽静,孙纪新,郝志新,李聪,武阳丰.中国北方农村成年人群心血管病高危个体简易检出方法的评价[J].中华流行病学杂志,2014,35(9):981-984
中国北方农村成年人群心血管病高危个体简易检出方法的评价
Evaluating a simplified method for identifying high-risk individuals for cardiovascular diseases in the resource-constrained rural areas of China
投稿时间:2014-04-29  
DOI:10.3760/cma.j.issn.0254-6450.2014.09.002
中文关键词: 心血管病;高危个体;适宜标准;农村
英文关键词: Cardiovascular diseases;High-risk individuals;Suitable standard;Rural areas
基金项目:美国国立卫生研究院心肺血研究所联邦基金(HHSN268200900027C)及美国联合健康集团慢性病行动联合资助
作者单位E-mail
李贤 100088 北京大学医学部乔治健康研究所 中国国际慢性病预防中心  
刘庭明 陕西省安康职业技术学院临床医学系  
张建新 河北省疾病预防控制中心  
阎丽静 100088 北京大学医学部乔治健康研究所 中国国际慢性病预防中心  
孙纪新 河北省疾病预防控制中心  
郝志新 100088 北京大学医学部乔治健康研究所 中国国际慢性病预防中心  
李聪 100088 北京大学医学部乔治健康研究所 中国国际慢性病预防中心  
武阳丰 100088 北京大学医学部乔治健康研究所 中国国际慢性病预防中心
北京大学公共卫生学院 
ywu@georgeinstitute.org.cn 
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中文摘要:
      目的 评价中国农村健康行动(CRHI)项目中提出的心血管病高危个体检出标准(CRHI标准)是否适宜在我国农村地区使用。方法 选择河北 省两县各12个村随机抽取的2 036名≥20岁成年人进行体格检查和问卷调查。以《中国成人血脂异常防治指南》中的高危定义作为“金标准”,评价采用CRHI标 准检出心血管病高危个体[有冠心病或卒中病史者;或高龄(男性≥50岁,女性≥60岁)且患有糖尿病者;或高龄且SBP≥160 mmHg者]的灵敏度和特异度以及阳 性和阴性预测值等。 结果 CRHI标准与“金标准”的符合率为92.9%,灵敏度和特异度分别为77.2%和98.5%,约登指数为0.76,阳性和阴性预测值分别为94.7% 和92.5%。按CRHI标准,心血管病高危个体检出率为21.3%,随年龄增长呈显著升高趋势(P<0.001)。其中60岁以上人群检出率约为44%。结论 CRHI标准简便 易行,适宜我国医疗卫生资源缺乏的农村地区检出心血管病高危人群。
英文摘要:
      Objective This research project aimed to evaluate whether a simplified method for identifying high-risk individuals for cardiovascular diseases proposed by the China Rural Health Initiative (CRHI) was feasible in the rural areas in China. Methods 2 036 adults,aged 20 years or older were stratified-randomly sampled from 12 villages in Luquan county and Anguo county (Hebei province) respectively,to receive physical examination and filling in administered questionnaires. "Gold Standard" was used on high risk in Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults to evaluate the CRHI standards:people with a history of coronary heart disease or stroke,or elderly as men ≥50 years or women ≥60 years with diabetes,or elderly with systolic blood pressure ≥160 mmHg. Sensitivity,specificity,positive and negative predictive values related to the identification of high-risk individuals for cardiovascular diseases were assessed. Results The concordance rate between the CRHI standard and the gold standard was 92.9%,with sensitivity as 77.2%,specificity as 98.5%,Youden's Index as 0.76, positive predictive value as 94.7% and negative predictive value as 92.5%. Under CRHI standard,21.3% of the adults were identified as high risk. The rate was increasing with age (P<0.001),reaching 44% among those who were over 60 years old. Conclusion The CRHI standard seemed simple and easy and was suitable for identifying high-risk individuals for cardiovascular diseases in the resource-constrained rural areas.
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