目的 分析2018-2020年某燃煤电厂职工职业健康检查结果、了解职业性危害因素对劳动者健康危害程度，为企业预防和 控制职业病危害因素提供参考依据。方法 采取回顾性研究调查方法，选取2018-2020年该电厂在岗期间职业健康检查640名为研究对象， 同时结合工作场所环境检测报告危害因素检测结果，比较不同年度、性别、接害工龄劳动者的职业健康检查结果进行分析。结果 2018- 2020年某电厂在岗期间职业健康检查共计640人，其中536人检查项目出现异常结果（至少有1项为异常），异常检出率为83.75%[1]；2018- 2020年异常项目检出率分别占84.18%、85.91%、81.48%，2019年所占比例较2018、2020年增加；职业禁忌证为33人，检出率5.16%人；男 性高血压、心电图、电测听、胸部X线、肺功能、血糖检查异常显著高于女性，差异有统计学意义（P<0.05）；女性血常规、尿常规、 ALT异常检出率较高。接害工龄在20-30组段与30年以上组段的肺功能、胸部X线、电测听、耳科、尿常规异常检查率随着工龄增加而明 显增高趋势，差异有统计学意义（P<0.05）[2]。结论 某电厂工作场所职业危害因素检测结果显示主要危害因素有游离二氧化硅粉尘、煤 尘、噪声、高温、一氧化碳、二氧化碳、氮氧化物等，劳动者健康不仅仅与接触的职业病危害因素有关，还与不同性别、工龄、生活 习惯、职业暴露等息息相关，定期做好职业检查，综合评估劳动者健康状况，提供企业有针对性的防护对策和措施至关重要。

服务认证是推动行业规范发展,提升服务能力和质量的国际通行方法.我国的健康管理服务认证工作刚刚起步,北京电力医院有幸参与了服务认证试点工作,成为全国首批通过健康管理服务认证的四级健康管理机构之一.本文通过回顾北京电力医院参评的过程,总结申报经验,分享以认证促进健康管理工作提升的体会,以期为同行提供参照和思路.

目的:在健康体检人群初探肺结节异常结果分级管理方法.方法:在我院健康管理中心进行年度常规体检且含有胸部CT检查项目统一阅片,分析肺结节检出情况,并进行分级管理.结果:探讨体检客户肺结节后续分级管理追访服务工作的意义,实现慢性病管理早发现早诊断早治疗的目标.结论:健康体检人群检后管理是非常重要的工作,肺结节分级管理的方法和经验,值得推广至其他重要异常结果的分级分类管理中.

肺癌是目前最常见的恶性肿瘤.随着中国早癌筛查工作的推广,早期肺结节检测诊断和精准管理,对提高肺癌早期诊断率具有重要意义.本文将从低剂量螺旋CT检查、人工智能图像识别及多学科诊疗在肺结节管理的应用进行综述,并介绍北京电力医院健康体检人群的肺结节管理模式,以期优化肺结节管理.

Objective To investigate the dose-response relationship between body mass index (BMI) and hyperuricemia (HUA) among aged 30-60 adults in Beijing. Methods A questionnaire survey was conducted on 8 866 adults in Beijing Electric Power Hospital in 2012. Multivariate logistic regression and restricted cubic spline methods were used to explore the relationship between BMI and hyperuricemia management and dose-response analysis. Results Among 8 866 participants, there were 5 623 males (63. 4% ) and 3 243 females (36. 6% ). The prevalence rate of HUA was 18. 4% , and male was higher than female (24. 9% vs. 7. 1% ). Age, sex, smoking, BMI, blood pressure (BP), glucose and serum lipid level were significantly different ( all P <0. 05) . After adjusting for factors such as age, smoking, BP, glucose, total cholesterol, triglyceride, HDL-C and LDL-C, results showed that overweight men ( OR =1. 68, 95% CI: 1. 42-1. 99), obesity men (OR=2. 16, 95% CI: 1. 76-2. 65), overweight women ( OR=1. 59, 95% CI: 1. 15-2. 20) and obesity women (OR=2. 77, 95% CI: 1. 79-4. 27) had increased the risk of HUA (all P<0. 0001). Restricted cubic spline analysis showed a non-linear dose-response relationship between the continuous change in BMI and hyperuricemia in the male population (χ2 =15. 49, P=0. 0004) and a linear relationship in female (χ2 =0. 57, P=0. 7521). Conclusions There is a certain correlation between continuous changes of BMI and HUA. A non-linear relationship is found in male and a linear relationship was found in female.

[Objective] To understand the effect of the component number of metabolic syndrome (MS) on hyperuricemia (HUA) among health examination population in Beijing Electric Power Hospital in 2015,and provide the basis for early diagnosis of HUA.[Methods] The data of health examination population in Beijing Electric Power Hospital in 2015 were collected,and multivariate logistic regression was used to analyze the correlation of the component number of MS and HUA.[Results] A total of 12 335 respondents (7 681 men and 4 654 women) with mean aged (45.46±14.16) were included in this study.The prevalence rate of HUA was 18.30％,and MS group was higher than that in normal group (P＜0.01).After adjusted for age,sex,smoking,drinking and other confounding factors,the results showed that the component number of MS was independent risk factors of HUA.Subjects were divided into six groups (0,1,2,3,4 and 5) according to the number of abnormal metabolic components.Compared with 0 as the reference group,the OR (95％CI) of H UA in other groups were 1.964 (1.679-2.298),3.347 (2.862-3.915),4.996 (4.228-5.903),6.702 (5.478-8.200),7.499 (5.233-10.745).With the increasing of the abnormal component number of MS,the prevalence risk of HUA increased (P＜0.01).[Conclusion] The component number of MS in health examination population has a certain relationship with the occurrence of HUA.

Objective To investigate the correlation between metabolic syndrome ( MS) and hyperuricemia( HUA) in physical examination population. Methods A cross-sectional survey was conducted in 2015 for the health examination of people aged over 18 years old at Beijing Electric Power Hospital. Multivariate logistic regression was used to assess the correlation between the components of MS and the risk of HUA. Results A total of 12335 subjects were enrolled in this study,including 7681 males and 4654 females,with an average age of 45. 5 ± 14. 2 years. The prevalence of HUA was 18. 30% (2257 /12335),which was significantly higher in MS group than that in the non-MS group( P < 0. 001). In full adjusted model,overweight(OR = 2. 310,95% CI:2. 054 - 2. 598),obesity(OR = 3. 920,95% CI:3. 413 -4. 502),hypertension(OR = 1. 660,95% CI:1. 505 - 1. 831),impared fasting glucose(OR = 1. 445,95% CI:1. 292 - 1. 617), hypertriglyceridemia ( OR = 2. 935,95% CI:2. 660 - 3. 237) and declined high density lipoprotein cholesterol ( OR = 2. 009, 95% CI: 1. 815 - 2. 224 ) were significantly associated with the prevalence of HUA(all P < 0. 05). Conclusions There is a certain relationship between MS components and hyperuricemia in adults in physical examination population.

Objective In this study,we intended to investigate whether dyslipidemia,blood glucose,blood uric acid and blood pressure were associated with body mass index.Methods A total of 2 336 healthy people were recruited from the tertiary care hospital in 2012,and the height and body weight,BMI,the blood pressure was collected,and the total cholesterol (TC),triglyceride (LDL-C),high density lipoprotein cholesterol (HDL-C),uric acid (UA) and fasting blood glucose (GLU)were analyzed.To investigate the prevalence of hyperuricemia,hypertension,impaired fasting glucose and dyslipidemia at different body mass index (BMI) levels,and to analyze the interaction between overweight,obesity and hyperuricemia,hypertension,impaired fasting glucose and dyslipidemia.Results The ratio of overweight to obesity of men was higher than female.With increases of age,the average BMI and overweight and obesity ratio increases,and the male was higher than female.The difference was statistically significant (P =0.000).The levels of TG,GLU,UA,SBP and DBP increases with the mean increase of body weight,while the mean level of HDL-C weight loss was reduced.There were significant differences in hypertriglyceridemia,abnormal glucose metabolism,hyperuricemia and hypertension between the obesity group and the normal,detail ratios for each factor were distributed as follows:2.2,2.1,2.6,and 2.4.The difference was statistically significant (P =0.015).Logistic regression analysis showed that sex,TG,GLU,UA,DBP,HDL-C were significantly associated with overweight and obesity(P ＜ 0.05).Conclusion The result of this study indicate that high blood pressure,dyslipidemia,hypertension,hyperuricemia are associated with overweight and obesity.Weight control is one of the most important measure to prevent cardiovascular disease and metabolic diseases.

目的 探讨北京市某三级医院体检人群尿酸与代谢综合征的关系.方法 对2012年在北京某三级医院进行健康体检的人群进行横断面调查,包括问卷、体格检查、生物化学指标测定等.采用2009年国际糖尿病联盟(Internal Diabetes Federation,IDF)和美国心脏协会(American Heart Association,AHA)/国立心肺和血液研究(National Heart Lung and Blood Institute,NHLBI)发表的联合声明作为代谢综合征诊断标准.根据四分位数将尿酸分为4组,采用多因素Logistic回归探讨年龄、性别、尿酸与代谢综合征的关联性.结果 符合纳入标准的研究对象共10 061例,其中男性6 089例,女性3 972例,平均年龄为(43.35±13.18)岁.根据尿酸四分位数将人群分为4组:Q1(＜264.85 μmol/L)、Q2(264.85～324.00 μmol/L、Q3(324.01 ～383.25 μmol/L),Q4(≥383.26 μmol/L).以尿酸第1四分位数(Q1)区间人群为参照组,调整年龄、性别后,尿酸第2、3、4四分位数区间人群发生代谢综合征的优势比(OR)及其95％ CI分别为:1.987 (1.570 ～2.514)、3.144 (2.470～4.000)、5.821 (4.573 ～7.410).随着尿酸的增加,患代谢综合征的风险增加(P trend＜0.000 1).结论 北京市成年人群尿酸与代谢综合征发生具有一定关联性.

目的 评价基于信息平台的某电网功能社区慢性病高风险人群健康干预效果.方法 2011年1月,选取某电网下属单位637名员工进行健康风险评估,对评估出的160例慢性病高风险人群按随机数字表法分为干预组(n=80)和对照组(n=80),于2011年2月～2012年3月通过健康管理信息平台对其进行干预,评估干预后效果.结果 干预后干预组中80例慢性病高风险人群收缩压(SBP)、空腹血糖(FBG)、血清总胆固醇(TC)3项指标水平较干预前明显下降(P＜0.05),体重指数(BMI)、舒张压(DBP)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)4项指标较干预前差异无统计学意义(P＞0.05);干预后对照组中80例慢性病高风险人群DBP、FBG、LDL-C水平较干预前明显升高(P＜0.05).结论有效而规范的功能社区健康管理可改善慢性病高风险人群的健康状况,延缓或逆转生化指标异常的发生.

人到中年，上有老下有小，在家是顶梁柱，在单位是骨干，难免时常加班熬夜，废寝忘食，有病了也总是无限期拖延。长期透支健康，身体多少会出现小问题。如何让自己健康地做好中年到老年的过渡？做到“5不熬”是重要措施。

Objective To explore the association between the count of lymphocyte and the occurrence of metabolic syndrome (Mets)in a cohort study in male and female Beijing adults specifically in gender.Methods Clinical data of 7 489 cases who took at least 3 health examination from 1st January 2007 to 31th December 2012 were retrospectively ana-lyzed in Beijing Electric Power Hospital and Beijing Xiaotangshan Hospital.The count of lymphocyte of research objects was obtained from the blood routine examination.And the lymphocytes were divided into 4 levels according to the quartile (Q1≤25%,Q2:25%-50%,Q3:50%-75%,Q4>75%)in gender.Metabolic syndrome was diagnosed by the last data of health examination.Generalized estimating equation model was used to assess the relationship between metabolic syndrome and the lymphocyte.Results During the 5 years’follow-up,378 cases appeared MetS,including 203 males and 175 fe-males.And the incidence density of Mets was 12.67 per 1000 person-years.Compared with Q1,the males’BMI increased in Q4 (RR=2.200 8,95% CI:1.090 8-2.045 7 ),and the males’TG increased in Q1,Q2 and Q3(RR=1.208 4, 1.442 5,1.707 7,95%CI:1.032 3-1.414 6,1.210 3-1.7192,1.406 5-2.073 5).Compared with Q1,the females whose lymphocytes were Q4 increased the risk of MetS (RR=2.200 8,95%CI:1.221 9-3.964 0).Conclusions The increase of males’lymphocytes may associate with the increase of BMI and TG,and the increase of females’lymphocytes may associ-ate with the occurrence of MetS in Beijing adults.

目的 探讨精益化管理在健康体检中的应用方法与效果.方法 采用精益化管理的思想,分解细化体检全过程,对其中每个工作环节进行细化管理,并对实行精益化管理前后健康体检接待量、收入、成本及服务满意度进行比较.结果 实行精益化管理后体检的接待量增加了56.0％,收入增加了39.8％,人均消耗降低了10.1％,客户满意度提高至98.5％.结论 在健康体检中实行精益化管理,能够有效提高客户接待量,降低物品消耗,提高客户满意度,增加体检收益,值得在体检工作中推广.

Objective To explore the relation of physical indicators to cardiovascular risk factors in occupation population of power transmission workplace to provide evidence for their health management.Methods A cross-section study was carried out in Beijing,Tangshan and Zhangjiakou.Multi-phase,stratified,unequal proportional and cluster sampling was adopted to investigate occupation population of power transmission workplace aged 18-60 years.Two sample or multiple samples were compared using x2 test.Multivariate linear regression was used for data analysis.Results In Beijing,Tangshan and Zhangjiakou,the distribution rate of overweight,obesity,high systolic blood pressure,high systolic blood pressure,high diastolic blood pressure,high diastolic blood pressure,impaired fasting glucose,fasting blood glucose,high total cholesterol,abnormal cholesterol,high triglyceride,abnormal triglyceride,high lowdensity lipoprotein,abnormal low-density lipoprotein,reduced high-density lipoprotein,abnormal interleukin,abnormal alanine transaminase and abnormal creatinine were 38.9％,9.7％,30.1％,17.4％,34.8％,24.4％,7.1％,6.6％,19.8％,7.9％,17.2％,21.8％,14.5％,3.8％,15％,2.7％,6.7％ and 4.6％,respectively.In multivariable liner regression analysis,systolic blood pressure,diastolic blood pressure,BMI,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein and alanine aminotransferase were significantly related to several risk factors of chronic disease.Conclusion The abnormal rate of physical indicators in occupation population aged 18-60 years was high.Health management for power supply occupation population should be strongly advocated.

Objective To explore the effects of antihypertensive medicines on brachia-ankle pulse-wave velocity of hypertension patients. Methods Total 129 patients who received health examination and were diagnosed as hypertension in our hospital from Dec. of 2012 to Dec. of 2013 were selected. According to the medicines they took,these subjects were divided into Aprovel group(n= 34),Diovan group(n = 25),Norvasc group(n = 29),Lotensin group(n = 23)and untreated group(n = 18);and then,the differences in heart rate,blood pressure,pulse pressure and baPWV were compared among 5 groups. Results The systolic pressure,diastolic pressure,pulse pressure and baPWV of the patients taking antihypertensive medicines were significantly different from those of the untreated patients(P < 0. 01),while there was no significant difference in heart rate. Among the 4 groups of patients receiving medicine treatment,the systolic pressure,diastolic pressure and pulse pressure had no significant difference(P > 0. 05). The baPWV of the 5 groups of patients was(1566. 2 ± 335. 0),(1589. 8 ± 288. 6),(1519. 5 ± 198. 4),(1702. 3 ± 517. 5)and(1858. 1 ± 341. 3)cm/ s, respectively,and there were differences among 5 groups(P < 0. 05). Conclusion Above four antihypertensive medicines can reduce effectively the blood pressure of hypertensive patients,but their effect in improving the function of arterial elasticity is different and the effect of Norvasc is the most remarkable comparatively.

目的：探讨颈动脉内膜增厚与高血压、高脂血症、糖尿病、冠心病的相关性，为对上述慢性病的干预提供科学资料。方法采用高分辨彩色多普勒超声对648例体检者进行颈动脉超声检查，同时进行病史询问、测量血压、测定空腹血糖、总胆固醇（TC）及三酰甘油（TG），并进行相关性统计分析。结果648例体检者中颈动脉内膜增厚481例（72．5％），其中高血压、高 TG 、高 TC 、糖尿病、冠心病5项全无者161例（24．8％），具有其中1项者241例（37．3％），2项者173例（26．7％），3项者63例（9．7％），4项者10例（1．5％），未见5项全有者。结论发现不同程度颈动脉内膜增厚的病例中，有75．2％兼有高血压、高血脂、糖尿病、冠心病，由此提示颈动脉内膜增厚与上述慢性病之间具有密切的相关性。

职业人群是人类社会最富生命力、创造力和生产力的宝贵资源,他们的文化技术素养、身心健康和社会适应状态,将直接影响国民经济发展和进步,影响企业生存发展和社会稳定[1-2].企业健康管理是节约和保护健康劳动力资源,促进我国经济社会可持续发展的必由之路.对企业来说,对员工进行健康管理不但能提高企业员工的健康素质能力,使企业员工在有限的时间内创造出更高的生产价值,而且还可节约不断上涨的医疗费用,使企业效率和利润获得非生产性提高[3].除此以外,通过职工健康管理可以体现企业对职工的关爱,增加职工生活的幸福感同时提高职工对企业的忠诚度.因此,开展职业人群健康管理的必要性和意义越来越被企业和社会认同[4].

Objective To investigate the association of rs1799724 polymorphism in tumor necrosis factor-α(TNF-α) gene promoter region with the susceptibility of pulmonary tuberculosis.Methods The case-control study was performed in 302 patients to 302 health people;the rs1799724 polymorphism genotype was detected by amplification refractory mutation system(ARMS-PCR).The data were analyzed by SPSS software.Results There were no significant in distribution of rs1799724 polymorphism of TNF-α gene in patients and healthy people(P0.05).Conclusion Our results indicated that the TNF-α gene rs1799724 polymorphism was not associated with the pulmonary tuberculosis susceptibility in Chinese Han people.