目的 评价石家庄市社区居民健康自我管理的效果.方法 以石家庄市参与健康自我管理小组活动的所有成员作为调查对象,2017年4月对其进行基线调查,然后对其进行综合干预,2017年12月再次对其进行随访调查.结果 干预后调查对象自觉控制油、盐摄入,自觉控制体质量的比例均高于干预前,差异有统计学意义(P均＜0.01),干预后调查对象合理使用限盐勺、控油壶、腰围尺及BMI尺等膳食指导工具,经常吃新鲜水果、经常吃新鲜蔬菜、正确保持口腔卫生、良好的洗手习惯、具有防范伤害发生意识的比例高于干预前,差异有统计学意义(P均＜0.01);吸烟率、被动吸烟率低于干预前,差异有统计学意义(P均＜0.01),腰围、收缩压、空腹血糖均低于干预前,差异有统计学意义(P均＜0.01),干预后高血压、糖尿病患病率均低于干预前,血压及空腹血糖及控制率均高于干预前,差异有统计学意义(P均＜0.01).结论 在社区利用健康自我管理小组的形式能够提高社区居民健康行为比例,改善体检指标.

目的 了解石家庄市成年居民高血压患病的流行病学特征及其相关危险因素,为制定综合防控措施提供参考依据.方法 2018年7-10月采用多层随机抽样,抽取石家庄市7个县(市、区)35个监测点＞18岁的居民4 375名,进行面对面调查,并进行健康检查和相关测量.结果 被调查人群中1 338人患高血压,患病率为30.58％,标化率为29.41％;城市居民高血压患病率为18.19％,农村居民高血压患病率为33.58％.不同年龄、性别、地区、职业、文化程度、婚姻、吸烟状况、每日摄盐量、每日蔬果摄入量、每日红肉摄入量、每日睡眠时间、锻炼、体质指数(BMI)、中心性肥胖、糖尿病及三酰甘油居民高血压患病率比较,差异均有统计学意义(均P＜0.05).男性、年龄大、农村、每日摄盐量超过6 g、中心性肥胖、超重肥胖、糖尿病和高三酰甘油是高血压患病的危险因素,OR(95％CI)分别为1.413(1.215～1.642)、1.706(1.617～1.799)、2.422(1.930～3.041)、2.215(1.270～3.862)、2.213(1.805～2.714)、1.419(1.178～1.710)、1.791(1.451～2.210)和1.589(1.305～1.935),经常锻炼是高血压的保护因素,OR(95％CI)为0.785(0.652～0.947).结论 石家庄市成年居民高血压患病率较高,城乡差异较大.发病与多种因素有关,应强化基层综合管理,加强健康教育,倡导健康生活方式,指导居民加强血压日常测量,达到早预防、早发现和早治疗的目的.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的了解河北省石家庄市≥18岁居民超重与肥胖现状及其影响因素,为采取相应干预措施提供参考依据。方法采用多阶段分层整群随机抽样方法在石家庄市9个区/县（市）抽取9 605名≥18岁居民进行问卷调查和体格检查。结果石家庄市≥18岁居民超重/肥胖率为53.5%,其中超重率为34.1%,肥胖率为19.4%;不同性别、年龄、文化程度、婚姻状况、饮酒情况、睡眠时间、上网时间和看电视时间居民超重/肥胖率差异均有统计学意义（均P&lt;0.05）;多因素非条件logistic回归分析结果显示,年龄≥30岁、婚姻状况为已婚/同居和离异/丧偶/分居、饮酒是石家庄市≥18岁居民超重/肥胖的危险因素,文化程度为中学是石家庄市≥18岁居民超重/肥胖的保护因素。结论石家庄≥18岁居民超重/肥胖率较高,年龄、文化程度、婚姻状况和饮酒情况是该地区居民超重/肥胖的主要影响因素。</span>

Objective To study the prevalence of smoking in 2013 and its change trend between 2008 and 2013 among residents in Shijiazhuang city and to provide reliable evidences for developing tobacco control strategies. Methods Through random stratified sampling,10 201 permanent residents ≥15 years old were selected from 9 districts in Shijiazhuang city and interviewed face-to-face with a questionnaire in 2013 and the change trend in the prevalence of smoking compared to in 2008 was analyzed. Results Among the residents the current smoking and everyday smoking rates were19. 8% and 16. 8%,and the average number of cigarettes smoked was 18. 1 ± 10. 3 per day for current smokers; for all the smokers the average age of initial smoking was 19. 8 ± 5. 2 years and the smoking cessation and successful smoking cessation rates were 29. 4% and 10. 9%. There were differences in the rates of current smoking,everyday smoking,and smoking cessation among the residents of different gender,age,and living residence( all P 0. 05). The smokers at different age and living in different areas had significantly different average number of cigarettes smoked per day,initial age of smoking,and successful smoking cessation rate( all P 0. 05). Both the standardized smoking rate and everyday smoking rate among the residents were lower( 20. 5% vs. 23. 9% and 17. 5% vs. 19. 0%) than those from a survey conducted in2008. Conclusion Smoking was more prevalent in the males and among rural residents than in the females and among urban residents and although the prevalence rate of smoking showed a decrease trend compared to that in 2008 but was still at a high level in Shijiazhuang city.

目的 了解石家庄市区2009-2012年慢性病的发病和死亡发展趋势及规律,为制定慢性病防治策略提供依据.方法 收集2009-2012年石家庄市内五区报表,对高血压、糖尿病、心血管病、脑血管疾病、肿瘤等慢性病发病和死亡情况进行分析.结果 2009-2012年石家庄市内五区全人群各种慢性病报告发病率1 323.96/10万,报告死亡率77.02/10万.高血压报告发病率居首位,占发病数的61.30％;其次分别是糖尿病、心血管疾病、脑血管疾病.慢病发病率男性高于女性,随年龄增加而增加,其它类疾病报告死亡数占总死亡数的28.37％.结论 慢性病是威胁石家庄市居民健康的重大疾病,应加强对主要慢性病的预防和控制.

目的 了解社区老年人跌倒的流行病学特征及医疗负担.方法 采取随机抽样的方法对石家庄市两个社区的1609名60岁及以上老年人过去一年跌倒发生情况进行回顾性调查.结果 180人发生跌倒,年跌倒发生率为11.2％.女性(12.5％)高于男性(9.1％) (x2=4.618,P=0.032 ＜0.05).跌倒282人次,人次跌倒发生率为17.5％.跌倒发生在家中占48.0％,家外小区内占25.6％,小区以外占38.8％;跌倒自身原因,以运动中没有保持平衡(22.9％)和注意力不集中(22.1％)为主.跌倒环境因素中,24.0％没有保护措施,18.0％地面不平,12.0％路滑,10.8％物品挡路.跌伤率36.5％.跌倒后4.8％住院,8.2％到门诊急诊处理;住院天数中位数为23 d,在家卧床天数中位数为30 d.受伤中骨折最多,占43.4％.跌伤后12.7％活动能力明显下降.跌倒后的医疗花费中位数为510元.结论 社区老年人跌倒对健康危害较严重,造成一定的医疗负担.

目的掌握石家庄市区慢性病的发病和死亡发展趋势及规律,为制定慢性病防治策略提供依据。方法汇集市内5区疾控报表,对辖区内2011年新发现和死亡的高血压、糖尿病、心血管病、脑血管疾病、肿瘤等慢性病进行登记报告。结果 2011年市内5区全人群各种慢性病报告发病率0.87%,报告死亡率47.65/10万。高血压报告发病率居首位,占发病数的55.91%,其次分别是糖尿病、心血管疾病、脑血管疾病。其它类疾病报告死亡数占总死亡数的33.01%,发病率随年龄增加而增加。结论大力宣传普及慢性病防治知识,加强全人群的慢性病一级预防,提倡健康的生活方式,以减少和延缓慢性病发生。

全球已有5 000万人受耐药结核分枝杆菌的感染,全世界约有2/3的结核病患者处于发生耐药结核病的危险之中[1].在传统观念上,人们认为耐药的产生是由化疗方案不合理、服药不规则所致,实际上这主要是指获得性耐药,而且是指耐药菌株产生的最初原因.但随着耐药菌株的传播,原发性耐药会逐渐增多.在许多结核病控制较好的地区原发性耐药患者已占全部耐药患者的多数[2].

我国是世界上结核病负担最重的22个国家之一,结核病病例数在世界排名第二,具有高患病率、高耐药率、高死亡率、高感染率、低递降率的特点.在许多结核病控制较好的地区原发性耐药患者已占全部耐药患者的多数[1].考虑到目前初始耐药的病人已占一定的比例,重度肺结核病人病情严重,为提高其治疗效果,本文探讨了莫西沙星联合其他抗结核药物治疗重度初治涂阳肺结核患者,与常规治疗对照分析,结果如下

目的了解石家庄18个市管县结核病实验室痰涂片室质控工作。方法检测全市18个市管县疾病预防控制中心结核病实验室。结果现场抽样痰涂片总数2320张,其中阳性痰涂片326张,阴性痰涂片1994张,盲法复检和第二复检者完成后的结果痰涂片合格率98.4%。结论石家庄市18个市管县结核病实验室室间质控情况仍存在误差,有待提高。

<正>为提高肺结核病人的发现,卫生部要求医疗卫生单位将疑似或确诊的肺结核病人统一转诊到结核病防治机构治疗管理,同时,在疾病监测信息报告管理系统中报告,到位的病人及时确诊,未到位的病人进行追踪。本文对2009年石家庄市区非结防机构网络直报肺结核病人追踪情况分析如下。

<正>为了解掌握目前石家庄市肺结核病人中HIV感染状况,于2009年4月开始对全市疾控结核门诊和定点医院确诊的肺结核病人采取自愿的原则进行了HIV抗体检测,现将结果分析如下。

Objective To realize status of HIV infection in pulmonary tuberculosis in shijiazhuang.Methods HIV test on volunteer among 6208 cases of pulmonary tuberculosis found from Apr.2009 to Mar.2010 were conducted.To collecting histories on drug use,bloodtransfusion or donation,harmful sexual behavior.Results Of 6208 cases with pulmonary tuberculosis,3068 cases were tested.The rate of screening HIV was 49.42%.There were 6 HIV positive cases,3 cases known.HIV positive rate was 0.2%.The six TB/HIV patients were consultation cases with symptom.They hadn't fixed occupation,and almost young and middle man,three resident,three in immigrant.The way of HIV infection was differently.Conclusion It is one of ways to fond out HIV infection in pulmonary tuberculosis,and too,is important means to early discover the TB and HIV double infection.It has realistic significance to control tuberculosis and TB/HIV patients to get formal treatment.

目的评价肺结核病人痰标本首次检查3个痰全部为阴性者而痰标本性状为脓样、血样痰、重新留取标本进行第二次检测,以提高痰菌检出的阳性率。方法采用直接厚涂片萋-尼氏法抗酸染色显微镜检对2422例肺结核病人痰标本中的脓血样痰进行第二次检测。结果2007年肺结核及可疑症状者查痰人数为1177,初次痰检阳性人数阳性检出率为11.4%,年度阳性检出率为12.4%,由于第二次查痰阳性率提高了1%。而2008年查痰人数为1245,初次痰检阳性人数阳性检出率为12.3%,年度阳性检出率13.3%,阳性率也提高了1%。结论首次检查3个痰全部为阴性的脓血样标本、进行第二次查痰,进一步提高涂阳肺结核病人的发现,达到控制肺结核传染源目的。

[Objective]To evaluate the implement effect of World Bank loaned/DFID granted China tuberculosis control project in Shijiazhuang.[Methods]According to the requirements of China Tuberculosis Program Implementation Guide,all works were implemented seriously.The routine monitoring data and various reports of 23 conuties and districts of this city from 2002 to 2008 were collected and analyzed.[Results]25 316 cases of smear-positive TB were detected in 7 years.The registration rate of smear-positive patients increased from 24.52/100 000 in 2002 to 41.67/100 000 in 2009,increased by 16.85/100 000.There were 22 210 cases of smear-positive TB in the initial treatment.The male peak age was 35～55 years old,and female peak age was 15～35 years old.The cure rate was 96.9%.The patients visited hospital actively accounted for 60.59% of suspicious patients.The tracing rate in 2005 and 2008 was 65.56% and 71.26%,respectively.[Conclusion]The rich experiences were accumulated in the implementation of the project,all works achieved remarkable progress.This project provides powerful support for the effective development of tuberculosis control in Shijiazhuang in further.

目的探索影响石家庄市区结核病人治疗管理的因素。方法检验当前的实施方法和管理办法的效果。结果2007年登记的市内五区的活动性肺结核病人的初治涂阳治愈率69.1%、复治涂阳病人治愈率42.9%、初治涂阴病人完成治疗率72.7%、活动性肺结核病人系统管理率71.2%。各项指标均未达到卫Ⅹ(世行货款、英国赠款中国结核病)项目要求的指标。结论单一的医务人员督导服药已不能适应当前大中城市结核病人管理的需要,对旧的管理模式应重新进行探讨。

从2005年开始,结防机构发现的活动性肺结核病人实行结核病网络报告制度,同时对报告的结核病可疑者进行转诊追踪.从而提高病人发现.

目的 在石家庄18个县乡镇卫生院设立结核病痰检点,提高病人的发现.方法 (1)75个乡镇卫生院痰检点萋-尼氏染色痰涂片查抗酸杆菌.(2)痰涂片检验人员涂片前对痰标本2小时紫外线消毒防止感染.结果 (1)75个乡镇卫生院痰检点,2006年痰涂片阳性检出率为0.17%,2007年为0.24%.(2)痰涂片检验人员严格操作程序无人员感染. 结论 乡镇卫生院结核病痰检点的设立,方便了疑似肺结核和肺结核病人,减少了结核病的传播,石家庄18个县农村地区结核病得到了有效控制.

Objective:To explore the curative effect of bronchofiberscope intervention combined with chemotherapy in management of multidrug-resistant pulmonary tuberculosis(MDR TB).Methods:During 01/2002 and 10/2004,100 patients who had received multi-treatment and were diagnosed as MDR TB by sputum culture were randomly divided into treatment group and control group.Both groups received chemotherapy of 3DZVThAk/15DVTh.Patients in treatment group also received bronchofiberscope intervention.Results:After 18 month,in treatment group negative conversion rate of sputum smear and culture were respectively 86% and 82%,the cavity closing rates were high,but in control group,negative conversion rate of sputum smear and culture were respectively 52% and 54%.the cavity closing rates were low,there were significant difference between the groups(P0.01).Conclusion: Bronchofiberscope intervention combined with chemotherapy in management of MDR TB is more effective than chemotherapy alone,it can promote sputum negative conversion rate,lesion absorption and the cavity closure.

Objective To analysis the curative effect and safety of levofloxacin combined with other anti-tuberculosis drugs on the treatment of serious smear-positive pulmonary tuberculosis(P-TB)cases.Methods During 6 months treatment,100 patients with serious smear-positive P-TB were divided into group including levofloxacin and control group with proportion 1∶1 random,parallel comparing method.At the end of full treatment courses,the patients were followed-up for 2 years.Results They had not significant deference between the two groups on the sputum negative conversion rates and the adverse drug reactions incident rates.The remarkable effective rates in chest X-ray of the two groups were 72% and 46% respectively,(χ2=9.24,P0.01),at the second month end of treatment,78% and 52%,(χ2=7.428,P0.01),at the sixth month end of treatment.Conclusion Levofloxacin combined with other anti-TB drugs may be used in serious initial sputum positive P-TB patients.It can improve the curative effect on anti-TB.