上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2023, Vol. 43 ›› Issue (11): 1348-1358.doi: 10.3969/j.issn.1674-8115.2023.11.002

• 心脑血管慢病专题 • 上一篇    下一篇

上海社区老年人群脑卒中与体力活动的关联性研究

王雅玉1,2(), 蒋惠如2, 叶梦月3, 李萍1,2, 袁安彩2, 张薇2,4(), 卜军2()   

  1. 1.蚌埠医学院公共卫生学院，安徽 233030
    2.上海交通大学医学院附属仁济医院心内科，上海 200127
    3.浙江省宁波市杭州湾医院体检中心，宁波 315336
    4.上海市肿瘤研究所流行病学研究室，上海 200032
  • 收稿日期:2023-04-07 接受日期:2023-09-19 出版日期:2023-11-28 发布日期:2023-11-28
  • 通讯作者: 卜　军，电子信箱：pujun310@hotmail.com。#共同通信作者。
    张　薇，电子信箱：zhangwei050080@renji.com
  • 作者简介:王雅玉（1998—），女，硕士生；电子信箱：wangyy0108@hotmail.com。
  • 基金资助:
    国家重点研发计划(2018YFC1312802);上海市科学技术委员会专业技术服务平台项目(22DZ2292400);上海市卫生健康委员会新兴交叉领域研究专项(2022JC013);上海市卫生健康委员会重中之重研究中心项目(2023ZZ02021);上海市加强公共卫生体系建设三年行动计划（2023—2025年）重点学科建设项目(GWVI-11.1-26);上海高水平地方高校创新团队(SHSMU-ZDCX20210700);上海市肿瘤研究所自主课题(ZZ-20-22SYL);上海市肿瘤研究所科研项目(JY162)

Association between stroke and physical activities in Shanghai Community Elderly Cohort

WANG Yayu1,2(), JIANG Huiru2, YE Mengyue3, LI Ping1,2, YUAN Ancai2, ZHANG Wei2,4(), PU Jun2()   

  1. 1.School of Public Health, Bengbu Medical College, Bengbu 233030, China
    2.Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    3.Physical Examination Center, Ningbo Hangzhou Bay Hospital, Zhejiang Province, Ningbo 315336, China
    4.Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China
  • Received:2023-04-07 Accepted:2023-09-19 Online:2023-11-28 Published:2023-11-28
  • Contact: PU Jun, E-mail: pujun310@hotmail.com.
    ZHANG Wei, E-mail: zhangwei050080@renji.com
  • Supported by:
    National Key R&D Program of China(2018YFC1312802);Professional Technical Service Platform Project of Shanghai Science and Technology Commission(22DZ2292400);New Interdisciplinary Research Project of Shanghai Municipal Health Commission(2022JC013);Shanghai Municipal Health Commission Top Priority Research Center Project(2023ZZ02021);Key Discipline Construction Project of Shanghai Three-year Action Plan for Strengthening Public Health System Construction (2023?2025)(GWVI-11.1-26);Innovative Research Team of High-Level Local Universities in Shanghai(SHSMU-ZDCX20210700);Independent Project of Shanghai Cancer Institute(ZZ-20-22SYL);Research Project of Shanghai Cancer Institute (JY162)

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摘要：

目的·通过上海社区老年人群队列基线调查，比较社区脑卒中人群与非脑卒中人群的体力活动情况，探索脑卒中人群不同类型体力活动的参与情况。方法·自2019年2月—8月建立的上海社区老年人群队列中，根据纳排标准筛选研究对象。根据自我报告是否有脑卒中史将研究对象分为非脑卒中组与脑卒中组，采用倾向性评分匹配法控制年龄与性别将2组进行2∶1配对。收集2组人群的基线特征资料，采用国际体力活动调查表（International Physical Activity Questionnaire，IPAQ）对研究对象过去1周与运动、交通和家务相关的体力活动状况进行调查。采用匹兹堡睡眠质量指数（Pittsburgh Sleep Quality Index，PSQI）评估研究对象的睡眠质量；采用7项广泛性焦虑障碍量表（Generalized Anxiety Disorder，GAD-7）和患者健康问卷抑郁量表（Patient Health Questionnaire-9，PHQ-9）分别评估对象的焦虑及抑郁状况。比较脑卒中组与非脑卒中组的上述特征，采用多因素Logistic回归模型比较2组人群不同类型体力活动的参与情况。结果·在纳入的17 948人中，脑卒中组有993人（5.5%），非脑卒中组有16 955人（94.5%）；经倾向性评分匹配后，非脑卒中组1 984人（66.7%），脑卒中组992人（33.3%）。2组人群在文化程度、退休前职业、腰围、体质量指数、睡眠状况、焦虑症状、抑郁症状、既往疾病史方面差异均具有统计学意义（均P<0.05）。体力活动方面，女性脑卒中人群相比非脑卒中人群每日进行中等强度运动时间更短，1周的骑行、步行天数更少，每日骑行时间更短，差异均具有统计学意义（均P<0.05）。男性和女性脑卒中组1周做家务天数以及每日做家务时间相较于非脑卒中组均处于较低水平，而每日久坐时间处于较高水平，差异均具有统计学意义（均P=0.000）。在体力活动水平方面，脑卒中组达到中、高水平的男性和女性比例均低于非脑卒中组，差异具有统计学意义（均P=0.000）。经多因素Logistic回归模型校正性别、年龄、职业、焦虑症状、高脂血症史、心房颤动史、慢性胃炎史、髋臀骨折史后，脑卒中人群参与剧烈运动的水平较低，1周内不进行家务劳动和每日久坐时间>180 min的比例较高，处于中、高活动水平的比例较低（均P<0.05）。结论·上海社区有脑卒中史的老年人群家务劳动参与频率与时长、体力活动水平较非脑卒中人群均处于较低水平，且久坐时间更长。

关键词: 脑卒中, 体力活动, 老年人, 久坐行为

Abstract:

Objective ·To compare the physical activities of stroke population and non-stroke population based on the baseline survey of the elderly population cohort in Shanghai communities, and explore the participation in different types of physical activities of stroke population. Methods ·The subjects were screened from Shanghai Community Elderly Cohort constructed from February to August, 2019 according to the admission criteria. The subjects were divided into non-stroke group and stroke group according to whether they had reported a history of stroke by themselves, and the two groups were matched 2 to 1 by controlling age and sex with propensity score matching. The baseline characteristics of the two groups were collected, and the physical activities related to sports, transportation and housework in the last week were investigated with the International Physical Activity Questionnaire (IPAQ). Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of the subjects. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression of the subjects, respectively. The above characteristics were compared between the stroke group and non-stroke group, and the participation of different types of physical activities were compared between the two groups by multivariate Logistic regression model. Results ·Among the 17 948 people included, there were 993 (5.5%) in the stroke group and 16 955 (94.5%) in the non-stroke group. After propensity score matching, there were 1 984 people (66.7%) in the non-stroke group and 992 people (33.3%) in the stroke group. There were significant differences in education level, pre-retirement occupation, waist circumference, body mass index, sleep status, anxiety symptoms, depression symptoms and disease history between the two groups (all P<0.05). In terms of physical activities, the female stroke group had shorter daily moderate exercises time, fewer riding and walking days in one week, and shorter daily riding time, compared with the non-stroke people, with statistical significance (all P<0.05). Compared with the non-stroke people, the weekly housework days and daily housework time in the male and female stroke groups were lower than those in the non-stroke group, while the daily sedentary time was longer, with statistical significance (all P=0.000). In terms of physical activity level, the proportions of men and women in the stroke group who reached medium or high level were lower than those in the non-stroke group, and the differences were statistically significant (all P=0.000). After adjusting for gender, age, occupation, anxiety symptoms, history of hyperlipidemia, history of atrial fibrillation, history of chronic gastritis and history of hip fracture by multivariate Logistic regression model, the level of vigorous exercise participation in the stroke group was lower, the proportions of no housework in the last week and sedentary time greater than 180 min per day were higher, and the proportion at medium and high activity levels was lower (all P<0.05). Conclusion ·The frequency and duration of housework participation and the physical activity level of elderly people with a history of stroke in Shanghai communities are at a lower level than those without stroke, and they also have a longer sedentary time.

Key words: stroke, physical activity, elderly, sedentary behavior

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