eiiO TAO VA HUAN m v p i D f THAO - S O 5/2019
THKC TRANG DjCH T I HOC BENH CAO HOYET AP DO 10l NGlTiill CAO TUOI TAI THANH PHO VINH - TJNH
N G H IAN
N g o Thj Nhu* T h e * T6m t i t :
Chung tdi tien hanh khao sat djch te hpc b§nh cao huyet ap (CHA) dp 1 d ngudi cao tuoi (NCT) tgi Th^nh pho Vinh (TP Vinh) - Tinh Nghe An theo 4 tieu chi: Md-c do b^nh, gidi tfnh, khu vyc sinh song va nghi nghipp chu yeu tru-dc d§y. K^t qua cho thay, ty le ngu'di bj CHA dp 1 chilm tJ" 10 cao, trong do nam cd tJ le cao hon nu'; NCT song d khu vyc trung tam thanh phd cd tJ-1§ mac b#nh cao hon vung ven thdnh pho; NCT cd nghe nghiep chCi ylu tofdc dSy thuOc nhdm nghe nghiep chju ap lifc cao mac CHA dp 1 nhieu hon nhan vidn van phdng, giao vien va nhdm lao dpng chan tay cd ty le NCT bj CHAdO 1 thap nh^t.
TIP khda: Djch t l hpc, cao huylt ap dp 1, ngu'di cao tuoi, Thdnh pho Vinh.
Current epidemiological situation of level-1 hypertension in the elderly in Vinh City - Nghe An Province
Abstract:
We have conducted an epidemiological survey about leve!-1 hypertension in the elderly in Vinh City - Nghe An Province, according to 4 criteria: disease severity, gender, living region and previous occupation. The result shows that the ratio of people having level-1 hypertension accounts for a high proportion, and men has a higher rate than women. Older people living in inner city have a higher incidence than the suburban area. Older people having previous high-pressure occupation have higher rate of level-1 hypertension more than office workers, teachers; and manual workers have the lowest rate of level-1 h^ertension incidence.
Keywords: Epidemiology, levei-1 hypertension, the elderly, Vinh City.
BAT VAN OE
Dich te hpc la khoa hpc nghien cuu ve tinh trang siic khde quan chiing va cac yeu td lien quan anh hudng den tinh trang siic khde do. Tim kiem mdi quan he giiia tinh trang siic khde va yeu td lien quan la viee xae dinh ca sd khoa hpc de lira chpn va xay dung giai phap can thiep nham duy tri, cai thien va nang cao tinh trang siic khde. Vdi muc dich sii dung Yoga nhu mot giai phap can thiep vao viec hd tro dieu tri CHA cho NCT tai TP. Vinh dupe dat ra trong luan an, chiing toi tien hanh khao sat dich te hpc bSnh CHA ndi chung v^ CHA dp 1 ndi rieng d NCT tai TP. Vinh - tinh Nghe An. Ket qua danh gia thuc trang la can eii thuc tien de lira chpn ndi dung va xay dung chuong trinh luyen tap Yoga phu hop vdi ddi tugng NCT bi CHA dd 1.
PHlltiNGPHAP NGHIEN ClfU
Trong qua trinh nghiSn ciiu chiing tdi da su dimg cac phuong phap nghien eiiu sau: Phuong phap tdng hpp va phan tich tai li6u; phuong
*ThS, Trudng Dgi hpc Vinh
phap phdng van, phuong phap kiem tra y hpc va phuong phap toan hpc thdng ke.
Ddi tupng khao sat: Bdc tham ngau nhien, NCT tai 4 Chi hpi thupc cae phudng: Trung Dd, Ben Thiiy (ven thanh phd), va Hung Binh, Hung Phiic (trung tam thanh phd), do tudi 60 - 74.
Cd mau nghien eiiu dugc tinh theo cdng thiic:
_Z\^„/'(l-?)_l,96'(0.5)(0.5)_
{Pxmf (0.5x0.1) 384,16 Trong do: p = 0,5; Khoang tin cay ^ 95% =>
Z^:^i/2 -1,96; (0 la sai so.
Du kien c6 5% NCT tra loi khong dSy dii, do do chpn ca mau 400.
S6 phiiu phat ra: 100 phiSu/phuong (50 nam, 50 nir). Tong; 400 phieu.
S6 phiSu thu vao hgp le: Nam 189, nu 192, n=381.
Chung toi su dving each phan loai CHA theo WHO/ISH nam 2004 va cac tieu chi dich tS hoc
BAI BAO KHOA HOC
Bang 1. Ty IS plian bo cao liuyet ap cua ngu'ai cao tuoi tai tiianli pho Vinh theo giffi tinh va miJc do benh (n=381)
TT 1 2 3
D6Gi6i Nam (n= 189) NO (n=192) Chung(n=381)
Doi mi 55 53 108
29.1
%
27.6 28.35
So 2 mi 10 11 21
5.29
%
5.73 5.51
D6 3 mi
7 6 13
3.7
%
3.13 3.41
CHA mi 72 70 142
38.09
%
36.46 37.27 benh CHA eiia Chuofng trinh Qudc gia phdng
chdng CHA, gdm: miic dp benh, gidi tinh, khu vuc sinh sdng va nghe nghiep chu yeu trudc day.
KET qUA NGHIEN CllfU VABANLUAN
1. Thu'c trang phan bo mirc do benh theo gid"! tinh
Ket qua khao sat ty le phan bo muc dp CHA d NCT tai TP. Vinh theo gidi tinh dupe thg hien d bang 1.
Kit qua bang 1 eho thky, ty le NCT bi CHA tai TP, Vinh giam dan theo miic dp tang nang eua benh. Cu the, ty le CHA dp 1 eao nhit (28,35%), tiip sau dd la CHA do 2 va dp 3, lln lugt la 5,51% va 3,41%.
Ty le NCT mac CHA chung va phan bd mue dp benh theo gidi tinh eua NCT bi CHA dp 1 d nam cao hon nu (29,10% so vdi 27,60%). Ty le nay cung thu dugc tuong tu d CHA dp 3, cdn nhdm NCT bi CHA dp 2 giiia nam va nii lai lai ed ty le tucmg ducmg nhau (5,29% so vdi 5,73%).
Xet ve ty le chung ket qua khao sat cho thay, ty le NCT bi CHA la kha cao d ea nam va nu vdi ty le chung la 37,27%.
2. Ty le phan bo cao huyet ap do 1 cua ngu'd'i cao tuoi theo khu virc sinh song
Khu vuc sinh sdng cung la mdt yiu td dich te hge, trong dd: Khu vuc trung tam thanh ph6 ed dieu kien CSVC phat trien la phudng Hung Binh, Hung Phiic; khu vuc Trung Dd, Hgn Thiiy la viing ven thanh pho, nai tap trung dong dan cu la lao ddng phd thdng. Ket qua khao sat th8 Bang 2. Ty le phan bo cao huyet ap do 1
cua ngu'd'i cao tuoi tai Thanh pho Vinh theo khu virc sinh song {n=381) TT
1 2 3 4
Khu vyc sinh song Hung Phuc Himg Binh Ben Thuy Trung Do
m, 93 97 95 96
%
24.41 25.46 24.93 25.20
Bi CHA do 1 m;
28 31 25 24
30.11
%
31.96 26.32 25.00
hien d bang 2.
Ket qua tren bang 2 cho thay, vdi sd Iugng NCT dugc khao sat d mdi phudng la tuong duong, thi ty le NCT bi CHA dp 1 d hai phudng thupc trung tam thanh phd eao hon d khu vuc vung ven. So lieu cho thay, NCT song d khu vuc trung tam thanh phd cd nguy ca bi CHA dp 1 cao ban d khu vuc vung ven thanh phd. Dieu nay cd the den hi thdi quen lao ddng, sinh boat, che dp dinh dudng khac nhau d ngudi dan khu vuc trung tam va vung ven ciia thanh phd.
3. Ty le phan bo cao huyet ap d$ 1 cua ngu'O'i cao tuoi tai thanh pho Vinh theo nghe nghigp chinh tru'd'c day
Theo cac chuyen gia, nghe nghiep cdng la mdt trong nhijng yeu td lien quan din ty 1$
CHA, vi vay, de tai da tien hanh khao sat ty le phan bd benh CHA dp 1 vdi yeu td nghe nghiep chinh trudc day cua NCT tai TP.Vinh.
NCT d TP.Vinh lam nhieu nghe nghiep khac nhau. De khao sat de tai da phan thanh 3 nhom nghe nghiep cd eiing dac diem chung.
Nhdm nghe lao dpng chan tay la nhiing nganh nghe nhu: Cdng nhan, nhan vien ban hang, thp ky thuat, thg xay, ndng dan... Nhdm nghe nay ed dac diem chung la ed su hoat dpng nhieu cua eo bap.
Nhdm nghe nhan vien van phdng, giao vien la nhihig nganh nghe nhu nhan vien ban giay, giao vien cac cap... Dae diem chung la hoat ddng nhe nhang ve ca bap nhung gd bd, it thay ddi ve tu the, cd su phdi hgp vdi lao ddng tri dc.
Nhdm nghe nghiep chiu ap lire cao la nhung nganh nghe nhu canh sat, cdng an, phdng chay chira ehay, y, bac si... Dac diem chung la thudng xuyen chiu su cang thang tam Iy do dp lire cong viec, doi hdi trach nhiem cao va dgc lap, phan ung nhanh.
Kit qua khao sat ty le phan bo CHA dd 1 ciia NCT tai thanh phd Vinh theo yiu td nghi nghiep
eiOTAOVAHUAHUIYBIHIIHM • SO 5/2019 Bang 3. Ty le phan bo cao huyet ap do 1 cua ngu'O'i cao tuoi
tai Thanh pho Vinh theo nghe nghiep chinh tru'6c day (n=381) TT
1 2 3
Nghe nghiep chinh trudge dSy Lao dong chan tay
Nhan vien van phong, giao vien Nghe nghiep chiu ap lire cao
Rli
103 166 112
%
27.03 43.57 29.40
Bi CHA d o i
m i
25 46 37
24.27
%
27,71 33.04 chinh trudc day dugc the hien d bang 3.
Sd lieu d bang 3 eho thiy, trong 381 ddi tugng khao sat, nhdm nghi nhan vien van phdng, giao vien chiem sd lugng Idn, tuang iing 43,57%, hai nhdm nghe cdn lai chiim ty le gSn tuang duang nhau. Trong dd, nhdm nghi nghiep chiu ap luc cao va nhan vien van phdng, giao vien cd ty le bi mSc CHA dp 1 chiim ty le Idn, hrong ling la 33,04% va 27,71%.. Kit qua da phan anh, nhiing cong viec lien quan nhiiu tdi hoat ddng co bap thi kha nang hi CHA cd ty le thap ban nhiing nganh nghi it cd hoat dpng thi chat hay nganh nghe chiu ap luc cdng viec cao.
Chua cd bang chiing nao cho thay, stress, cang thang tam Iy don dpc ed the gay ra tang huyet ap nhung nhieu cdng trinh nghien eiiu cho thay stress, cang thang tam ly lai cd the dan tdi cac thdi quen cd hai khac, bao gdm phan ling thai qua, nigu bia va mat ngu. Cac he qua do stress, cang thang tam Iy gay ra nhu rdi loan lo au, tram cam, loi sdng co lap khdi cdng dong ...
cd the la nguy ca dan tdi tang huyet ap va cac benh Iy tim mach khae. Mat khac, cac hormone san sinh ra moi khi gap stress, cang thang tam Iy eiing ed the gay ton thuong h& thdng thanh mach va tir do gia tang nguy ca mac cac benh Iy tim mach, trong dd cd cao huyet ap. Nhiing ea che tac dpng cua stress, cang thang tam Iy keo dai tdi huyet ap la mgt trong nhiing Iy giai eho viee ty le NCT bi CHA dp 1 cua mau khao sat d ngudi cd nghe nghiep chu yeu trudc day tiiudc nhdm nghe nghiep chiu ap luc cao chiem ty le cao hon ban nhiing nhdm nghi edn lai.
Cae khao sat v8 dich te hpe benh CHA dugc diiu tra phd bien tren pham vi toan Quoe va nhiiu dia phuang, tuy nhien, khdng cd cdng trinh nao dua ra sd lieu khao sat rieng ddi vdi CHA dg 1 va thong k£ danh rieng eho ddi tugng NCT tir 60 - 74 tuoi. Vi vay de tai khong cd nhimg ban luan so sanh vdi ket qua nghien cuu
khac, tuy nhien, so sanh vdi cac dieu tra Dich te hpc benh CHA d ngudi trudng thanh (>25 tuoi) tai Viet Nam giai doan 2001 - 2009 ciia Du an Qude gia phdng chdng tang huyit ap cd thi thay: Ty le bi CHA cua NCT tai TP. Vinh la 37,27%, cao han ty le trung binh chung d ngudi trudng thanh (25,1%). Ket qua nay phu hgp vdi qui luat khach quan ve dich te hpe benh CHA bdi ddi tugng khao sat eua de tai la NCT, la ddi tugng cd nguy co hi CHA cao han cac nhdm tudi khac.
KET LUAN
Ket qua khao sat dich ti hpc benh CHA do 1 d NCT tai TP Vmh cho thAy:
Ty le NCT tai TP. Vinh hi CHA dp 1 chiim ty le Idn la 37.27%. Trong dd, chii yiu NCT bi CHA dp 1 (28,35%); nam bi CHA dp 1 nhiiu hon nir, \kn lugt la 29,10%o va 27,60%; Ty le hi CHA dp 1 d NCT tai TP. Vinh sdng tai vung trung tam thanh phd eao hon NCT sdng d vung ven thanh phd. Ty le NCT hi CHA dp 1 cd nghi nghiep chii yeu trudc day mang tinh chat cang thang tam ly keo dai, ap lire cao, lao dpng tri dc cao han nhdm NCT lam cdng viee lien quan nhieu den lao dpng chan tay.
TAI LIEU THAM KHAO
1. Pham Khue (2000), Tdng huyet dp, Bdch khoa thu benh hpc, Vol. 1, Nxb tu diin Bach khoa. Ha Ndi.
2. Nguyen Lan Viet (2007), "Ap dung mpt sd giai phap can thiep thich hgp de phdng chiia benh tang huyet ap d cpng ddng", De tdi cdp Bp, chu bien, Dai hpc Y Ha Ndi, Ha Ndi.
3.Nguyen Lan Viet va cs (2008), "Ket qud dieu tra dich te tdng huyet dp tgi 8 tinh vd thdnh pho cua Viet Nam ".
4.Nguyin Lan Viet (2012), Dich ti hpc tang huyet ap va eae yeu td nguy ca tim mach tai Viet Nam (2001-2009), Dai hgi tim mach toan qude Ian thii 13, chii bien.
(Bdi nop ngay 25/10/2019, Phan bien ngay 30/10/2019, duyet in ngay 15/11/2019
