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目的 观察进餐前后、排尿前后健康体检受检者血压、体重指数(BMI)、腰围(WC)测值的变化,探讨体检流程对数据质量的影响.方法 选择受检者518名(第一组)、533名(第二组,需憋尿经腹超声检查前列腺或子宫附件者),分别测量进餐前后、排尿前后收缩压(SBP)、舒张压(DBP)、BMI、WC,观察测值的变化规律.在两组中分别随机选择80、83人进行问卷调查,了解其在体检中安排进餐或排尿与测量血压、BMI、WC的先后顺序.网上调查体检中心52家,统计各家测血压、BMI、WC的工作流程.结果 第一组,男女餐后SBP、DBP均下降(P＜0.05),40岁以上者血压变化显著(P＜0.05);餐后收缩期高血压、舒张期高血压的检出率分别下降2.4l%、2.22%(P＜0.05),餐后超重、肥胖、中心性肥胖的检出率分别增加1.35%、0.97%、1.93%(P＜0.05).第二组,排尿后女性SBP、DBP、WC、BMI均下降(P＜0.05),男性无明显变化.女性随年龄增加,排尿后血压下降更加明显(P＜0.05);按SBP、DBP统计,女性排尿后高血压检出率分别下降5.59%、4.46%(P＜0.05);以WC为判断依据,女性排尿后中心性肥胖检出率下降5.83%(P＜0.05);以BMI为判断依据,女性排尿后超重和肥胖的检出率分别下降了2.86%、1.88%(P＜0.05).调查52家体检中心,在采集血压、BMI和WC数据时,要求受检者餐前占5.8%、餐后占9.6%、餐前或餐后均可占88.5%;均未提及采集上述数据与排尿的先后关系.调查163位受检者,对采集血压、BMI和WC数据的安排,在餐前还是餐后持无所谓态度的占80%,在餐前、餐后各占5%、15%;均认为采集上述数据与排尿与否无关系.结论 进餐、排尿明显影响血压、BMI、WC测值,体检中心及受检者对这种影响认识不足.体检中心如不统一采集血压、BMI和WC的工作流程,将严重影响体检数据质量.

Objective To evaluate the effect of health screening procedure on data quality. Methods A total of 518 health screening people as first group and 533 health screening people as second group were measured for blood pressure ( BP), body mass index ( BMI ) and waist circumference (WC) before and after breakfast and passing water. One hundred and sixty-three of them ( 80 from first group and 83 from second group ) were selected to finish the questionnaire to learn their health screening procedure. Fifty-two health screening centers were surveyed in the internet to define their health screening procedure. Results There were significant decline in BP after breakfast in first group (P < 0. 05 ),especially in those over forty years (P < O. 05 ).The identification of over-weight,obesity and central obesity increased respectively 1.35%, 0. 97% and 1.93% after breakfast( P < O. 05 ). There were significant decline in women in BP, WC, MBI after passing water in second group ( P < 0. 05 ). The identification of hypertension,over-weight,obesity and central obesity dropped respectively after passing water (P < O. 05 ).About 88. 5% of the health screening centers measured the BP either before or after breakfast. About 80% of health screening people believed that breakfast intake had no impact on BP level. Both the health screening centers and health screening people adopted an indifferent attitude to that breakfast intake and passing water had impact on WC and MBI level. Conclusion Breakfast intake and passing water may have significant impact on the BP, BMI and WC measurement. The health screening centers should use standardized procedure to improve data quality.