90年代上海社区脑卒中发病率、死亡率及其危险因素动态分析

目的：了解90年代上海社区人群脑卒中发病和死亡情况及其危险因素的变化趋势。方法：在人群中建立疾病监测风,按照世界卫生组织“多国心血管病趋势和决定因素监测”方案,监测1991－1999年35－74岁每年脑卒中的发生率和死亡率。分别于1992年1998年在监测人群中整群随机抽取35－39岁男女各类,约1000人进行危险因素调查,结果：监测社区1991－1999年间35－74岁年龄组脑卒中平均年发病率为168．2／10万,其中男性为194．5／10万,明显高于女性（144。9／10万）脑卒中发病率呈上升趋势,而且,男性的每年增长速度也高于妇性。脑卒中年平均死亡率为79．2／10万,其中男性87．2／10万 ,明显高于妇性（71．4／10万）脑卒中死亡率呈下降趋势。无论男女,脑卒中发病随着年龄的增长而增长;男女发病年龄差异不大,但1996－1999年平均发病年龄为66．1岁,比1991－1995年提前了3．5岁（69．6岁）。无论男女、血中总胆固醇均值,血压均,体重指数,高血压患病率、动脉粥样硬化指数、腰臂比值,高胆固醇现患率、低高0密度脂蛋白现患率等因素皆有升高趋势,另外男性甘油三酯也有升高趋势仅吸烟率和饮酒率有下降趋势,尤其在男性中,结论：90年代上海社区脑卒中发病率呈上升趋势,同时大部分脑卒中危险因素也呈上升趋势,而脑卒中死亡呈下降趋势。

Dynamic analysis of incidence and mortality of stroke and the risk factors in the communities in Shanghai, in the 1990's

Objective To understand the trend of incidence,mortality of stroke and the risk factors at the community level in the 1990's. Methods To establish a network of disease surveillance. Both incidence and mortality of stroke were surveyed in the 35 74 age group during 1991 1999 using the method of WHO MONICA. By cluster sampling in 1992 and 1998, 500 individuals aged 35 59 from each female and male group were investigated respectively on the risk factor of stroke. Results The incidence of stroke was averaged 168.2 per 100 000 in the group aged 35 79 during 1991 to 1999 with 194.5 and 144.9 pre 100 000 respectively for the male and female group of this age. The incidence of stroke in the male group was higher than that in the female group, also with a faster speed of increase in the male group. The overall mortality of stroke was averaged 79.2 per 100 000 with 87.2 and 71.4 per 100 000 in male and female groups respectively of this age group. The incidence of stroke increased with age in both male and female groups. The average age of onset had been 66.1 year olds during 1996 1999, 3.5 years older than that age groups during 1991 1995, but did not show much difference between male group and female group. CHO,Blood Pressure,BMI,Prevalence of Hypertension,TC/HDLC,WHR,Prevalence of High CHO,Prevalence of Low HDL all had a tendency of increase in both male and female groups. The rates of smoking cigarettes and drinking alcohol both decreased, especially in the male group. Conclusion The incidence of stroke and some relative risk factors seemed to increase in the 1990's, but the mortality of stroke had a decrease in the same period in the communities in Shanghai.