2016年上海市金山区某社区脑卒中高危人群筛查结果分析

目的 了解金山区居民脑卒中高危人群危险因素分布情况,为特异性预防提供科学依据。 方法 2016年9月采取随机整群抽样的方法抽取金山区某社区35岁以上户籍居民2 102人,问卷调查其一般情况、疾病既往史、疾病行为和危险因素信息等信息,测量身高、体重、血压等。采用SPSS 17.0软件分析高危人群检出率、危险因素暴露率等指标。 结果 检出高危人群669人,检出率31.83%,其中有短暂性脑缺血发作史者或者卒中史者90人(检出率4.28%),脑卒中危险因素≥3 项者579人(检出率27.55%)。男性检出率(38.27%)高于女性(27.32%)(χ²=28.09,P<0.001)。随着年龄的增长,高危人群检出率逐渐增高(χ²_趋势=41.46,P<0.001)。在579名危险因素≥3的高危人群中,同时有3种和4种危险因素共计502例,所占比例达到86.70%。高危人群危险因素的暴露率依次是高血压(90.33%)、血脂异常(64.59%)、超重(48.53%)、缺乏运动(39.38%)、糖尿病(39.03%)、吸烟(34.72%)、卒中家族史(25.04%)以及房颤(13.82%),其中男性的吸烟率(65.42%)高于女性(2.82%)(χ²=250.25,P<0.001),女性的血脂异常率(69.01%)、房颤率(17.25%)高于男性(血脂异常60.34%、房颤10.85%)(血脂χ²=4.76,P=0.029;房颤χ²=4.94,P=0.026)。高血压(χ²=0.17,P=0.680)、超重(χ²=0.74,P=0.390)、缺乏运动(χ²=0.10,P=0.755)、糖尿病(χ²=1.93,P=0.165)、卒中家族史(χ²=3.59,P=0.058)的暴露率男女比较差异无统计学意义。 结论 金山区居民脑卒中高危人群危险因素暴露率较高,应采取有效措施控制高血压、血脂异常以及超重。

Screening results of high-risk stroke population in a community in Jinshan District,Shanghai, 2016

Objective To investigate the distribution of risk factors in population at high risk for stroke among residents in Jinshan District so as to provide a scientific basis for its specific prevention. Methods A random cluster sampling method was used to select 2,102 permanent residents aged 35 years and above in a community in Jinshan District in September, 2016. General information, past medical history, illness behavior and risk factors were collected through a questionnaire survey; meanwhile, height, weight and blood pressure were measured. The detection rate of high risk population and the exposure rate of risk factors were analyzed with SPSS 17.0 software. Results Six hundred and sixty-nine (31.83%) residents at high risk for stroke were detected, including 90 (4.28%) residents with transient ischemic attack or stroke history and 579 (27.55%) residents with ≥ 3 risk factors. The high risk detection rate was higher in males than in females (38.27% vs. 27.32%, χ²=28.09, P<0.001). The high risk detection rate gradually increased with the increasing age ( χ²tendency=41.46, P<0.001). Among 579 residents with ≥3 risk factors, 502 (86.70%) residents had 3 or 4 risk factors simultaneously. The exposure rates of risk factors in the high risk residents were hypertension (90.33%), dyslipidemia (64.59%), overweight (48.53%), lack of exercise (39.38%), diabetes mellitus (39.03%), cigarette smoking (34.72%), family history of stroke (25.04%) and atrial fibrillation (13.82%). The exposure rate of cigarette smoking was significantly higher in males than in females (65.42% vs. 2.82%, χ²=250.25, P<0.001), while the exposure rates of dyslipidemia and atrial fibrillation were higher in females than in males (69.01% vs. 60.34%, χ²=4.76, P=0.029;17.25% vs. 10.85%, χ²=4.94, P=0.026). No statistically significant differences were found in the exposure rates of hypertension(χ²=0.17, P=0.680), overweight (χ²=0.74, P=0.390), lack of exercise (χ²=0.10, P=0.755), diabetes mellitus (χ²=1.93, P=0.165) and family history of stroke (χ²=3.59, P=0.058) between male and female residents. Conclusions The exposure rates of risk factors in residents at high risk for stroke in Jinshan District are high; and hence, effective measures should be taken to control hypertension, dyslipidemia and overweight.