南昌市基于社区不同人群卒中筛查及规范化管理效果分析

目的 通过对南昌市周围农村居民、城市居民及教师群体进行卒中筛查，了解本地区卒中高危人群在不同群体的分布情况，探讨卒中筛查的意义及规范化管理后的效果。 

Effectiveness Analysis of Community-based Different Mass Stroke Risk Factors Screening and Management in Nanchang City

Objective To investigate the effectiveness of community-based stroke risk factors screening
and standardized management in Nanchang city, and to understand the prevalence of high risk
population of stroke in different population in Nanchang area.
Methods Stroke risk factors were evaluated by questionnaire and physical examination in rural
inhabitants, urban inhabitants, and teachers in different communities of in Nanchang city. The
people who had more than three risk factors were considered as high-risk people of stroke. The
high-risk people were given 3-year of standardized management including changing the life style
and/or drugs intervention. The risk factors were re-assessed after 3 years to evaluate the effect of
these intervention.Results Of 746 rural inhabitants who participated in the screening, 177 (23.72%) were at high
risk, and the mean score of risk factor assessment by questionnaire was (3.30±0.59). Of 1005 urban
inhabitants who participated in the screening, 281 (27.96%) were at high risk, and the mean score
of risk factor assessment was (3.68±0.78). Of 1359 teachers having undergone the screening, 172
(12.66%) were at high risk, and the mean score was (3.21±0.51). All the high-risk subjects were given
standardized management, and their risk factors and prognosis including new-onset stroke and death
were re-evaluated after 3 years. After 3 years, of the rural inhabitants, 5 people occurred new-onset
stroke, 5 died from stroke, 1 died from other disease, 19 high-risk persons improved into non-high risk
ones by intervention, and their mean score of risk factor assessment dropped to (2.97±0.55) (P <0.001);
of urban inhabitants, 5 people occurred new-onset stroke, 5 died from recurrent stroke, 88 highrisk
persons improved into non-high risk ones, their mean score decreased to (2.75±0.72) (P <0.001);
of teachers, 2 persons occurred new-onset stroke, 1 person died from recurrent stroke, 59 high-risk
persons improved into non-high risk ones, and their mean score declined to (2.81±0.78) (P <0.001). A
total of 51 persons underwent artery stenting for symptomatic intracranial and/or extracranial arterial
stenosis, 8 persons underwent aneurysm embolization for intracranial aneurysms. The top three risk
factors in rural inhabitants were dyslipidemia (72.88%), hypertension (58.19%) and obesity (46.33%);
the three ones in urban inhabitants were hypertension (77.22%), dyslipidemia (58.36%) and obesity
(54.80%); and the three ones in teachers were lack of exercise (86.05%), dyslipidemia (84.84%) and
hypertension (62.79%).
Conclusions The difference in the prevalence of high-risk people and the distribution of high
risk factors in different population may be related to dietary structure and education level; and
standardized management achieved a good effect in high-risk individuals in different population.
These findings demonstrated the feasibility and usefulness of community-based stroke risk factors
screening and management.