2013—2015年度大连市脑卒中高危人群危险因素的暴露情况分析

目的 了解大连市脑卒中筛查人群和高危人群中危险因素的暴露水平及其分布特征,为脑卒中高危人群干预管理提供科学依据。 方法 依据国家“脑卒中高危人群筛查与干预项目”要求,2013年10月—2015年9月采取随机整群抽样的方法,对大连市40岁以上常住人口开展脑卒中高危人群筛查工作。 结果 2013年10月—2015年9月累计完成筛查任务12 041人,脑卒中高危人群1 948人,检出率16.18%,脑卒中危险因素≥3项者1 531人(检出率12.71%)。筛查人群中脑卒中危险因素的暴露率分别是缺乏运动(35.57%)、高血压(22.43%)、超重或肥胖(19.56%)、血脂异常(17.64%)、吸烟史(11.46%)、糖尿病(7.91%)、脑卒中家族史(6.38%)、房颤或瓣膜性心脏病(5.73%)和既往脑卒中或短暂性脑缺血发作(transient ischemic attacks,TIA)病史(3.46%)。其中城市的缺乏运动、高血压和血脂异常的暴露率(分别为42.92%、24.12%和20.63%)高于乡镇(分别为24.34%、19.85%、13.07%);而乡镇的超重或肥胖、脑卒中家族史的暴露率(分别是22.41%、9.95%)高于城市(分别是17.69%、4.04%),差异均有统计学意义(P<0.05)。1 948例高危人群中脑卒中危险因素的暴露率分别是既往脑卒中或TIA病史(15.55%)、高血压(7.70%)、血脂异常(6.93%)、缺乏运动(6.16%)、脑卒中家族史(4.77%)、超重或肥胖(4.16%)、糖尿病(3.64%)、房颤或瓣膜性心脏病(3.44%)、吸烟史(2.67%)。乡镇高危人群中既往脑卒中或TIA病史、卒中家族史(分别为18.38%、7.06%)的暴露率高于城市(分别为13.78%和3.34%),城市高危人群中缺乏运动(7.02%)的暴露率高于乡镇(4.79%),城乡差异有统计学意义(P<0.05)。 结论 加强大连地区筛查人群和高危人群中暴露率较高的脑卒中危险因素的管理,控制危险因素水平,进一步提高脑卒中防治的能力和水平。

Status of exposure to risk factors among high-risk population of stroke in Dalian city, 2013-2015

Objective To investigate the exposure level and distribution characteristics of risk factors for stroke among screening population and high-risk population in Dalian city, and to provide a scientific basis for intervention and management of high-risk population of stroke. Methods According to the requirements of the National Screening and Intervention Program for High-risk Groups of Stroke, a cluster random sampling method was used to screen high-risk groups of stroke among permanent residents over 40 years old in Dalian city from October 2013 to September 2015. Results A total of 12,041 residents were screened from October 2013 to September 2015, and 1,948 residents were at high risk of stroke, with the detection rate of 16.18%. There were 1,531 residents with three or more risk factors for stroke (with the detection rate of 12.71%). The exposure rates of risk factors for stroke, including lack of exercise, hypertension, overweight or obesity, dyslipidemia, smoking history, diabetes mellitus, family history of stroke, atrial fibrillation or valvular heart disease, and previous history of stroke or transient ischemic attacks (TIA), in the screened population were 35.57%, 22.43%, 19.56%, 17.64%, 11.46%, 7.91%, 6.38%, 5.73% and 3.46%, respectively. The exposure rates of inactivity, hypertension and dyslipidemia were higher in urban residents (42.92%, 24.12% and 20.63%, respectively) than in rural ones (24.34%, 19.85% and 13.07%, respectively), whereas the exposure rates of overweight or obesity and family history of stroke were both higher in rural residents (22.41%, 9.95%) than in urban ones (17.69%, 4.04%), with statistically significant differences (all P<0.05). The exposure rates of risk factors for stroke, including previous history of stroke or TIA, hypertension, dyslipidemia, lack of exercise, family history of stroke, overweight or obesity, diabetes mellitus, atrial fibrillation or valvular heart disease and smoking, in the 1,948 high-risk residents were 15.55%, 7.70%, 6.93%, 6.16%, 4.77%, 4.16%, 3.64%, 3.44% and 2.67%, respectively. The exposure rates of previous history of stroke or TIA and family history of stroke were both higher in the rural high-risk group than in the urban high-risk group (18.38% vs. 13.78%, 7.06% vs. 3.34%), while the exposure rate of inactivity was higher in the urban high-risk group than in the rural high-risk group (7.02% vs. 4.79%), with statistically significant differences between urban and rural groups (P<0.05). Conclusions It is necessary to strengthen the management of stroke-related risk factors with high exposure rate in screening population and high-risk population in Dalian region, control the level of risk factors, and further improve the ability and level of stroke prevention and treatment.