2018年上海市宝山区脑卒中高危人群筛查结果分析

目的 了解上海市宝山区脑卒中高危人群危险因素暴露水平及其人群分布特征,为开展脑卒中防治提供建议。方法 采取整群随机抽样的方式抽取2018年宝山区35岁以上常住居民20 374人进行调查,了解其一般情况、疾病既往史和危险因素等信息。结果 20 374人中发现3 693例高危对象,检出率为18.13%,其中有脑卒中或短暂性脑缺血发作史者1 015例(检出率为4.98%),脑卒中危险因素≥3项者2 678例(检出率为13.14%)。在2 678例高危人群中男性检出率(19.51%)高于女性(17.10%),差异有统计学意义(P<0.05);并随着年龄的增加检出率不断增高(χ²趋势性检验P<0.001)。在2 678例危险因素≥3项的高危人群中,同时具有3种危险因素所占比例最高,为74.57%(1 997例);各危险因素的暴露率由高到低依次为高血压(87.71%)、很少进行体育活动(75.62%)、BMI≥26 kg/m²(51.17%)、糖尿病(43.35%)、血脂异常(38.20%)、吸烟(22.52%)、卒中家族史(15.72%)、房颤史(1.79%),其中男性的吸烟暴露率高于女性,女性的血脂异常、糖尿病、很少进行体育活动、BMI≥26 kg/m²、卒中家族史的暴露率均高于男性,且差异有统计学意义(P<0.05)。结论 上海市宝山区脑卒中高危人群危险因素暴露水平较高,应积极采取措施加强锻炼,有效控制血压、体重。

Screening results of high-risk stroke population in Banshan district,Shanghai, 2018

Objective To investigate the exposure level of risk factors among high-risk stroke population and distribution characteristics of the population in Baoshan district, Shanghai, and to provide suggestions for stroke prevention and control. Methods A random cluster sampling method was used to select 20,374 permanent residents aged 35 years and above in Baoshan district in 2018, and their general information, history of diseases and risk factors for stroke were investigated. Results Among the 20,374 residents surveyed, 3,693 (18.13%) cases at high risk of developing stroke were detected, including 1,015 (4.98%) cases with stroke history or transient ischemic attack and 2,678 (13.14%) cases with three or more than three brain stroke risk factors. Among the 2,678 high-risk cases, the high risk detection rate was significantly higher in males than in females (19.51% vs. 17.10%), showing a statistically significant difference (P<0.05). And the high risk detection rate increased with the increasing age (P<0.001). Among the 2,678 residents with three or more than three brain stroke risk factors, the proportion of cases with three risk factors was the highest (74.57%, 1,997/2,678). The exposure rates of risk factors in the high-risk stroke population were hypertension (87.71%), lack of physical exercise (75.62%), BMI ≥ 26 kg/m² (51.17%), diabetes mellitus (43.35%), dyslipidemia (38.20%), cigarette smoking (22.52%), family history of stroke (15.72%) and history of atrial fibrillation (1.79%). The exposure rate of cigarette smoking was significantly higher in males than in females, while the exposure rates of dyslipidemia, diabetes mellitus, lack of physical exercise, BMI ≥26 kg/m² and family history of stroke were higher in females than in males, with statistically significant differences (all P<0.05). Conclusions The exposure rates of risk factors among high-risk stroke population in Baoshan district, Shanghai are high; and hence, measures should be taken actively to strengthen physical exercise and control blood pressure and body weight.