深圳市中老年居民脑卒中患病率的性别差异及影响因素研究

目的探讨不同性别脑卒中患病率差异及其相关影响因素,为脑卒中的防控提供参考。方法2013年3月至2015年4月采用整群抽样的方法选取深圳市3个社区筛查点≥40岁常住居民12908例,结合问卷调查、体格检查和实验室检查等方法进行筛查,利用χ~2检验、Fisher精确概率法和logistic回归分析探讨脑卒中患病率性别差异及其主要影响因素。结果12908例社区居民,脑卒中粗患病率4.06%,脑卒中标化患病率3.70%,男性脑卒中的标化患病率(4.79%)高于女性(2.76%)。在男性人群中,年龄越大(OR=1.65,95%CI:1.46~1.88);非在婚(OR=2.5895%CI:1.57~4.24);无医疗保险(OR=1.61,95%CI:1.02~2.17);有卒中家族史(OR=2.84,95%CI:1.94~4.14);吸烟情况(现在吸烟:OR=1.58,95%CI:1.17~2.15;戒烟:OR=2.57,95%CI:1.74~3.79);饮酒频率(偶尔:OR=0.58,95%CI:0.40~0.85;经常:OR=0.58,95%CI:0.34~0.96);水果摄入不足(OR=1.69,95%CI:1.30~2.19);奶类和奶制品摄入不足(OR=1.43,95%CI:1.09~1.87);口味偏咸(OR=2.73,95%CI:2.09~3.55);患有高HCY血症(OR=1.82,95%CI:1.39~2.39)是影响脑卒中患病的主要因素。在女性人群中,年龄越大(OR=1.42,95%CI:1.19~1.68);文化程度(小学及以下:OR=2.12,95%CI:1.18~3.79;高中:OR=1.94,95%CI:1.04~3.64);有卒中家族史(OR=3.07,95%CI:2.03~4.66);缺乏体育锻炼(OR=1.73,95%CI:1.21~2.49);水果摄入不足(OR=1.86,95%CI:1.35~2.55);口味偏咸(OR=1.87,95%CI:1.33~2.63);患有高血压(OR=1.40,95%CI:1.01~1.95);患有高HCY血症(OR=1.59,95%CI:1.15~2.20)是脑卒中患病的主要因素。结论深圳市社区居民脑卒中患病率仍较高,不同性别之间的脑卒中患病影响因素差异较大,应针对不同性别的人群特征制定干预措施,以有效地开展脑卒中的防控工作。

Gender difference in prevalence of stroke and its related influencing factors among residents over 40 years old in Shenzhen

Objective To understand the gender difference in the prevalence of stroke among residents over 40 years old in Shenzhen and to discuss its related influencing factors.Methods A random cluster sampling method was used to recruit 12908 residents aged over 40 years from three communities of Shenzhen during March 2013 and April 2015.All participants received questionnaire survey,physical examination and laboratory examination.Chi-square test,Fisher′s exact probability method and logistic regression model were used to analyze the gender difference in the prevalence of stroke and its related influencing factors.Results The crude prevalence and age-standardized prevalence of stroke were 4.06%and 3.70%,respectively.The agestandardized prevalence of stroke was higher in males(4.79%)than in females(2.76%).In male residents,older age(OR=1.65,95%CI:1.46-1.88),unmarried(OR=2.5895%CI:1.57-4.24),with no medical insurance(OR=1.61,95%CI:1.02-2.17),family history of stroke(OR=2.84,95%CI:1.94-4.14),current smoking(OR=1.58,95%CI:1.17-2.15)and former smoking(OR=2.57,95%CI:1.74-3.79),binge drinking(OR=0.58,95%CI:0.40-0.85)and regular drinking(OR=0.58,95%CI:0.34-0.96),insufficient fruit intake(OR=1.69,95%CI:1.30-2.19),insufficient intake of dairy and dairy products(OR=1.43,95%CI:1.09-1.87),salt intake(OR=2.73,95%CI:2.09-3.55),and HCY(OR=1.82,95%CI:1.39-2.39)were significant risk factors for stroke(P<0.05).However,in females,older age(OR=1.42,95%CI:1.19-1.68),education level of primary school or below(OR=2.12,95%CI:1.18-3.79)and high school(OR=1.94,95%CI:1.04-3.64),family history of stroke(OR=3.07,95%CI:2.03-4.66),physical inactivity(OR=1.73,95%CI:1.21-2.49),insufficient fruit intake(OR=1.86,95%CI:1.35-2.55),salt intake(OR=1.87,95%CI:1.33-2.63),hypertension(OR=1.40,95%CI:1.01-1.95),and HCY(OR=1.59,95%CI:1.15-2.20)were significantly associated with stroke.Conclusions The prevalence of stroke is still high among residents in Shenzhen,and the influencing factors for the prevalence of stroke between male and female residents vary significantly.Therefore,in order to prevent the occurrence of stroke,gender targeted intervention measurements should be formulated.