广西城乡成年居民脑卒中流行特征及其危险因素研究

Study on Epidemiological Characteristics and Risk Factors of Stroke Between Adult Residents in Urban and Rural Areas of Guangxi

目的了解广西城乡居民脑卒中患病流行病学特征及脑卒中发生的危险因素,为有针对性防治脑卒中提供科学依据。方法采取多阶段整群随机抽样,对广西4个城市和4个县18岁及以上城乡居民进行问卷调查和体检与抽血化验。结果共调查18岁以及以上成人8 388人,报告脑卒中病例60例,脑卒中粗患病率为715/10万、标化患病率519/10万,其中城市居民粗患病率、标化率分别高达1 253/10万、1 026/10万,显著高于农村(215/10万、178/10万,P<0.01);男性居民粗患病率、标化率分别为658/10万、548/10万,显著高于女性(357/10万、292/10万,P<0.01);城乡居民均呈现出随着年龄增长脑卒中患病率而上升。单因素分析显示,大专以上学历、高收入、低体力活动和汉族人群是脑卒中高发人群,超重、肥胖、高血压、糖尿病、高TG、高TC、有心脑血管或脑卒中家族史的人群易罹患脑卒中;而非条件Logis-tic回归模型多因素分析结果显示,心脑血管家族史、年龄是城乡居民脑卒中的危险因素。结论估计广西成人中有12.33万脑卒中现患病人,其中城市5.57万,农村6.76万,对广西社会、家庭经济和劳动生产力危害严重;预防脑卒中发生,除有效预防控制好高血压、肥胖和高TG、高TC外,加强体力活动和积极防治糖尿病十分重要。

Objective To investigate the epidemiological characteristics and risk factors of stroke between the residents in urban and rural areas of Guangxi, and to provide references for implementing directive individual intervention. Methods A total of 8,388 residents aged above 18 years in 4 cities and 4 counties of Guangxi were selected by using multistage stratified randomized cluster sampling method to conduct questionnaire interview and perform physical examination and blood test, Results The investigation results indicated that 60 cases of stroke were reported, and the prevalence rate and the age adjusted prevalence rate of stroke were 715/100,000 and 519/100,000. The prevalence rate and the ageadjusted prevalence rate of stroke in the urban residents were 1,253/100,000 and 1,026/100,000, and were both significantly higher than those of the rural residents （215/100,000, 178/100,000）. The prevalence rate and the age- adjusted prevalence rate of stroke in males were 658/100,000 and 548/100,000, and were both significantly higher than those in females （357/100,000, 292/100,000）. Stroke prevalence rate increased as the age increasing. The singlefactor analysis showed that the high risk population was usually the people with well education, high income, light physical activity and the Han nationality; and people with overweight, obesity, hypertension and diabetes mellitus, hypertriglyceridemia, hypercholesterolmia and family cerebrovascular or stroke history were more vulnerable from stroke. Multi - factors unconditional logistic regression analysis revealed that the family cerebrovascular history and age were the risk factors for stroke in urban and rural residents. Conclusions It is estimated that 123,300 individuals suffer from stroke in Guangxi, among them 55,700 in urban areas and 67,600 in rural areas, which are serious problems for society, family financial condition, and productive forces. Besides to prevent and control of hypertension, obesity, hypertriglyceridemia, and hypercholesterolmia, it is very important to strengthen physical exercises and to prevent and control diabetes mellitus for prevent stroke.