我国三城市开展社区人群干预九年脑卒中发病率的变化

The change in incidence of stroke after a community-based intervention for nine years in three cities of China

目的 探索适合国情的社区人群降低脑卒中发病率和死亡率的有效干预措施。方法 在脑卒中高发城市北京、上海、长沙 3个市区约 30万人群中开展社区综合性预防研究 ,其中半数设为对照人群。结果 开展加强干预 9年来 ,干预社区脑卒中发病率男性下降 5 1.5 % ,女性下降 5 2 .7%。同期对照社区男女分别下降 7.3%和 15 .7% ,两组比较有非常显著性差异。干预社区 10年平均发病率为 16 7.0 2 10万 ,对照社区为 199.96 10万 ,统计学比较差异有显著性意义 (P <0 .0 1)。在干预社区 ,5 0岁以上高龄组发病专率逐年下降的同时 ,35～ 49岁组发病率却显示有上升趋势。结论 在人群中开展经常性的健康教育和健康促进活动 ,同时实施积极控制高血压为主的干预措施可明显降低脑卒中的发病率。

Objective To find the effective and suitable measures for lowering incidence and mortality of stroke in community population.Methods A community based comprehensive intervention trial was conducted in 300?000 population in three urban communities of Beijing,Shanghai and Changsha.Results In the past nine years,the incidence of stroke decreased by 51.5% in males,and 52.7% in females in intervention community.During the same period,the incidence of stroke in control community decreased by 7.3% in males and 15.7% in females respectively.The average incidence rates were 167.02/100?000 in intervention population and 199.96/100?000 in control population,showing a statistically significant difference between the two groups (P<0.01). It should be noticed that the age specific incidence rate in 35 49 age group has increased gradually.Conclusion An intensive prevention and control on hypertension together with a regular health education and health promotion in community population could evidently reduce the incidence of stroke.