社区人群脑卒中危险因素综合干预研究

A Community-based Comprehensive Intervention Trial on Risk Factors of Stroke

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预防措施。方法选择脑卒中高发的北京、上海、长沙三个城市约30万人群中开展社区综合性干预研究。对其中约14万人口进行以管理高血压、糖尿病和控烟为主的特殊干预,另外半数人口设为对照人群。结果 4年后,干预社区人群中几种主要危险因素水平下降,男性脑卒中发病率下降了41.4％,女性下降了46.3％。干预前后相比,脑卒中死亡率男女各下降31.8％和19.0％;用5年平均发病率和死亡率进行比较,两社区人群之间的差别均有显著性意义(P<0.01)。结论在人群中开展经常化的健康教育和健康促进活动,同时采用积极控制高血压、糖尿病等为主的干预措施可明显降低脑卒中的发病率和死亡率。

Objective To explore the effective and suitable measures to reduce the incidence and mortality of stroke in community population. Methods A community - based compredhensive intervention trial was conducted among 300 000 population in three urban communities in Beijing, Shanghai and Changsha. About 140 000 population was intervened with managing hypertension, diabetes and controlling cigarette smoking.The other half population was designed as a control group. Results Four years later, the main risk factors' level were declined, and the incidence of stroke were decreased by 41.4% in male and 46.3% in female in the intervention community.The mortality of stroke were decreased by 31.8% in male and 19.0% in female respectively.It was showed a significant difference between the two groups (P< 0.01) when making a comparison with the average incidence and mortality rates. Conclusion An intensive prevention and control on hy- pertension together with a regular health education and health promotion in community population could evidently reduce the incidence and mortality of stroke.