上海市郊某镇55岁以上居民脑卒中危险因素筛查分析

Screening and analysis of stroke risk factors in residents aged 55 and over in a suburban town of Shanghai

目的:了解和掌握上海市宝山区罗泾镇脑卒中高危人群危险因素暴露水平及分布特征,为社区进行有针对性的干预提供参考依据。方法:采取整群抽样的方法选取5个居委> 55岁居民2 081人进行调查。结果:有效调查2 071人,应答率99. 52%。参加调查的居民平均年龄男女性分别为66. 02±4. 86岁和65. 85±5. 20岁。2071名居民中有287人被评估为脑卒中高危人群,检出率为13. 86%。高危人群中有短暂性脑缺血发作(TIA)史者22人,脑卒中/TIA合并脑卒中危险评估≥3分者10人,仅脑卒中危险评估≥3分者255人。脑卒中8项危险因素暴露排列前5位的:男性人群依次是高血压88. 44%、缺乏锻炼60. 12%、糖尿病56. 65%、吸烟52. 60%、血脂50. 29%;女性人群是高血压92. 98%、糖尿病65. 79%、血脂异常63. 16%、缺乏锻炼59. 65%、明显超重或肥胖56. 14%,55～59岁组的血脂异常者达100. 00%。男性吸烟暴露率高于女性(χ2=160. 322,P=0. 000),"房颤"情况只出现在男性对象中(χ2=133. 250,P=0. 000),55～59岁组缺乏锻炼的比例高于同组女性(χ2=60. 063,P=0. 000)。女性高危对象的血脂异常(χ2=14. 735,P=0. 000)、糖尿病(χ2=11. 478,P=0. 018)、超重和肥胖(χ2=16. 455,P=0. 000)高于男性。结论:罗泾镇脑卒中高危人群危险因素整体暴露水平较高,应针对不同人群采取有效的干预措施,控制高危人群的主要危险因素。

Objective To exploreand master the exposure level and distribution of risk factors in Luojing Town,Baoshan District,Shanghai,and to provide reference for community intervention. Methods A cluster sampling method was used to investigate 2081 residents of 5 neighborhoods over 55 years old. Results The valid number of the respondants were 2071( 99. 52%). The average age of the residents surveyed was 66. 02 ± 4. 86 for males and 65. 85 ± 5. 20 for females,respectively. Of the 2071 residents,287 were assessed as a high risk group for stroke with a detection rate of 13. 86%. There were 22 patients with history of transient ischemic attack( TIA),10 patients with combined stroke/TIA risk assessment score ≥3points,and 255 patients with stroke risk assessment score≥3 points. The first five risk factors of stroke among the total eight were hypertension( 88. 44%),lack of exercise( 60. 12%),diabetes( 56. 65%),smoking( 52. 60%) and blood lipid( 50. 29%) for male population and hypertension( 92. 98%),diabetes( 65. 79%),dyslipidemia( 63. 16%),lack of exercise( 59. 65%),and obvious overweight or obesity( 56. 14%) for female population. The proportion of residents with dyslipidemia was 100. 00% in the age group between 55 and 59 years old. Atrial fibrillation was found only in male subjects( χ^2=133. 250,P = 0. 000). The proportion of male residents lack of exercise in the age group between 55 and 59 years old was higher than that of females in the same group( χ^2= 60. 063,P = 0. 000). The prevalence of hyperlipidemia( χ^2= 14. 735,P= 0. 000),diabetes( χ^2= 11. 478,P = 0. 018),overweight and obesity( χ^2= 16. 455,P = 0. 000) were higher in women than in men. Conclusions The overall exposure level of high risk factors for stroke in Luojing Town was high. Effective intervention measures should be taken to control the main risk factors of high risk groups.