马陆镇缺血性脑卒中高危人群筛查分析

Analysis of the screening results of the high risk population with the ischemic stroke in Malu Community

目的 :了解上海市嘉定区马陆镇辖区内缺血性脑卒中的危险因素和高危人群的分布。方法 :2014年6月采用完全随机方法抽取辖区2个村2 274名40岁以上居民进行问卷调查和体格检查,以筛查缺血性脑卒中高危人群及其危险因素,并对筛查出的高危人群进一步进行血清同型半胱氨酸水平和颈动脉超声检查。结果 :2 274名中有缺血性脑卒中高危因素649名(28.54%),其中有脑卒中病史58名(2.55%)。男性检出率37.53%(355/946),脑卒中病史36名;女性检出率23.9%(294/1 228),脑卒中病史22名,男女差异有统计学意义(χ2=47.093,P=0.001)。很少进行体育活动和肥胖是脑卒中的主要危险因素。脑卒中高危人群中,男性高同型半胱氨酸血症检出率为32.94%(111/337),女性为18.73%(53/283),差异有统计学意义(χ2=15.965,P<0.01);颈动脉斑块的检出率无性别差异(P>0.05)。结论 :马陆镇辖区内缺血性脑卒中高危人群检出率高,有必要在社区开展脑卒中高危人群筛查及干预工作。

Objective： To learn the risk factor of the ischemic stroke and distribution of the high risk population in Malu Community, Jiading District, Shanghai. Methods： In June, 2014, with the complete random method, 2 274 residents aged 40 and over in two villages were chosen to be investigated with the questionnaire and physical examination to screen the high risk population with the ischemic stroke and the risk factor, and the serum homocysteine level and carotid artery ultrasonography were performed in the high risk population who had been screened out. Results： In 2 274 residents, 649 （28.54%） had the high risk factor of the ischemic stroke, among them, 58 （2.55%） had the history of the stroke. The detection rates were 37.53% （355/946）, and 23.9% （294/1 228）, and the number of people with the history of the cerebral stroke was 36 in the male and 22 in the female, and the difference between the male and female had the statistical significance （ X z=47.093, P=0.001）. Less sports and obesity were the main risk factors for the stroke. In the population with high risk of the stroke, the hyperhomocysteinemia detection rates were 32.94% （111/337） in the male and 18.73% （53/283） in the female, and the difference had the statistical significance （X 2=15.965, P〈0.01）. There was no sex difference in the detection rate of carotid artery plaque （P〉0.05）. Conclusion： The detection rate in the population with high risk of the ischemic stroke is high, and it is necessary to carry out the screening in them and intervention work in the communities.