郑州市卒中及其常见危险因素城乡流行现状对比

Comparison of the Prevalence of Stroke and Its Common Related Risk Factors between Urban and Rural Areas in Zhengzhou

目的研究郑州市40岁以上人群卒中患病率及其常见危险因素的城乡流行现状。方法以社区为基本单位进行整群抽样,纳入符合要求的郑州市40岁以上常住人口11 366例,采集人口学、卒中危险因素、既往用药、体格检查和实验室检查等信息,用单因素和多因素Logistic回归分析卒中及其常见危险因素的城乡差异。结果从2013年12月至2014年3月共纳入11 366例社区居民,其中卒中患者344例,卒中标化患病率农村高于城市（3.3%vs 2.5%,Z=-2.649,P=0.004）,逐步调整各项影响因素后,卒中的患病率与居住地为农村呈正相关（OR 1.77,95%CI 1.31-2.38）。心房颤动、明显超重或肥胖、缺乏运动和既往发生过短暂性脑缺血发作的比例农村低于城市（P〈0.001）,吸烟比例农村高于城市（P〈0.001）。结论郑州市卒中及其危险因素的城乡差异显著,卒中防控工作应当针对当地卒中防控的薄弱环节,制订更有针对性的卒中社区防治策略。

Objective To investigate the epidemiological characteristics of stroke and its common related risk factors among the urban and rural population aged above 40 years old in Zhengzhou.Methods Using cluster sampling method in community-unit, a total of 11 366 inhabitants over 40 years old in Zhengzhou were recruited. The collected information covered basic individual information, related risk factors, past medicine information, physical and laboratory examinations. Single factor analysis and multiple logistic regression analysis were used to compare the prevalence of stroke and related risk factors between urban and rural areas based on the information including demographic data, risk factors of stroke, past medication history, physician and laboratory examinations, etc.Results From December 2013 to March 2014, 11 366 cases over 40 years old in Zhengzhou were involved in the study. The number of the patients with stroke was 344, and the standardized prevalence rate of stroke in rural areas was signifi cantly higher than that in urban areas（3.3% vs 2.5%, Z =-2.649, P=0.004）. After adjusted for the relevant infl uencing factors in a step-by-step manner, living in rural areas was still positively associated with stroke（OR 1.77, 95%CI 1.31-2.38）. The prevalence of atrial fi brillation, overt overweight or obese, lack of exercises and previous transient ischemic attack in rural areas was signifi cantly lower than that in urban areas（P〈0.001）; and the prevalence of smoking in rural areas was signifi cantly higher than that in urban areas（P〈0.001）.Conclusion There were signifi cant differences of stroke and its risk factors in rural and urban areas in Zhengzhou. The prevention and treatment work for stroke would be adapted to the strategy of community prevention and treatment in allusion to the local weaknesses.