不同年龄和性别脑卒中高危人群的危险因素调查分析

Risk factors for stroke in high-risk populations of different ages and genders

目的了解不同年龄和性别脑卒中高危人群危险因素分布特征,为制定精准的干预措施提供依据。方法采用国家脑卒中高危人群筛查和干预项目风险评估表于2016年1-12月调查丽水市城郊社区居民6445例,通过卡方检验分析不同年龄和性别脑卒中高危人群的危险因素分布特征及共患情况。结果脑卒中高危人群检出率21.88%,危险因素比例由高到低依次是高血压病(86.88%)、运动缺乏(76.38%)、超重或肥胖(60.57%)、吸烟(40.92%)、糖尿病(33.97%)、血脂异常(27.52%)、房颤或瓣膜性心脏病(12.27%)、脑卒中家族史(9.36%)。女性高血压病(92.36%)、血脂异常(30.38%)、糖尿病(41.26%)、超重或肥胖(66.04%)、运动缺乏(79.63%)的检出率均高于男性(高血压病82.95%、血脂异常25.46%、糖尿病28.75%、超重或肥胖56.64%、运动缺乏74.06%)(χ^2高血压病=26.65,P<0.001;χ^2血脂异常=4.19,P=0.041;χ^2糖尿病=23.93,P<0.001;χ^2超重或肥胖=12.70,P<0.001;χ^2运动缺乏=5.90,P=0.015)。高血压病、房颤或瓣膜性心脏病、运动缺乏随年龄的升高检出率升高(χ^2高血压病=36.55,P<0.001;χ^2房颤或瓣膜性心脏病=76.10,P<0.001;χ^2运动缺乏=84.66,P<0.001)。最常见的危险因素共患组合是高血压+超重或肥胖+运动缺乏(33.83%),在不同性别和年龄间检出率均较高。高血压+超重或肥胖+运动缺乏和高血压+吸烟+运动缺乏的检出率随着年龄增长呈增高趋势,高血压+血脂异常+超重或肥胖和高血压+血脂异常+运动缺乏的检出率随着年龄增长呈下降趋势。结论脑卒中高危人群的危险因素存在年龄和性别差异,需要根据高危人群的危险因素特征制定精准的干预方案。

Objective To investigate the distribution characteristics of risk factors of stroke in high-risk populations of different ages and genders,and to provide a basis for formulating precise intervention measures.Methods The National Risk Assess-ment Table of Stroke Screening and Intervention Project was used to investigate 6,445 suburban community residents in Lishui city from January to December 2016.Chi-square test was employed to analyze the distribution characteristics and co-occurrence of risk factors for stroke in high-risk populations of different ages and genders.Results The detection rate of population at high risk of stroke was 21.87%.Risk factors ranked from high to low were hypertension(86.88%),lack of physical exercise(76.38%),overweight or obesity(60.57%),smoking(40.92%),diabetes(33.97%),dyslipidemia(27.52%),atrial fibrillation or valvular heart disease(12.27%)and family history of stroke(9.36%).The detection rates of hypertension,dyslipidemia,diabetes,overweight or obesity and lack of physical exercise were higher in females than in males(92.36%vs.82.95%,χ^2=26.65,P<0.001;30.38%vs.25.46%,χ^2=4.19,P=0.041;41.26%vs.28.75%,χ^2=23.93,P<0.001;66.04%vs.56.64%,χ^2=12.70,P<0.001;79.63%vs.74.06%,χ^2=5.90,P=0.015).The detection rates of hypertension(χ^2=36.55,P<0.001),atrial fibrillation or valvular heart disease(χ^2=76.10,P<0.001)and lack of physical exercise(χ^2=84.66,P<0.001)increased with the increasing age.The most common risk factor combination was hypertension+overweight or obesity+lack of physical exercise(33.83%),and the detection rate was higher in populations of different genders and ages.The detection rates of hypertension+overweight or obesity+lack of physical exercise and hypertension+smoking+lack of physical exercise showed an upward trend with the increasing age,while the detection rates of hypertension+dyslipidemia+overweight or obesity and hypertension+dyslipidemia+lack of physical exercise reflected a downward trend with the increasing age.Conclusions There are age and gender differences in the risk factors in the high-risk population of stroke;and hence,it is necessary to formulate precise interventions according to the characteristics of risk factors in the high-risk population.