合肥市一社区脑卒中高危人群危险因素筛查分析

Analysis on the screening results among high-risk stroke residents in a community of Hefei

目的开展合肥市四里河社区脑卒中高危人群筛查,了解脑卒中高危人群危险因素暴露情况,以期制定针对性的脑卒中防治策略。方法采取整群抽样方法,选取合肥市四里河社区40岁以上常住居民2 682例进行脑卒中风险评估,筛查出的脑卒中高危人群完善颈部血管超声检查。结果社区居民2 682例中共筛查出762例脑卒中高危人群,检出率为28.41%。高危人群的危险因素主要包括高血压(86.35%)、血脂异常(62.99%)、缺乏锻炼(48.29%)、明显超重或肥胖(34.38%)、脑卒中家族史(31.76%)、糖尿病(28.22%)、吸烟(23.49%)和房颤(3.94%)。高危人群男性检出率(37.92%)高于女性(22.99%)(χ^(2)=67.970,P<0.001),男性高危人群吸烟率高于女性(χ^(2)=240.6,P<0.001);女性脑卒中家族史危险因素暴露率高于男性(χ^(2)=7.16,P<0.05)。高危人群中高同型半胱氨酸(Hcy)血症组(>15μmol/L)共867例(32.35%)。脑卒中高危人群颈动脉粥样硬化检出率为65.08%。Logistic回归分析结果显示本地人群中脑卒中最主要独立危险因素为缺乏运动(OR=33.675,95%CI 22.061~49.239)。结论合肥市四里河社区脑卒中高危人群危险因素暴露水平较高,应早期识别脑卒中的高危人群,干预危险因素并规范诊治高血压、糖尿病等慢性疾病,防治脑卒中发生。

Objective To provide the scientific evidence for the prevention and cure of stroke by investigating its risk factors in residents of Hefei Silihe community.Methods A total of 2 682 permanent residents aged ≥40 years were included in this study via cluster sampling method.Carotid vessel color ultrasound examination was implemented in the high-risk group of stroke.Results 762 high-risk people were screened out,with a detection rate of 28.41%.In a descending order,the exposure rates of risk factors were 86.35% for hypertension,62.99%for dyslipidemia,48.29% for lack of exercise,34.38% for overweight or obesity,31.76% for family history of stroke,28.22% for diabetes,23.49% for smoking,and 3.94% for atrial fibrillation.The detection rate of male was higher than that of female in high risk group(37.92%,22.99%)(χ^(2)= 67.970,P<0.001).Smoking rate in male was higher than that in female(χ^(2)= 240.6,P<0.001).Exposure rate of risk factors of female stroke family history was higher than that of male(χ^(2)= 7.16,P<0.05).There were 867 cases of high Hcy group in high-risk population(32.35%).The positive ratio of carotid atherosclerosis was 65.08%.Logistic regression analysis showed that lack of exercise and storke were significantly related(OR=33.675,95% CI: 22.061-49.239).Conclusion Exposure rate of risk factors for stroke in high-risk population in Hefei Silihe community is high.It is necessary to identify the high-risk group of stroke early.Intervene modifiable risk factors actively,standardize the diagnosis,and treatment of chronic diseases like hypertension and diabetes are benefit to reduce the prevalence of stroke.