上海市浦东新区某社区老年脑卒中高危人群筛查结果分析

Analysis of screening results of elderly stroke high-risk population in a community in Pudong New Area,Shanghai

目的了解上海市浦东新区三林社区老年脑卒中高危人群危险因素暴露情况及其人群分布特征,为制定老年脑卒中高危人群防治策略提供依据。方法于2015-2017年采取整群抽样方法对浦东新区三林社区65岁及以上常住户籍人口开展现场询问调查和相关的体格检查,进行血脂、空腹血糖、糖化血红蛋白、同型半胱氨酸、心电图检测,以筛查缺血性脑卒中高危人群及其危险因素。结果2015-2017年筛查居民总数为9195人,筛查出脑卒中高危人群1504人,高危人群比例为16.78%,有短暂性脑缺血发作史或者卒中史535人(5.82%),危险因素≥3项的高危人群969人(10.54%)。1504名高危人群中危险因素暴露率从高到低依次为高血压、超重、高血脂、糖尿病、卒中史、吸烟史、家族史、缺乏运动、房颤。969例危险因素≧3的高危人群中,女性糖尿病、高血脂暴露率高于男性,男性吸烟率、超重高于女性。参加筛查的社区人群中,高Hcy血症的检出率为53.72%。男性检出率为63.8%,女性为45.7%,差异有统计学意义。结论三林地区65岁以上人群高危人群检出率与上海其他地区相似;高血压、超重、高血脂是暴露率最高的三项危险因素。男性和女性某些危险因素暴露情况有差异。高同型半胱氨酸血症在高龄、男性人群检出率高。应结合不同人群的危险因素发生情况实施定期随访管理,以达到预防脑卒中的目的。

Objective To understand the risk factors exposure and population distribution characteristics of the elderly population at high risk of stroke in Sanlin Community,Pudong New Area,Shanghai,and to provide basis for the development of prevention and treatment strategies for the elderly population at high risk of stroke.Methods from 2015 to 2017 by using cluster sampling method of pudong new area three forest community more than 65 years old and permanent population of field investigation and related physical examination,blood lipid,fasting blood glucose,glycosylated hemoglobin,homocysteine,ECG detection,with screening of ischemic cerebral apoplexy risk groups and its risk factors.Results From 2015 to 2017,there were 9,195 residents in total,1,504 people with high risk of stroke were screened,and the proportion of high risk population was 16.78%;535 people(5.82%)had a history of tia or stroke,and 969 people(10.54%)had more than 3 risk factors.Among the 1,504 high-risk groups,the risk factor exposure rates ranged from high to low for hypertension,overweight,hyperlipidemia,diabetes,history of stroke,smoking,family history,physical inactivity,and atrial fibrillation.Among the 969 patients with risk factors≥3,the incidence of diabetes and hyperlipidemia exposure was higher in women than in men,and the incidence of smoking and overweight in men was higher than in women.The detection rate of Hcy hyperemia was 53.72%in the community population participating in screening.The detection rate was 63.8%for males and 45.7%for females,and the difference was statistically significant.Conclusion The detection rate of high-risk groups over 65 years old in Sanlin area was similar to that in other areas of Shanghai.Hypertension,overweight,and hyperlipidemia were the three risk factors with the highest exposure rates.Men and women have different exposures to certain risk factors.High homocysteine in the elderly,male population detection rate is high.In order to prevent stroke,regular follow-up management should be carried out in combination with the occurrence of risk factors in different populations.