2015~2019年烟台市脑卒中高危人群危险因素暴露情况对比分析

Comparative analysis of exposure to risk factors of stroke high-risk population in Yantai from 2015 to 2019

目的分析2015~2019年烟台市东厅街道社区卫生服务中心居民的脑卒中高危人群危险因素暴露变化情况,了解社区脑卒中防控项目成效,为烟台地区脑卒中筛查防治提供依据,指导今后的筛查防治工作。方法根据国家卫生健康委脑卒中高危人群筛查和干预项目的筛选标准,采用整群抽样方法对2015、2017及2019年烟台市筛查点40岁以上常住居民进行调查研究;比较2015~2019年烟台市脑卒中筛查人群既往脑卒中史、短暂性脑缺血发作(Transient ischemic stroke, TIA)、危险分层动态变化及高危人群危险因素暴露动态变化。结果 2015、2017及2019年分别纳入5490、3955、4024人,烟台市脑卒中高危人群检出率分别为17.0%、23.4%及28.8%;2015、2017年筛查人群中高、中、低危人群及既往脑卒中占比均有明显差异(P<0.05)。2017、2019年筛查人群中既往TIA史、高危人群、低危人群构成比均有明显差异(P<0.05);2015、2017年筛查高危人群中危险因素(高血压病、糖尿病、房颤或心瓣膜病、血脂异常、吸烟史、明显超重或肥胖、缺乏运动及脑卒中家族史)构成比有明显差异(P<0.05);2017、2019年筛查高危人群中危险因素(房颤或心瓣膜病、血脂异常、吸烟史、缺乏运动、脑卒中家族史、既往TIA史及性别)构成比有明显差异(P<0.05)。结论脑卒中高危人群筛查检出率逐年增高,高血压病仍是脑卒中危险因素防治重点,而血脂异常、超重或肥胖已成为脑卒中危险因素预防控制的新目标。

Objective To evaluate the effect of community stroke prevention project, provide a basis for stroke screening prevention and control in the Yantai, and guide the future screening prevention and control work by analyzing the dynamic alteration of risk factors in the high-risk population in the Dongting street community from 2015 to 2019.Methods According to the screening criteria of stroke high-risk population screening and intervention project of the National Health Commission, the cluster sampling method was adopted to investigate the permanent residents over 40 years old at the screening sites in Yantai City in 2015, 2017, and 2019. The dynamic changes of previous stroke, TIA,risk stratification, and the risk factors of the high-risk population in stroke screening population were compared from 2015 to 2019 in Yantai.Results There were 5490, 3955 and 4024 patients enrolled in 2015, 2017 and 2019, respectively. The detection rates of high-risk stroke population in Yantai were 17.0%, 23.4% and 28.8%, respectively. Among the screening population in 2015 and 2017, there were statistically significant differences in the proportion of high, medium, and low-risk groups and stroke history(P<0.05). There were statistically significant differences in the composition of the TIA history, high-risk group, and low-risk group among the screening population in 2017 and 2019(P<0.05). Among the high-risk population screened in 2015 and 2017, there were statistically significant differences in risk factor composition ratio(P<0.05), including hypertension, diabetes mellitus, atrial fibrillation or heart valvular disease, dyslipidemia, smoking history, significantly overweight or obesity, physical inactivity, and family history of stroke. Among the high-risk groups screened in 2017 and 2019, there were statistically significant differences in risk factor composition ratio(P<0.05), including atrial fibrillation or heart valvular disease, dyslipidemia, smoking history, physical inactivity, family history of stroke, TIA, and gender. Conclusion The proportion of the high-risk population of stroke in Yantai increased all the time. Hypertension was always the focus of prevention and control of stroke risk factors, while dyslipidemia, overweight, or obesity had become the new object of prevention and control of stroke risk factors.