上海市松江区社区脑卒中人群共病现状研究

Cross-sectional study on comorbidities in community patients with stroke in Songjiang District,Shanghai

【目的】了解上海市松江区社区脑卒中人群的共病现况,描述该人群共病患病率,分析共病特点及其影响因素,为脑卒中的防治提供科学依据。【方法】于2016年4月—2017年10月在上海市松江区部分社区开展了一项基于自然人群的队列研究,对队列人群进行问卷调查、体格检查和生化指标检测等,了解基线1523名脑卒中现患者的共病现状。【结果】脑卒中人群共病患病率为74.0%,女性(76.36%)高于男性(70.76%),平均共病数为(2.62±1.56)个,女性(2.70±1.58)多于男性(2.52±1.54),差异有统计学意义(t=−2.31,P=0.021)。在该人群中最常见的2种疾病共病组合为高血压+中心性肥胖(35.85%),最常见的3种疾病共病组合为高血压+血脂异常+中心性肥胖(17.20%),在不同性别和年龄组之间差异均有统计学意义(P<0.05)。多因素分析显示,年龄≥65岁、城镇人群、患有高同型半胱氨酸血症(HHcy)、有高血压家族史是共病的危险因素,初中、高中及中专文化水平、每周体育锻炼1~3 d是共病的保护因素。【结论】上海市松江区脑卒中人群共病患病率较高,应倡导控制血压、体重,拥有健康的生活方式,采取综合防治措施。

[Objective] To investigate the comorbidity of community patients with stroke in Songjiang District,Shanghai,determine the prevalence and characteristics of comorbidities and influencing factors,and provide scientific evidence for prevention and treatment of stroke.[Methods]A natural population-based cohort study was conducted in several communities of Songjiang District from April 2016 to October2017. Questionnaire survey,physical examination and biochemical examination were conducted in the cohort population to understand the comorbidity of 1 523 patients with stroke at baseline.[Results]The prevalence of comorbidities in community patients with stroke was 74.0%,which was higher in female(76.36%) than that in male(70.76%). The average number of comorbidities was 2.62±1.56,which was significantly higher in female(2.70±1.58)than that in male(2.52±1.54)(t=-2.31,P=0.021). In this population,the most common twocomorbidity combination was hypertension+central obesity(35.85%),and the most common three-comorbidity combination was hypertension+dyslipidemia+central obesity(17.20%),with statistically significant differences by gender and age groups(P<0.05). Multivariate analysis showed that age ≥65 years,urban population,hyperhomocysteinemia(HHcy),and family history of hypertension were risk factors associated with comorbidities,whereas educational level of middle school and high school,and physical exercise 1-3 days per week were protective factors.[Conclusion]Prevalence of comorbidity is high in community patients with stroke in Songjiang District,Shanghai. It is suggested to control blood pressure and body weight,adopt healthy lifestyle and take comprehensive prevention and treatment measures in this population.