湖北省武汉市汉中社区居民脑卒中患病率及危险因素分析

Analysis on the prevalence and risk factors of stroke in residents of Hanzhong community in Wuhan city,Hubei province

目的了解湖北省武汉市汉中社区居民的脑卒中患病率及各项危险因素情况,制定下一步防治措施。方法2023年5月1日至7月31日,采取多阶段整群随机抽样的方法对湖北省武汉市汉中社区801例≥40岁居民的人群进行问卷调查、体格检查与实验室检查。结果801例中,脑卒中28例,脑卒中患病率为3.5%,高危人群255例,占31.8%。脑卒中的高危因素从高到低占比分别为:高血压占24.3%,血脂异常占23.6%,缺少运动占17.6%,吸烟占13.1%,糖尿病占12.0%,脑卒中家族史占9.0%,肥胖或超重占8.6%,房颤或瓣膜性心脏病占3.0%;男性高危人群高于女性,随着年龄的增长其高危人群的检出率也不断升高(χ^(2)=33.95,P<0.001);同型半胱氨酸很可能是通过高血压的方式导致脑卒中的发生(χ^(2)=42.63,P<0.001),同型半胱氨酸水平也成为高危人群的另一重要危险因素(χ^(2)=5.74,P<0.05)。结论湖北省武汉市汉中社区≥40岁居民脑卒中危险因素以吸烟、高血压以及超重与肥胖为主,同型半胱氨酸血症与脑卒中高危因素有很大关系,高同型半胱氨酸的筛查与防治将是之后脑卒中的筛查与预防工作的重要指标之一。

Objective To investigate the prevalence and risk factors of stroke in residents of Hanzhong community,Wuhan city,Hubei province,and develop subsequent prevention and treatment measures.Methods A questionnaire survey,physical examination,and laboratory tests were conducted from May 1 to July 31,2023,among a population of 801 residents aged 40 years and older in Hanzhong community,Wuhan city,Hubei province,using multi-stage whole cluster random sampling.Results Among the 801 residents surveyed,28 were found to have suffered from stroke,yielding a prevalence rate of 3.5%.Additionally,there were 255 individuals identified as high-risk,accounting for 31.8%of the population.The risk factors for stroke,ranked from highest to lowest in prevalence,were as follows:hypertension(24.3%),dyslipidemia(23.6%),lack of exercise(17.6%),smoking(13.1%),diabetes(12.0%),family history of stroke(9.0%),obesity or overweight(8.6%),and atrial fibrillation or valvular heart disease(3.0%).The prevalence of stroke is higher in men than in women,and it continues to increase with advancing age(χ^(2)=33.95,P<0.001).Homocysteine is likely to contribute to the occurrence of stroke through its association with hypertension(χ^(2)=42.63,P<0.001).Additionally,homocysteine levels have emerged as another significant risk factor for stroke among individuals who are at high risk(χ^(2)=5.74,P<0.05).Conclusion In Hanzhong community,Wuhan city,Hubei province,smoking,hypertension,overweight,and obesity are the major risk factors for stroke among residents aged 40 years and older.Homocysteinemia is closely related to these high-risk factors for stroke.Therefore,screening and prevention of elevated homocysteine levels will be one of the critical indicators for the subsequent screening and prevention of stroke.