队列人群脑血管病危险因素干预效果评价

Evaluation on a cohort based population intervention project regarding risk factors for cerebrovascular diseases

目的 分析队列人群脑血管病危险因素干预前后变化及对脑卒中发病的影响 ,评价干预效果。方法 1 987年在长沙市区选取 1个干预社区和 1个对照社区 ,选择具有可比性的两组人群 ,对 35岁以上居民的脑血管病危险因素进行调查 ,作为基线指标 ,并将其作为随访对象 (已确诊的脑血管病患者除外 )。对干预组进行 1 4年的脑血管病危险因素综合干预 ,同时监测脑卒中发病情况 ,2 0 0 0年进行复查。结果 1 4年后 ,干预组高血压、糖尿病患病率和平均收缩压、舒张压、体重均增加 ,其变化分别为 33 .8%～ 35 .7% ,30 /万～ 1 2 9/万 ,1 2 8.41～ 1 34 .49mmHg(1mmHg =0 .1 33kPa) ,77.78～ 78.54mmHg,54 .80～ 57.78kg,对照组上述值的变化分别是从 35 .9%～ 56 .8% ,30 /万～2 2 8/万 ,1 2 7.70～ 1 4 1 .80mmHg,78.2 7～ 82 .89mmHg,54 .92～ 59.69kg,除干预组的高血压患病人数和舒张压增加未达到统计学意义外 ,其余各指标增加差异均具有显著性 ,但均以对照组增加明显 ;两组人群的饮酒率均有显著性下降 ,吸烟虽有下降但差异无统计学意义 ,两组人群进行比较 ,无论吸烟率还是饮酒率变化差异均无显著性 ;干预组累积脑卒中发病率 (3 .4% )明显低于对照组 (4.7% )。结论 高血压。

Objective To analyze the changes of risk factors in cerebrovascular diseases in cohort based population after intervention and evaluating the intervention effect. Methods In 1987, an intervention cohort and a control cohort were selected randomly in urban areas of Changsha. Risk factors in cerebrovascular diseases were investigated in two cohort populations aged over 35 years as baseline indication. Then comprehensive prevention of cerebravascular diseases was carried out in intervention cohort during 1987 2000. After intervention for 14 years, a reexamination was taken in the two groups noted above. Results After 14 years,the prevalence of diabetes mellitus, hypertention, mean systolic and diastolic pressure, weight increased from 33.8 % to 35.7 %, 30 to 129 per 10 000 , 128.41 mm Hg to 134.49 mm Hg, 77.78 mm Hg to 78.54 mm Hg, 54.80 kg to 57.78 kg in the intervention group, respectively while the baseline indication increased from 35.9 % to 56.8 %, 30 to 228 per 10 000 , 127.70 mm Hg to 141.80 mm Hg, 78.27 mm Hg to 82.89 mm Hg, 54.92 kg to 59.69 kg in the control one. The changes were of statistical significance in each group except diastolic pressure and the prevalence of hypertension in intervention group, but all the parameters increased significangtly in the control group; rate of alcohol intake decreased significantly in two groups,but rate of cigarette smoking decreased with no significance. The changes between two groups were not significant either; the cumulative incidence of stroke was significantly lower in intervention cohort ( 3.4 %) than in control cohort ( 4.7 %). Conclusion The risk factors for cerebrovascular diseases (such as hypertension, diabetes mellitus etc.) were increasing along with by aging. Intervention programs can delay the increase of risk factors and down regulate the incidence of stroke.