军队男性中老年人脑卒中发病和死亡的队列研究

Study on mortality, incidence and risk factors of stroke in a cohort of elderly in Xi'an, China

目的 前瞻性探讨军队男性中老年人脑卒中发病及死亡的危险因素。方法 采用队列研究设计。研究对象为居住西安市 2 2个军队干休所的 12 6 8名男性军队离退休干部。 1987年基线调查的主要内容包括 :年龄、体重指数 (BMI)、血压、血脂、吸烟、饮酒、既往病史及家族史等。终点指标为新发脑卒中、脑卒中死亡和总死亡。结果 随访至 2 0 0 1年 6月 ,观察人年为 15 5 46。新发脑卒中113例 ,调整发病率为 72 7/ 10万人年 ;脑卒中死亡 45例 ,调整死亡率为 2 89/ 10万人年。调整了年龄、血脂、吸烟、饮酒、既往心脑血管病病史及家族史等主要危险因素后 ,基线血压水平、BMI和既往冠心病和高脂血症病史是影响该人群脑卒中发病和死亡的主要危险因素。结论 军队男性中老年人群的脑卒中发病率和死亡率低于一般同龄人群 ,中老年人体重和血压水平进行监测和控制对预防中老年人群的脑卒中发病和死亡有重要意义。

Objective To prospectively study the relationship between risk factors and stroke incidence and mortality in the Chinese elderly. Methods An analytic study in a cohort population of 1 268 male retired cadres in a military setting. A health-screening program was carried out for all cadres aged 55 years or older in Xi'an in February 1987. Baseline data on smoking, cholesterol, triglyceride, blood pressure, body mass index (BMI), histories of hypertension, hyperlipidemia and coronary heart disease(CHD), stroke, diabetes and family histories of cadiovascular disease were investigated. Main outcome measures were stroke incidence, stroke and all-cause mortality. Results The cohort was followed up until June 30, 2001 and a total number of follow-up person-year was 15 546. During the follow-up period, there were 113 new stroke cases identified and the adjusted incidence was 727 per 100 000 person-year. Forty-five deaths were due to stroke and the adjusted mortality was 289 per 100 000 person-year. Using Cox model analysis, after adjustment on age, total cholesterol, triglyceride, smoking, drinking and physical exercise, we noticed that the systolic pressure, BMI, history of CHD and hyperlipidemia were independent risk factors for stroke incidence and morality. Conclusion The incidence and mortality of stroke in this cohort were lower than those in the same age group of general population. Monitoring and controlling body mass index and blood pressure level seemed to be important factors for the prevention of stroke in the elderly.