西安市中老年社区居民脑卒中高危人群筛查结果及危险因素聚集性研究

doi:10.12183/j.scjpm.2022.1179

摘要/Abstract

摘要： 目的调查中老年社区居民的脑卒中高危人群现状,分析其危险因素聚集性特点。方法采取整群随机抽样法,随机抽取西安市3个区（灞桥区、雁塔区和未央区）,每个区随机抽取3个社区,共9个社区,以辖区内≥40岁的常住居民做为调查对象进行问卷调查、体格调查及生理生化指标检测。按照《国家脑卒中高危人群筛查和干预项目》中规定对调查对象脑卒中高危情况进行评估,采用描述性分析方法对结果进行分析。结果完成调查人数18 312人,其中男性8 483人,占46.32%;女性9 829人,占性53.68%。年龄40~93岁,其中50~59岁所占比例较高,为30.13%。共筛选出符合脑卒中高危人群特征的居民3 325例,高危率18.16%。不同性别和年龄的中老年社区居民的脑卒中高危人群检出率差异有统计学意义（P<0.05或P<0.01）。脑卒中高危人群中检出的8项危险因素前3项依次为体育运动缺乏（71.40%）、高血压（70.86%）和吸烟（47.67%）。3 325例脑卒中高危人群符合3项危险因素为1 880例（56.54%）,符合4项为894例（26.89%）,符合5项404例（12.15%）,符合6项及以上者147例（4.42%）。脑卒中高危人群危险因素聚集性在不同性别和年龄中差异明显,男性和年龄较大者的危险因素聚集度明显更高（P<0.05）。结论西安市中老年社区居民脑卒中高危率较高,且多重危险因素聚集现象普遍存在,应针对性加强居民健康生活方式的宣教和干预。

关键词: 脑卒中, 高危人群, 筛查, 危险因素, 聚集性

Abstract: Objective To investigate the detection rate of the high stroke-risk individuals among middle-aged and elderly community residents, and analyze clustering characteristics of risk factors. Methods The cluster random sampling method was adopted to randomly select three districts in Xi'an （Baqiao District, Yanta District, and Weiyang District）, three communities in each district, a total of 9 communities, and to conduct questionnaire survey, physical survey, and physiological and biochemical indicators testing for permanent residents aged 40 and over in the area under their jurisdiction. According to the National High Stroke-Risk Individuals Screening and Intervention Program, the high-risk situation of stroke among the survey objects was evaluated, and the results were analyzed using descriptive analysis methods. Results A total of 18 312 residents completed the survey, including 8 483 males, accounting for 46.32%, and 9 829 females, accounting for 53.68%. The age range was 40-93 years old, of which 50-59 years old accounted for a high proportion, accounting for 30.13%. There were 3 325 residents with high stroke-risk, with a high-risk rate of 18.16%. There were significant differences in the detection rate of the high stroke-risk individuals among the middle-aged and elderly community residents of different genders and ages （P＜0.05 or P＜0.01）. The first three of the eight risk factors detected in the high stroke-risk individuals were lack of sports （71.40%）, hypertension （70.86%）, and smoking （47.67%）, respectively. Among the 3 325 high stroke-risk individuals, 1 880 cases （56.54%） with three risk factors, 894 cases （26.89%） with four risk factors, 404 cases （12.15%） with five risk factors, and 147 cases （4.42%） with six or more risk factors. The clustering of risk factors in high stroke-risk individuals was significantly different in different genders and ages, and the clustering of risk factors in males and older people was significantly higher （P＜0.05）. Conclusions The high-risk rate of stroke among middle-aged and elderly community residents in Xi'an is high, and the clustering of multiple risk factors is serious. It is necessary to strengthen the education and intervention of residents' healthy lifestyles.

Key words: Stroke, High risk individuals, Screening, Risk factor, Clustering

中图分类号:

R195

高露露, 王线妮, 高媛, 张楠. 西安市中老年社区居民脑卒中高危人群筛查结果及危险因素聚集性研究[J]. 华南预防医学, 2022, 48(10): 1179-1183.

GAO Lu-lu, WANG Xian-ni, GAO Yuan, ZHANG Nan. Screening results and risk factors clustering of high stroke-risk individuals in middle-aged and elderly community residents in Xi'an[J]. South China Journal of Preventive Medicine, 2022, 48(10): 1179-1183.

参考文献

[1] 《中国脑卒中防治报告》编写组.《中国脑卒中防治报告2019》概要[J].中国脑血管病杂志,2020, 17(5):272-281.
[2] Guan T, Ma J, Li M, et al.Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013[J]. Neurology, 2017, 89(1): 53-61.
[3] Zhou M, Wang H, Zeng X, et al.Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158.
[4] 中华人民共和国国家卫生健康委员会. 脑卒中高危人群筛查和干预试点项目管理办法(试行)[EB/OL]. (2012-04-13)[2022-04-24]http://www.nhc.gov.cn/cms-search/xxgk/getManuscriptXxgk.htm?id=54492 .
[5] 中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华心血管病杂志, 2011, 39(7): 579-616.
[6] 中国成人血脂异常防治指南修订联合委员会. 中国成人血脂异常防治指南(2016年修订版)[J]. 中国循环杂志, 2016, 31(10):937-950.
[7] 李梅,刘传玉.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[J].卒中与神经疾病,2022,29(1):33-37.
[8] 熊莲莲, 吴光辉, 傅兰勇. 福建省宁德市社区居民脑卒中高危人群筛查结果分析[J]. 中国公共卫生, 2020, 36(12):1822-1824.
[9] 邓雅丽, 詹思延. 北京市房山区脑卒中高危人群筛查结果分析[J]. 中华疾病控制杂志, 2015, 19(3):215-217.
[10] 邬至平, 邱伟文, 蔡学礼,等. 丽水市社区脑卒中高危人群筛查[J]. 中华全科医学, 2015, 13(3):438-440.
[11] 马林, 巢宝华, 曹雷, 等. 2007—2017年中国脑卒中流行趋势及特征分析[J]. 中华脑血管病杂志:电子版, 2020, 14(5): 253-258.
[12] 邢立莹, 井丽, 田园梦,等. 辽宁省城市地区≥40岁居民脑卒中患病现状及其相关危险因素分析[J]. 中国公共卫生, 2020, 36(3):327-330.
[13] 孙文慧, 李建彬, 冯石献,等. 2014—2017年郑州市居民脑卒中流行病学特征分析[J]. 广东医学, 2019, 40(11):1584-1588.
[14] 王晓唐,邹哲华,李燕莉.秦皇岛市脑卒中高危人群筛查结果分析[J].华南预防医学,2022,48(3):376-378,382.
[15] 吴萃, 陈秋艳, 万金豹. 2018年上海市宝山区脑卒中高危人群筛查结果分析[J]. 实用预防医学, 2020, 27(10): 1207-1209.
[16] Talmor-Barkan Y, Bar N, Shaul AA, et al. Metabolomic and microbiome profiling reveals personalized risk factors for coronary artery disease[J]. Nat Med, 2022,28(2):295-302.
[17] Dong S, Fang J, Li Y, et al.The population attributable risk and clustering of stroke risk factors in different economical regions of China[J]. Medicine, 2020, 99(16): e19689.
[18] Peters SAE, Wang X, Lam TH, et al.Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations: Results from the Asia Pacific Cohort Studies Collaboration[J]. BMJ open, 2018, 8(3): e019335.
[19] Volgman AS, Palaniappan LS, Aggarwal NT, et al.Atherosclerotic cardiovascular disease in South Asians in the United States: Epidemiology, risk factors, and treatments: A scientific statement from the american heart association[J]. Circulation,2018,138(1):e1-e34.
[20] 郑荣,南京柱,高艳红.UA、TG、LDL-C、Plip对冠心病二级预防降脂治疗患者的危险因素研究[J].标记免疫分析与临床,2021,28(10):1770-1775.