渠井泉 渠长满 黄学

摘 要 目的：了解社區脑卒中高危人群危险因素分布及流行特征，为开展脑卒中社区综合干预提供参考依据。方法：于2017年10-11月采取整群抽样方法对上海金山区山阳镇社区35岁及以上常住人口1 979人进行问卷调查、体格检查及血液检查，分析脑卒中高危人群危险因素。结果：筛出脑卒中高危对象518人，占26.17%，男性检出率高于女性（P<0.05），不同年龄段的检出率差异有统计学意义（P<0.05）。高危对象中，高血压、高同型半胱氨酸血症（>10 μmol/L）、缺乏运动、体质指数≥26 kg/m2、血脂异常、吸烟、家族史、糖尿病、房颤、既往脑梗/短暂性脑缺血发作者的检出比例分别为85.91%、79.73%、58.11%、54.83%、51.16%、40.54%、26.06%、22.39%、10.04%、8.30%。结论：社区脑卒中高危人群的危险因素暴露水平较高。需加强对脑卒中危险因素的防控；加强脑卒中高危人群的高血压、血脂异常管理以及高同型半胱氨酸血症筛查，并指导居民改变不良生活方式和饮食习惯。

关键词 社区脑卒中；高危人群；危险因素

中图分类号：R743.3 文献标志码：A 文章编号：1006-1533（2018）24-0035-03

Analysis of risk factors in high risk population with stroke in a community in Shanghai

QU Jingquan1， QU Changman2， HUANG Xue3（1. General Medical Wards of Shanyang Community Health Service Center of Jinshan District， Shanghai 201508， China； 2. Department of Medicine of Medical School of Hubei University for Nationalities， Enshi 445000， Hubei Province， China； 3.Preventive Department of Jinshan Industrial Area Community Health Service Center of Jinshan District， Shanghai 201506， China）

ABSTRACT Objective： To understand the distribution and epidemiological characteristics of risk factors in high risk population with cerebral apoplexy to provide reference for the community comprehensive intervention of stroke. Methods： A cluster sampling survey was conducted among 1 979 residents aged 35 years and over in Shanyang Community， Jinshan District， Shanghai from October to November， 2017. Through questionnaires， physical examination and blood tests， the risk factors in high risk patients with stroke were analyzed. Results： Among the 1 979 respondents， 518 people with high risk of stroke were screened out （26.17%）. The detection rate of the male high-risk group was higher than that of the females（P<0.05）， and the differences of detection rates among different age groups were statistically significant（P<0.05）. Among the high-risk subjects， the proportions of detection rates of hypertension， hyperhomocysteinemia（>10 μmol/L）， lack of exercise， body mass index ≥26 kg/m2， dyslipidemia， smoking， family history， diabetes， atrial fibrillation， previous cerebral infarction and transient ischemic attack were 85.91%， 79.73%， 58.11%， 54.83%， 51.16%， 40.54%， 26.06%， 22.39%， 10.04%， and 8.30%， respectively. Conclusion： Exposure to risk factors in high-risk populations with stroke in the community is high. It is necessary to strengthen the prevention and control of risk factors for stroke； strengthen the management of hypertension， dyslipidemia and hyperhomocysteinemia in highrisk population with stroke， and guide residents to change their unhealthy lifestyles and eating habits.

KEY WORDS community stroke； high risk population； risk factor

隨着居民生活水平的不断提高和膳食结构的改变，脑卒中已成为居民健康的第一大杀手。脑卒中具有“高发病率、高致残率、高死亡率、高复发率”四大特点，已成为严重的公共卫生问题[1]。有研究显示，脑卒中的发病趋势与危险因素的暴露水平有着密切的关系，加强危险因素的控制是预防和延缓脑卒中事件发生的有效途径[2]。本次筛查旨在了解上海金山区山阳镇脑卒中高危人群危险因素分布情况，为制定干预策略提供参考依据。

1 对象和方法

1.1 对象

于2017年10月至11月以整群抽样方法抽取的上海金山区山阳镇社区35岁及以上常住居民为研究对象。……