李昊 谢向东 韩国辉 张雁儒

[摘要] 目的 了解本地区脑卒中高危人群危险因素暴露情况及分布状况，为焦作市脑卒中防治工作提供参考依据。方法 2020年8—12月，采用多阶段分层随机抽样的方法抽取焦作市≥18岁常驻居民5385名进行问卷调查和体格检查，采用χ2检验、Logistic回归模型和决策树模型进行数据分析。 结果 排除不合格问卷后，共有5316名研究对象，筛查出763名高危对象，检出率为14.35%。前三位危险因素分别为高血压（83.36%）、血脂异常（72.87%）和明显超重或肥胖（42.20%）。高危人群检出率：男性（21.18%）高于女性（10.20%），中老年（老年：17.55%、中年：15.07%）高于青年（9.16%）。二元Logistic回歸分析和决策树穷举CHAID分类树分析结果相似，吸烟史和糖尿病与脑卒中的发病存在较高的关联性。 结论 焦作市城乡居民中脑卒中高危人群占比较多，发病风险较高，应重点针对高危人群采取全方位干预措施，降低人群患病率。

[关键词] 脑卒中;高危人群;高血压;危险因素

[中图分类号] R743.3          [文献标识码] B          [文章编号] 1673-9701（2021）32-0150-05

[Abstract] Objective To understand the exposure and distribution of risk factors in high-risk groups of stroke in this region， so as to provide a reference basis for the prevention and treatment of stroke in Jiaozuo City. Methods From August to December 2020， a total of 5385 residents aged more than 18 years in Jiaozuo City were selected as the study subjects according to a multistage stratified random sampling method. These study subjects all participated in a questionnaire survey and underwent physical examination， and the data were analyzed by χ2 test，Logistic regression model and decision tree model. Results After excluding unqualified questionnaires， there were 5316 study subjects were included， and 763 high-risk subjects were screened out， with a detection rate of 14.35%. The top 3 risk factors were hypertension （83.36%）， dyslipidemia （72.87%） and obvious overweight or obesity （42.20%）. The detection rate of high-risk groups was higher in males （21.18%） than that in females （10.20%），and higher in middle-aged and elderly （elderly （17.55%）， middle-aged （15.07%） than that in youth （9.16%）.The results of binary logistic regression analysis and decision tree-exhaustive Chi-squared Automatic Interaction Detector （CHAID） classification tree analysis were similar， and the results showed that the smoking history was highly correlated with diabetes mellitus and the incidence of stroke. Conclusion There is a large number of groups suffering from stroke among urban and rural residents in Jiaozuo City， and the morbidity is relatively high. Therefore， interventions should be focused on high-risk groups to reduce the prevalence of the disease.

[Key words] Stroke; High-risk groups; Hypertension; Risk factors

脑卒中是一种急性突发性疾病，包括缺血性脑卒中和出血性脑卒中，是增加疾病负担的最重要因素，2019年脑卒中造成的全球疾病负担上升至第三位[1]。目前，脑卒中是我国成年人致死、致残的第一位原因，具有五高特点[2]，且发病逐渐年轻化，严重影响居民的健康质量，给家庭和社会带来了沉重的经济负担。即使近年来脑卒中的年龄标化死亡率和患病率已经呈现下降的趋势，但是脑卒中的疾病负担仍然持续在增高[3]。城乡居民一旦发生脑卒中，对身体的伤害是不可逆转的，且复发率极高，容易引发焦虑或抑郁的不良心理状态。……