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目的了解社区脑卒中高危人群的危险因素暴露水平及分布特点,为针对性地进行危险因素综合性社区干预提供科学依据。方法 2015年6—7月采用随机整群抽样的方法抽取上海市某社区40岁及以上的具有本市户籍的常住居民1 142人进行问卷调查和体格检查。结果 853人被评估为脑卒中高危人群,占总人数的74.7%。8项危险因素的暴露率从高到低依次为:高血压(80.7%)、体育锻炼很少(68.5%)、血脂异常(60.1%)、脑卒中家族史(45.7%)、糖尿病(38.2%)、明显超重(25.9%)、吸烟(23.3%)、房颤或瓣膜性心脏病(13.5%)。女性高危人群的血脂异常的暴露率高于男性,男性高危人群的吸烟率高于女性。高血压、房颤或瓣膜性心脏病、糖尿病的暴露率随着年龄的增长而升高,40~49岁和50~59岁年龄段人群的吸烟率和脑卒中家族史暴露率相对于其他年龄段更为突出。Logistic回归分析显示年龄、受教育程度、体育锻炼、睡眠障碍与脑卒中高危人群中脑卒中的发病存在回归关系(P<0.05)。结论高危人群的危险因素暴露率处于较高水平。基于社区开展脑卒中危险因素防控,重点加强血压、血糖和血脂的管理,改变不良饮食和生活习惯,针对不同人群进行健康教育,对社区脑卒中的防控具有重要意义。
Objective To understand the exposure level and distribution characteristics of risk factors for high risk stroke community in community and provide a scientific basis for targeted community intervention in risk factors. Methods From June to July 2015, a random cluster sampling method was used to survey 1,142 permanent residents aged 40 and over in a community in Shanghai with questionnaire and physical examination. Results 853 people were assessed as high risk of stroke, accounting for 74.7% of the total. The highest exposure rates of the eight risk factors were high blood pressure (80.7%), physical activity (68.5%), dyslipidemia (60.1%), family history of stroke (45.7%) and diabetes mellitus (38.2% ), Significantly overweight (25.9%), smoking (23.3%), atrial fibrillation or valvular heart disease (13.5%). The prevalence of dyslipidemia in women at high risk is higher than that in men, and the prevalence of smoking in men at high risk is higher than that of women. Hypertension, atrial fibrillation or valvular heart disease, diabetes, the exposure rate increases with age, smoking rates and family history of stroke in 40 to 49 years old and 50 to 59 age groups exposure rate relative to other age Section is more prominent. Logistic regression analysis showed that age, education level, physical activity, sleep disturbance had a regression relationship with the incidence of stroke at high risk of stroke (P <0.05). Conclusion The exposure rate of risk factors in high-risk groups is at a high level. It is of great importance to prevent and control stroke risk in community based on community prevention and control of stroke risk factors, focusing on the management of blood pressure, blood glucose and blood lipid, changing bad diet and living habits, and health education for different groups.