珠海市卒中高危人群城乡现状分析

摘要

目的：了解珠海市卒中高危人群现状，分析城乡卒中危险因素暴露水平及差异，为建立全市卒中防控网络体系提供理论依据。方法采用整群随机抽样方法，对2012年12月至2013年12月珠海地区≥40岁的常住居民进行横断面调查，筛查人数总计22981人，按卒中高危诊断标准筛查出高危人群进行人口学信息统计、危险因素分析、体格检查，统计筛查结果，组间比较采用两独立样本t检验及χ2检验分析，多因素采用logistic回归分析。结果共筛查出卒中高危人群城市534例、农村526例。珠海地区卒中粗患病率为0.51%，其中城市为0.50%，农村为0.52%。城市卒中高危人群前三位危险因素为高血压（74.53%）、缺乏锻炼（61.61%）、血脂异常（61.61%），农村为高血压（72.05%）、血脂异常（55.70%）、吸烟（51.71%）。男性、年龄、卒中家族史是珠海市城乡卒中高危人群共同卒中风险因素，低学历、高血压是农村卒中高危人群的独立风险因素，饮酒是城市卒中高危人群的独立风险因素，高学历是其重要的保护因素。结论根据珠海市城乡卒中高危因素的不同，制定珠海市城乡各具特色的卒中防治方案。早期发现并干预可干预危险因素，健康生活方式，以降低珠海市城乡卒中的发生率和复发率。%ObjectiveTo investigate the status quo about high stroke risk populations and analysis the differences and the exposure levels of risk factors between residents of the rural and urban areas in Zhuhai to provide theoretical evidence for the next prospective intervention study. MethodsAccording to the cluster random sampling method,a total of 22981 residents aged over 40 years in rural(Doumeng Town,Baijiao Town and Lianzhou Town)and urban(Shishan community and Cuixiang community)areas in Zhuhai were recruited in our study from Dec 2012 to Dec 2013. They were given questionnaire survey for the demographic statistics,past medical history collection and physical examinations. The statistical analysis were carried out through SPSS 20.0. Two independent samples t-test and 2 test were used to analysis 2 different groups,and the logistic regression was adopted to analysis multivariate risks.Results534 cases in urban and 526 cases in rural with high stroke risk were screened out. 3 major risk factors in people with high stroke risk were hypertension(74.53%),lack of exercise(61.61%)and dyslipidemia(61.61%)in urban,and synchronously hypertension(72.05%),dyslipidemia(55.70%)and smoking(51.71%)in rural.The analysis of multivariable unconditional logistic regression showed that,for stroke both in the rural and urban areas in Zhuhai,sex,age and family history of stroke were the common risk factors. Low education and hypertension were the independent risk factors for rural. Drinking was the independent risk factor for urban,while high education was the significant protective factor.Conclusion It is imperative to develop the individual stroke prevention program according to the different risk factors for high-risk populations in Zhuhai to early detect and intervene the interfered risk factors,health lifestyle and strengthen the stroke preventing awareness in citywide.