90年代上海社区脑卒中发病率、死亡率及其危险因素动态分析  

Dynamic analysis of incidence and mortality of stroke and the risk factors in the communities in Shanghai, in the 1990's

作　　者：黄茂盛[1] 洪震[1] 曾军[1] 周玢[1] 金美华[1] 沈明庭 刘德安 

机构地区：[1]复旦大学医学院附属华山医院神经病学研究所神经流行病室,上海200040 [2]上海市静安寺医院内科 [3]上海市日晖医院防保科

出　　处：《中华流行病学杂志》2001年第3期198-201,共4页Chinese Journal of Epidemiology

基　　金：国家 “九五”攻关课题(96-906-02-01)

摘　　要：目的　了解 90年代上海社区人群脑卒中发病和死亡情况及其危险因素的变化趋势。方法　在人群中建立疾病监测网 ,按照世界卫生组织“多国心血管病趋势和决定因素监测”方案 ,监测1991～ 1999年 35～ 74岁每年脑卒中的发生率和死亡率。分别于 1992年和 1998年在监测人群中整群随机抽取 35～ 5 9岁男女各半 ,约 10 0 0人进行危险因素调查。结果　监测社区 1991～ 1999年间35～74岁年龄组脑卒中平均年发病率为 16 8.2 / 10万 ,其中男性为 194.5 / 10万 ,明显高于女性(144 .9/ 10万 ) ,脑卒中发病率呈上升趋势 ;而且 ,男性的每年增长速度也高于女性。脑卒中年平均死亡率为 79.2 / 10万 ,其中男性为 87.2 / 10万 ,明显高于女性 (71.4/ 10万 ) ,脑卒中死亡率呈下降趋势。无论男女 ,脑卒中发病率随着年龄的增长而增长 ;男女发病年龄差异不大 ,但 1996～ 1999年平均发病年龄为 6 6 .1岁 ,比 1991～ 1995年提前了 3.5岁 (6 9.6岁 )。无论男女 ,血中总胆固醇均值、血压均值、体重指数、高血压患病率、动脉粥样硬化指数、腰臀比值、高胆固醇现患率、低高密度脂蛋白现患率等因素皆有升高趋势 ,另外男性甘油三酯也有升高趋势 ;仅吸烟率和饮酒率有下降趋势 ,尤其在男性中。结论　Objective To understand the trend of incidence,mortality of stroke and the risk factors at the community level in the 1990's. Methods To establish a network of disease surveillance. Both incidence and mortality of stroke were surveyed in the 35 74 age group during 1991 1999 using the method of WHO MONICA. By cluster sampling in 1992 and 1998, 500 individuals aged 35 59 from each female and male group were investigated respectively on the risk factor of stroke. Results The incidence of stroke was averaged 168.2 per 100 000 in the group aged 35 79 during 1991 to 1999 with 194.5 and 144.9 pre 100 000 respectively for the male and female group of this age. The incidence of stroke in the male group was higher than that in the female group, also with a faster speed of increase in the male group. The overall mortality of stroke was averaged 79.2 per 100 000 with 87.2 and 71.4 per 100 000 in male and female groups respectively of this age group. The incidence of stroke increased with age in both male and female groups. The average age of onset had been 66.1 year olds during 1996 1999, 3.5 years older than that age groups during 1991 1995, but did not show much difference between male group and female group. CHO,Blood Pressure,BMI,Prevalence of Hypertension,TC/HDLC,WHR,Prevalence of High CHO,Prevalence of Low HDL all had a tendency of increase in both male and female groups. The rates of smoking cigarettes and drinking alcohol both decreased, especially in the male group. Conclusion The incidence of stroke and some relative risk factors seemed to increase in the 1990's, but the mortality of stroke had a decrease in the same period in the communities in Shanghai.

关 键 词：脑卒中 发病率 死亡率 危险因素 

分 类 号：R181.32[医药卫生—流行病学]