上海市浦东新区某社区脑卒中高危人群筛查报告  

A report on a screening of high-risk population for stroke in a community of Pudong New Area,Shanghai

作　　者：高黎黎[1] 付建辉[2,3] 王卫忠 王瑛 孙晓伟 肖伟忠[2] 李清华[2] 丁玎[3] 龚旻[5] 杨莉华[6] 余波[7] GAO Li-li FU Jian hui WANG Wei-zhong WANG Ying SUN Xiao-wei XIAO Wei zhong LI Qing-hua DING Ding GONG Min YANG Li-hua YU Bo(Center for Medical Research and Innovation Department of Neurology ,5Department of Urinary Surgery ,6 Medical Network Office 7 Department of Vascular Surgery, Shanghai Pudong Hospital-Fudan University Pudong Medical Center Shanghai 201399, China Department of Neurology, Huashau Hospital, Fudan University, Shanghai 200040, Ch ina Community Health Center of Zhuqiao Town, Pudong New Area, Shanghai 201323, China)

机构地区：[1]上海市浦东医院-复旦大学附属浦东医院医学科研与创新中心,上海201399 [2]上海市浦东医院-复旦大学附属浦东医院神经内科,上海201399 [3]复旦大学附属华山医院神经内科,上海200040 [4]上海市浦东新区祝桥镇社区卫生服务中心,上海201323 [5]上海市浦东医院-复旦大学附属浦东医院泌尿外科,上海201399 [6]上海市浦东医院-复旦大学附属浦东医院医联部,上海201399 [7]上海市浦东医院-复旦大学附属浦东医院血管外科,上海201399

出　　处：《复旦学报（医学版）》2017年第1期82-86,共5页Fudan University Journal of Medical Sciences

基　　金：上海市浦东新区卫生和计划生育委员会科技发展专项基金(PW2013D-13)~~

摘　　要：目的了解上海市浦东新区某社区脑卒中高危人群危险因素暴露水平及其人群分布特征,为建立浦东新区脑卒中高危人群筛查干预体系提供依据。方法采取整群抽样方法对浦东新区祝桥社区45岁及以上居民开展筛查,并对所筛高危人群行颈动脉超声检查。结果筛出脑卒中高危933人,检出率15.6%,包括短暂性脑缺血发作者178人(3.0%),危险因素≥3项者755人(12.6%)。在755名高危人群中,危险因素暴露率从高到低依次为高血压、明显超重/肥胖、缺乏体育锻炼、吸烟、糖尿病、血脂异常、脑卒中家族史、房颤。其中女性危险因素暴露率较高的为糖尿病及血脂异常,男性为吸烟率及超重/肥胖,65岁及以上者高血脂、超重/肥胖及脑卒中家族史暴露率比45~65岁人群高。超声检出颈动脉粥样硬化(carotid atherosclerosis,CAS)383人(50.7%),颈动脉轻度狭窄者100人(13.2%),中度狭窄者5人(0.7%),发现斑块者379人(50.2%);结合斑块性质,斑块单发者234人(61.7%),多发者145人(38.3%),不规则者368人(98.9%),低回声者9人(2.4%)。结论上海市浦东新区某社区脑卒中高危人群检出率较低,高危人群颈动脉斑块特点及狭窄程度变化较大,后期可开展社区全人群健康教育和高危人群随访相结合的双层面干预。Objective To evaluate the exposure level and distribution characteristics of the risk factors for stroke in a community of Pudong New Area,Shanghai,and to provide basic data for building screening intervention system for high-risk population for stroke in the community. Methods Zhuqiao community residents who were older than 45 years in Pudong New Area were investigated by cluster sampling,and those of high-risk for stroke underwent carotid artery ultrasound. Results Of 933（ 15. 6%） high-risk population enrolled for stroke, 178（ 3. 0%） were transient ischemic attack and755（ 12. 6%） were with more than 3 risk factors. Among people with more than 3 risk factors,hypertension,overweight / obesity,lack of exercise,smoking history,diabetes,dyslipidemia,family history and atrial fibrillation were as risk factors for stroke in turn. The prevalence of diabetes and dyslipidemia was higher in female. Overweight / obesity and smoking history rate was higher in male. The prevalence of dyslipidemia,overweight / obesity and family history among people older than 65 years was higher than younger. The detection rate of carotid atherosclerosis,plaque and mild stenosis by ultrasound was 383（ 50.7%）,379（ 50. 2%） and 100（ 13. 2%） respectively,but only 5（ 0. 7%） in moderate and severe stenosis.And the proportion of single,multiple,irregular and hypoechoic plaque was 234（ 61. 7%）,145（ 38. 3%）,368（ 98. 9%） and 9（ 2. 4%）. Conclusions The detection rate of high-risk population for stroke is relatively low in Zhuqiao community of Shanghai. Among people with more than 3 risk factors,there are some differences of carotid plaques characteristics and stenosis degree,so it is necessary to carry out interventions including health education and follow-up from two perspectives based on whole and high risk population.

关 键 词：脑卒中 筛查 社区 上海 

分 类 号：R181.38[医药卫生—流行病学]