上海市奉贤区40岁以上人群脑卒中危险因素现况调查和风险预测  

Risk factors and risk prediction of stroke among people over 40 years old in Fengxian district of Shanghai

作　　者：吴勤花[1] 韩叙 张斌[1] 瞿剑峰[1] 殷勇[1] 王静怡 

机构地区：[1]上海交通大学附属第六人民医院奉贤分院神经内科,上海201400 [2]建平中学

出　　处：《上海医学》2017年第11期667-670,共4页Shanghai Medical Journal

摘　　要：目的通过对上海市奉贤区40岁以上人群脑卒中危险因素进行现状调查,并应用改良弗明汉卒中量表(FSP)预测该人群未来10年脑卒中的发生风险,为更好地预防脑卒中的发生提供参考。方法采用多阶段、分层、随机抽样的方法,对上海市奉贤区某社区40岁以上人群进行脑卒中危险因素问卷调查,根据纳入的8个脑卒中常见危险因素(高血压、血脂异常、少运动、肥胖、吸烟、脑卒中家族史、糖尿病、心脏病)分为高危、中危和低危人群,计算FSP评分值,每个评分值对应一个脑卒中风险值,以预测未来10年脑卒中的发生风险。以男性、高血压、糖尿病、吸烟、心脏病、血脂异常、少运动、肥胖、脑卒中家族史为自变量,脑卒中危险程度为应变量,采用多重线性回归分析各危险因素与脑卒中危险程度的关系。结果最终纳入研究对象504人,其中男256人、女248人,年龄40~80岁,中位年龄为56.3岁。8项危险因素中,总群体危险因素的暴露率大小依次为高血压39.6%、血脂异常34.9%、少运动27.0%、肥胖25.4%、吸烟23.8%、有脑卒中家族史17.5%、糖尿病15.9%、心脏病7.9%,总体高危、中危、低危人群分别占31.7%、15.9%、52.4%。男性中吸烟、心脏病、肥胖、少运动、有脑卒中家族史和高危人群的比例均显著高于女性(P值分别<0.01、0.05),而糖尿病、血脂异常的比例显著低于女性(P值分别<0.05、0.01)。总体、男性、女性的中位FSP评分值分别为8.3、7.8、8.4分,其相对应的中位脑卒中风险值分别为9.3%、10.1%、8.5%。不同性别间FSP评分值和相对应脑卒中风险值的差异均无统计学意义(P值均>0.05)。多重线性回归分析结果显示,高血压、吸烟、少运动和肥胖均与脑卒中危险程度呈正相关(P值均<0.05)。结论上海市奉贤区40岁以上人群10年脑卒中风险较高,建议加强调控血压、血脂,并应戒烟和加强运动等,以降低脑卒中�Objective To investigate the present risk factors of stroke in people over 40 years old in Shanghai Fengxian area, and to predict the risk of stroke in the next 10 years by the Framingham Stroke Scale （FSP）. Methods A questionnaire survey of risk factors of the stroke was performed by multistage stratified random sampling in the people over 40 years old in a community of Shanghai Fengxian area. According to eight common risk factors of the stroke （hypertension, dyslipidemia, lack of exercise, obesity, smoking, family history of stroke, diabetes and heart disease）, the subjects were divided into high, moderate and low risk groups. The FSP score was calculated, and each score corresponded to a stroke risk value to predict the risk of stroke in the next 10 years. Male, hypertension, diabetes, smoking, heart disease, dyslipidemia, lack of exercise, obesity and family history of stroke were taken as independent variables, and the risk of stroke was a variable. Multiple linear regression analysis was used to analyze the relationship between the risk factors and the risk of stroke. Results A total of 504 persons were enrolled in this study, including 256 males and 248 females aged from 40 to 80 years, with a median age of 56.3 years. The exposure rates of hypertension, dyslipidemia, less exercise, obesity, smoking, family history of stroke, diabetes and heart disease were 39.6%, 34.9%, 27.0%, 25.4%, 23.8%, 17.5%, 15. 9% and 7. 9%, respectively. The high, moderate and low risk population respectively accounted for 31.7%, 15.9% and 52.4%. Male smoking, heart disease, obesity, lack of exercise, family history of stroke and high-risk population proportions were significantly higher than female （P〈0.01, 0.05）, while male population proportions of diabetes mellitus and dyslipidemia were significantly lower than female （P 〈 0. 05, 0.01）. The median FSP score of overall, men and women were 8.3, 7.8 and 8.4, and the corresponding risk of stroke were 9.3%, 10.1% and 8.5%. There was no significant difference in

关 键 词：脑卒中 危险因素 现况调查 风险评估 

分 类 号：R743.3[医药卫生—神经病学与精神病学]