机构地区:[1]南昌大学研究生院医学部,南昌330006 [2]南昌市疾病预防控制中心,南昌330038 [3]江西省预防医学重点实验室,南昌330006 [4]南昌市青山湖区疾病预防控制中心,南昌330006 [5]南昌市东湖区疾病预防控制中心,南昌330006
出 处:《南昌大学学报(医学版)》2019年第6期62-66,共5页Journal of Nanchang University:Medical Sciences
基 金:南昌大学研究生创新项目专项资金资助(CX2018227)
摘 要:目的研究南昌市脑卒中流行现状,分析脑卒中相关危险因素,为脑卒中防治和干预工作提供科学依据。方法采用整群抽样的方法抽取南昌市部分社区40岁以上当地常住居民为研究对象,通过实验室检查、体格检查、问卷调查的方式,研究脑卒中患病率特点,并运用Logistic回归模型和穷举卡方自动交互法(CHAID)分类树模型分别对脑卒中高危人群患病影响因素进行分析。结果共筛查研究对象6003人,其中高危人群1009人(16.81%),中危人群1683例(28.04%),低危人群3089例(51.46%),短暂性脑缺血发作24人(4.00%),脑卒中198人(3.30%);随着年龄的增加,高危人群比例增加,且主要集中在70~79岁,男性高危人群比例高于女性(χ2=136.07,P<0.01),脑卒中患病率随着年龄的增长而上升,男性患病率高于女性(χ2=43.77,P<0.01)。Logistic回归分析结果显示,患脑卒中的主要危险因素包括家族史(OR=1.459,95%CI:1.023~2.080)、房颤或瓣膜性心脏病(OR=6.665,95%CI:3.597~12.349)、高血压(OR=4.207,95%CI:3.004~5.893)、糖尿病(OR=1.712,95%CI:1.195~2.453)、吸烟史(OR=1.750,95%CI:1.201~2.549)。穷举CHAID所建立的分类树模型共包括三层8个节点,共筛选出高血压、糖尿病、吸烟史、家族史4个解释变量。结论南昌市脑卒中患病率随着年龄的增长而升高,且男性患病风险高于女性,高危人群主要危险因素为高血压、糖尿病、吸烟史、家族史,因此,南昌市脑卒中防治应针对其危险因素及其不同人群特征采取相应的预防措施。Objective To study the prevalence of stroke and its risk factors in Nanchang,and to provide a scientific evidence for prevention and intervention of stroke.Methods Cluster sampling method was used to select local residents over 40 years old from some communities in Nanchang.The prevalence of stroke was investigated by laboratory determination,physical examination and questionnaire survey.In addition,the factors influencing the incidence of stroke in high-risk populations were analyzed using the logistic regression model and CHi-squared Automatic Interaction Detection(CHAID)tree model.Results A total of 6003 subjects were screened,including 1009(16.81%)at high risk,1683(28.04%)at medium risk,3089(51.46%)at low risk,24(4.00%)with transient ischemic attack(TIA),and 198(3.30%)with stroke.The proportion of high-risk populations increased with age,and the increased risk was mainly found in people aged 70 to 79 years.The proportion of male high-risk group was higher than that of female high-risk group(χ2=136.07,P<0.01).Furthermore,the prevalence of stroke increased with age,and the prevalence in males was higher than that in females(χ2=43.77,P<0.01).Logistic regression analysis showed that the major risk factors for stroke included family history(OR=1.459,95%CI:1.023-2.080),atrial fibrillation or valvular heart disease(OR=6.665,95%CI:3.597-12.349),hypertension(OR=4.207,95%CI:3.004-5.893),diabetes(OR=1.712,95%CI:1.195-2.453),and smoking history(OR=1.750,95%CI:1.201-2.549).The classification tree model established by CHAID included 8 nodes in 3 layers,and 4 explanatory variables including hypertension,diabetes,smoking history and family history were screened out.Conclusion The prevalence of stroke in Nanchang increases with age,and the risk of stroke in males is higher than that in females.The main risk factors are hypertension,diabetes,smoking history and family history in high-risk populations.Therefore,the prevention and treatment of stroke should be taken according to the risk factors and characteristics of differen
分 类 号:R195.4[医药卫生—卫生统计学] R743.3[医药卫生—卫生事业管理]
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