贵州省铜仁市40岁及以上仡佬族常住居民脑卒中风险筛查及颈动脉斑块分析  

Stroke risk screening and analysis of carotid plaque of Gelao permanent residents aged≥40 years in Tongren City,Guizhou Province

作　　者：梁勇 董春燕[1] 刘忠杰 甘露芹 刘建刚[2] 张伊洁 沈梅芬[2] 王云霞[2] LIANG Yong;DONG Chunyan;LIU Zhongjie(Department of Neurosurgery,the People's Hospital of Shiqian County,Tongren 554300,Guizhou China)

机构地区：[1]贵州省铜仁市石阡县人民医院神经外科,贵州铜仁554300 [2]苏州大学附属第一医院神经外科

出　　处：《癫痫与神经电生理学杂志》2022年第1期22-28,共7页Journal of Epileptology and Electroneurophysiology(China)

基　　金：贵州省卫生健康委员会科学技术基金(gzwjkj2019-1-150,gzwjkj2021-1-190)。

摘　　要：目的探讨贵州省铜仁市仡佬族脑卒中高危人群情况及其相关危险因素,为建立区域性脑卒中防控策略提供依据。方法采用整群抽样法,选取贵州省铜仁市仡佬族常住居民1154例(年龄≥40岁)进行问卷调查和病史采集,并对筛查出的脑卒中高危人群进行颈动脉超声检查,分析颈动脉斑块特征。结果1154例居民中共筛查出高危人群335例,检出率为29.03%。脑卒中高危人群主要集中在60~79岁年龄段(66.87%)。高危人群危险因素占比由高到低依次为既往卒中205例(61.19%)、高血压180例(53.73%)、吸烟105例(31.34%)、运动缺乏102例(30.45%)、肥胖79例(23.58%)、血脂异常70例(20.90%)、短暂性脑缺血发作(TIA)67例(20.00%)、糖尿病41例(12.24%)、卒中家族史24例(7.16%)以及房颤或心瓣膜病10例(2.99%)。除既往卒中、高血压、TIA、运动缺乏和糖尿病外,各项危险因素性别间差异有统计学意义(P<0.05)。脑卒中高危人群行颈动脉超声检查提示颈动脉内膜增厚、斑块及狭窄的检出率分别是16.12%、69.85%和13.13%。不同年龄段高危人群颈动脉内膜增厚和斑块检出率的差异均有统计学意义(P<0.05)。在检测出颈动脉斑块的234例居民中,既往卒中患者占64.10%、高血压患者占52.56%、吸烟者占31.20%、运动缺乏者占28.63%、TIA病史者占20.51%、肥胖者占19.66%及血脂异常者占19.23%。结论基于现状,应积极建立高危人群健康档案,做好健康宣教。Objective To explore the population of Gelao ethnic group at high risk of stroke and risk factors for the stroke in Tongren City,Guizhou Province,and provide a basis for the establishing regional stroke prevention and control strategies.Methods A random cluster sampling method was used to select 1154 Gelao permanent residents aged≥40 years in Tongren,Guizhou Province as study subjects.Questionnaire survey and medical history were collected from these subjects.Carotid ultrasound was performed on screened subjects at high risk of stroke.The characteristics of carotid plaques were analyzed.Results A total of 335 out of 1154 Gelao residents were identified as high-risk subjects,with a detection rate of 29.03%.The population at high risk of stroke was aged between 60-79 years old(66.87%).The risk factors from high to low in the subjects at high-risk included previous stroke(n=205,61.19%),hypertension(n=180,53.73%),smoking(n=105,31.34%),less exercise(n=102,30.45%),obesity(n=79,23.58%),dyslipidemia(n=70,20.90%),TIA(n=67,20.00%),diabetes(n=41,12.24%),family history of stroke(n=24,7.16%)and atrial fibrillation or heart valve disease(n=10,2.99%).Except for previous stroke,hypertension,TIA,exercise deficiency,and diabetes,there were statistically significant differences in the rest of the risk factors between males and females(P<0.05).Carotid ultrasound examination showed that the detection rates of thickened carotid artery intimal,plaque and stenosis were 16.12%,69.85%and 13.13%,respectively.The detection rates of thickened artery intimal and plaque were statistically significant different at different ages in high risk subjects(P<0.05).In 234 subjects with carotid artery plaques,the subjects with previous stroke accounted for 64.10%,the subjects with hypertension for 52.56%,the subjects with smoking for 31.20%,the subjects with less exercise for 28.63%,the subjects with TIA for 20.51%,the subjects with obesity for 19.66%and the subjects with dyslipidemia for 19.23%.Conclusion Based on the current situation,health archiv

关 键 词：脑卒中 筛查 危险因素 颈动脉超声 颈动脉斑块 高血压 吸烟 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R195.4[医药卫生—临床医学]