改良弗明汉卒中风险积分规则对社区老年体检者适用性的评价  

Evaluation of applicability of modified Framingham stroke profile in community elderly people in the physical check-up

作　　者：温朝阳 王小群 蔡小英 孙国峰 张松 姚强 顾召华 WEN Zhaoyang;WANG Xiaoqun;CAI Xiaoying;SUN Guofeng;ZHANG Song;YAO Qiang;GU Zhaohua(Medical Department of Zhoupu Community Health Service Center of Pudong New District,Shanghai.201318,China)

机构地区：[1]上海市浦东新区周浦社区卫生服务中心医务科,上海201318

出　　处：《上海医药》2023年第16期53-57,共5页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:评价社区老年人脑卒中风险及改良弗明汉卒中风险积分规则(modified Framingham stroke profile,mFSP)的适用性。方法:调查年龄≥60岁的社区老年体检者的卒中危险因素,按照不同性别mFSP积分规则进行积分,再根据积分-风险对照表查阅10年卒中发病概率。描述mFSP分值和10年卒中发病率的分布和计入积分7项因素的暴露情况,分析卒中发病风险与体质量指数和血脂水平的关系。结果:(1)男性和女性mFSP积分中位数(四分位)分别为13(11,16)和13(10,15),10年卒中发病概率中位数(四分位)分别为15(11,22)%和11(6,16)%,差异均有统计学意义(均P<0.01),男性和女性卒中高危人群的比例分别为98.9%和88.5%,卒中高危率随着年龄的增长而上升,差异均有统计学意义(均P<0.01)。(2)女性的收缩压的积分值高于男性,男性的年龄、心血管病史、心房颤动、左心室肥厚、吸烟等积分因素的暴露率高于女性,差异均有统计学意义(均P<0.01)。(3)男性和女性卒中风险等级随体质量指数的上升而升高,女性不同卒中风险等级组间的三酰甘油、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇的差异均有统计学意义(均P<0.01)。结论:调查社区老年人卒中高危者的比例较高,mFSP有可能高估社区老年人的10年卒中发病风险,尤其是男性。mSFP中预测因子的整体暴露水平男性高于女性,卒中风险水平与BMI和血脂水平相关。Objective:To evaluate the risk of stroke in elderly people in the community and the applicability of the modified Framingham stroke profile(mFSP).Methods:The stoke risk factors of the community elderly people aged≥60 years in the physical check-up were investigated.The scores were calculated according to the mFSP score rules for different genders,and then the incidence probability of stroke in 10 years was checked according to the score-risk comparison table.The distribution of mFSP score and 10-year stroke incidence and exposure to 7 factors included in the score were described,and the relationship between stroke risk level and body mass index(BMI)and blood lipid level was analyzed.Results:(1)Median mFSP scores of male and female(quartile)were 13(11,16)and 13(10,15),respectively.The median probability of stroke onset were 15(11,22)%and 11(6,16)%,respectively and the difference was statistically significant(P<0.01).The proportion of male and female at high risk of stroke was 98.9%and 88.5%,respectively,the high risk rate of stroke increased significantly with age,and the difference was statistically significant(P<0.01).(2)Systolic blood pressure score was higher in females than that in males,and the exposure rates of age,cardiovascular history,atrial fibrillation,left ventricular hypertrophy and smoking were higher in males than those in females,and the difference was statistically significant(P<0.01).(3)The risk score of stroke increased with the increase of BMI both in male and female,and there were significant differences in triglyceride,total cholesterol,low density lipoprotein and high density lipoprotein among different stroke risk groups of female and the difference was statistically significant(all P<0.01).Conclusion:The proportion of elderly people at high risk of stroke in the surveyed community is relatively high,mFSP may overestimate the 10-year stroke risk among the elderly in the community,especially among men.Overall exposure to predictors in mSFP is higher in males than in females,and stroke ris

关 键 词：脑卒中 风险评估 改良弗明汉卒中风险积分 社区 老年人 

分 类 号：R74[医药卫生—神经病学与精神病学]