中国三城市脑血管病危险因素干预前后效果评价  

Evaluation of effectiveness of intervention on risk factors for cerebrovascular disease in three cities of China

作　　者：刘运海[1] 杨期东[1] 朱文斌[1] 王文志[2] 吴升平[2] 洪震[3] 许宏伟[1] 周艳宏[1] 黄茂盛[3] 

机构地区：[1]中南大学湘雅医院神经病学研究所,长沙410008 [2]北京市神经外科研究所 [3]复旦大学神经病学研究所

出　　处：《中华预防医学杂志》2003年第2期105-108,共4页Chinese Journal of Preventive Medicine

基　　金：国家"九五"攻关课题 ( 96 - 90 6 - 0 2- 2 0 )

摘　　要：目的　评价社区人群脑血管病危险因素干预效果。方法　 1997～ 2 0 0 0年选取长沙、北京、上海三城市社区居民约 30万人 ,按整群抽样方法随机抽取 35～ 74岁 2 5 86人 (干预组 )和 2 72 3人(对照组 ) ,统一检查血压、血脂、吸烟、饮酒情况及体重指数 (BMI) ,并将其作为干预效果评价指标。在干预社区人群中进行健康宣教 ,戒烟、控酒并对糖尿病及高血压病人进行强化治疗。 3年后按同样方法分别在干预组和对照组抽取 2 5 44人和 2 5 2 3人 ,对上述指标进行复查。结果　干预组平均收缩压下降 3 2 1mmHg( 1mmHg =0 133kPa) ,平均血清胆固醇下降 0 5 8mmol/L ,平均甘油三酯增高 0 48mmol/L。干预后两组平均血糖均有增高 ,但对照组平均血糖净增高 0 30mmol/L。两组平均高密度脂蛋白胆固醇均有增高 ,但差异不明显。对照组平均BMI增高了 0 5 6kg/m2 ,干预组未见明显变化 ;干预组男性人群吸烟率下降了 5 4%,女性人群吸烟率下降了 2 4%,对照组无变化。结论　通过进行社区干预 ,脑血管病危险因素水平可明显下降。Objective To evaluate the effects of community intervention on risk factors of cerebrovascular disease. Methods With cluster sampling, 2 586 and 2 723 women and men aged 35 to 74 were selected randomly as intervention cohort and control cohort, respectively, from about 300 thousand community population in Beijing, Shanghai and Changsha, during 1997 to 2000.Their blood pressure, levels of blood lipid, body mass index (BMI) were measured and status of smoking and alcohol consumption were surveyed as indices of evaluation.Health education for smoking quit, alcohol consumption restriction and reinforced treatment for diabetic and hypertensive patients were implemented in the intervention communities.And, 2 544 and 2 533 persons in the two cohorts responded three years after intervention, and then all the indices mentioned above were measure again for them. Results Average reduction in systolic blood pressure by 3.21 mm Hg and serum level of total cholesterol by 0.58 mmol/L was achieved in intervention cohort after intervention, but with 0.48 mmol/L increase in triglyceride.Average blood levels of both high density lipoprotein-cholesterol (HDL-C) and glucose increased in the two cohorts after intervention, but with 0.30 mmol/L net increase of blood glucose in control cohort.There was no significant difference in average increase of HDL-C between the two cohorts.BMI increased by 0.56 in control cohort, and no significant change in intervention cohort.Proportion of smoking decreased by 5.4% in men and 2.4% in women of intervention cohort, and no change in control cohort. Conclusion Level of risk factors for cerebrovsacular disease reduced significantly with community intervention.

关 键 词：北京 上海 长沙市 脑血管病 危险因素 干预 血压 血脂 体重 

分 类 号：R743.3[医药卫生—神经病学与精神病学]