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南昌市青山湖区2018—2023年40岁及以上常住居民脑卒中高危人群筛查及危险因素分析
杨盈华, 李敏, 陈昔梅, 彭怡城
安徽预防医学杂志 ›› 2025, Vol. 31 ›› Issue (4) : 318-324.
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南昌市青山湖区2018—2023年40岁及以上常住居民脑卒中高危人群筛查及危险因素分析
Screening and risk factor analysis of high-risk groups for stroke among permanent residents aged 40 years and above in Qingshanhu District of Nanchang from 2018 to 2023
目的 了解南昌市青山湖区脑卒中高危人群分布特征及危险因素暴露情况,为脑卒中防治工作提供依据。方法 基于2018—2023年脑卒中高危人群筛查和干预项目,采用整群抽样法,从南昌市青山湖区抽取11 146名40岁及以上常住居民进行脑卒中高危筛查,收集其一般情况和危险因素等信息。采用χ2检验比较不同特征人群脑卒中高危人群检出率,采用多因素 logistic 回归模型分析脑卒中影响因素并计算人群归因危险度百分比(PAR%)。结果 2018—2023年南昌市青山湖区40岁及以上常住居民脑卒中高危人群检出率为18.26%(2 035/11 146),其中,男性为28.40%(1 031/3 630),女性为13.36%(1 004/7 516)。在脑卒中高危人群中,暴露率居前3位的危险因素依次为高血压(86.33%,1 757/2 035)、血脂异常(72.18%,1 469/2 035)和脑卒中家族史(43.63%,888/2 035)。检出脑卒中共261例,患病率为2.34%(261/11 146)。logistic回归分析显示,40岁及以上常住居民脑卒中的危险因素为高血压(OR=3.755,95%CI:2.658~5.304)、血脂异常(OR=1.616,95%CI:1.249~2.090)、糖尿病(OR=1.387,95%CI:1.031~1.866)、房颤或瓣膜性心脏病(OR=3.547,95%CI:1.829~6.877)、吸烟史(OR=1.734,95%CI:1.176~2.557)和脑卒中家族史(OR=1.495,95%CI:1.091~2.049)。脑卒中检出最主要的归因因素为高血压(PAR%=61.84%),其次为血脂异常(PAR%=21.47%)。结论 南昌市青山湖区40岁及以上常住居民脑卒中高危人群检出率处于较低水平,但危险因素暴露水平较高,需加强脑卒中高危人群管理,以减少和消除相关危险因素,降低脑卒中风险。
Objective To understand the distribution characteristics and risk factor exposure of high-risk stroke populations in Qingshanhu District of Nanchang,and to provide basis for the prevention and treatment of stroke. Methods Based on the Screening and Intervention Program for People at High Risk of Stroke from 2018 to 2023,11 146 permanent residents aged 40 years and above in Qingshanhu District of Nanchang were selected for stroke risk screening by using the cluster sampling method.The general information and risk factors were collected.The chi-square test was used to compare the detection rates of high-risk stroke populations with different characteristics,and multivariate logistic regression model was used to analyze the influencing factors of stroke,and the population attributable risk percentage (PAR%) was calculated. Results From 2018 to 2023,the detection rate of high-risk stroke among permanent residents aged 40 years and above in Qingshanhu District of Nanchang was 18.26% (2 035/11 146),with 28.40% (1 031/3 630) in males,and 13.36% (1 004/7 516) in females.Among the high-risk stroke populations,the top three risk factors in terms of exposure were hypertension (86.33%,1 757/2 035),dyslipidemia (72.18%,1 469/2 035),and family history of stroke (43.63%,888/2 035).A total of 261 stroke cases were detected,with a prevalence rate of 2.34% (261/11 146). Logistic regression analysis showed that the risk factors for stroke in permanent residents aged 40 years and above were hypertension (OR = 3.755,95%CI: 2.658-5.304), dyslipidemia (OR = 1.616,95%CI: 1.249-2.090), diabetes mellitus (OR=1.387,95%CI: 1.031-1.866), atrial fibrillation or valvular heart disease (OR=3.547,95%CI: 1.829-6.877), history of smoking (OR=1.734,95%CI:1.176-2.557),and family history of stroke (OR=1.495,95%CI: 1.091-2.049). The most important attributing factor for stroke detection was hypertension (PAR%=61.84%),followed by dyslipidemia (PAR%=21.47%). Conclusion The detection rate of high-risk stroke among permanent residents aged 40 years and above in Qingshanhu District of Nanchang is relatively low,but the exposure level of risk factors is high.It is necessary to strengthen the management of high-risk stroke populations in order to reduce and eliminate the related risk factors and reduce the risk of stroke.
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