上海市浦东新区某社区脑卒中高危人群筛查报告

发布时间：2018-05-02 23:58

本文选题：脑卒中 + 筛查　；参考：《复旦学报(医学版)》2017年01期

【摘要】：目的了解上海市浦东新区某社区脑卒中高危人群危险因素暴露水平及其人群分布特征,为建立浦东新区脑卒中高危人群筛查干预体系提供依据。方法采取整群抽样方法对浦东新区祝桥社区45岁及以上居民开展筛查,并对所筛高危人群行颈动脉超声检查。结果筛出脑卒中高危933人,检出率15.6%,包括短暂性脑缺血发作者178人(3.0%),危险因素≥3项者755人(12.6%)。在755名高危人群中,危险因素暴露率从高到低依次为高血压、明显超重/肥胖、缺乏体育锻炼、吸烟、糖尿病、血脂异常、脑卒中家族史、房颤。其中女性危险因素暴露率较高的为糖尿病及血脂异常,男性为吸烟率及超重/肥胖,65岁及以上者高血脂、超重/肥胖及脑卒中家族史暴露率比45~65岁人群高。超声检出颈动脉粥样硬化(carotid atherosclerosis,CAS)383人(50.7%),颈动脉轻度狭窄者100人(13.2%),中度狭窄者5人(0.7%),发现斑块者379人(50.2%);结合斑块性质,斑块单发者234人(61.7%),多发者145人(38.3%),不规则者368人(98.9%),低回声者9人(2.4%)。结论上海市浦东新区某社区脑卒中高危人群检出率较低,高危人群颈动脉斑块特点及狭窄程度变化较大,后期可开展社区全人群健康教育和高危人群随访相结合的双层面干预。
[Abstract]:Objective to investigate the risk factors exposure level and population distribution in a community high risk group of stroke in Pudong New area of Shanghai, and to provide the basis for establishing a screening intervention system for high risk population of stroke in Pudong New area. Methods Cluster sampling was used to screen the residents aged 45 and above in Zhuqiao community of Pudong New area and carotid artery ultrasound was performed in the high-risk population. Results 933 patients with high risk of stroke were screened out, the detection rate was 15.60.There were 178 patients with transient ischemic attack, 755 patients with more than 3 risk factors. In 755 high risk population, the risk factors were hypertension, obvious overweight / obesity, lack of physical exercise, smoking, diabetes, dyslipidemia, family history of stroke, atrial fibrillation. The higher exposure rate of female risk factors was diabetes mellitus and dyslipidemia, the male was smoking rate and hyperlipidemia of overweight / obesity group aged 65 and above, and the exposure rate of overweight / obesity and stroke family history was higher than that of 45 to 65 years old. Carotid atherosclerosis was detected by ultrasonography in 383 patients, carotid artery stenosis was found in 100 patients with mild stenosis (n = 100), moderate stenosis in 5 patients (n = 5), carotid artery stenosis in n = 379 patients (n = 379). According to the nature of plaque, there were 234 patients with single plaque (n = 234), 145 patients with multiple lesions (n = 145), 38.3patients with multiple lesions, 368 patients with irregular lesions (n = 368), and 9 patients with hypoechoic lesions (n = 9). Conclusion the detection rate of high risk population of stroke in a community of Pudong New District of Shanghai is low, the carotid artery plaque characteristics and stenosis degree of high risk population changes greatly, and the two-layer intervention can be carried out in the later stage of community health education and follow-up of high risk population.
【作者单位】：上海市浦东医院-复旦大学附属浦东医院医学科研与创新中心;上海市浦东医院-复旦大学附属浦东医院神经内科;复旦大学附属华山医院神经内科;上海市浦东新区祝桥镇社区卫生服务中心;上海市浦东医院-复旦大学附属浦东医院泌尿外科;上海市浦东医院-复旦大学附属浦东医院医联部;上海市浦东医院-复旦大学附属浦东医院血管外科;
【基金】：上海市浦东新区卫生和计划生育委员会科技发展专项基金(PW2013D-13)~~
【分类号】：R743.3

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