上海市某社区脑卒中高危人群危险因素调查

目的 了解社区脑卒中高危人群的危险因素暴露水平及分布特点，为针对性地进行危险因素综合性社区干预提供科学依据。 方法 2015年6—7月采用随机整群抽样的方法抽取上海市某社区40岁及以上的具有本市户籍的常住居民1 142人进行问卷调查和体格检查。 结果 853人被评估为脑卒中高危人群，占总人数的74.7%。8项危险因素的暴露率从高到低依次为:高血压(80.7%)、体育锻炼很少(68.5%)、血脂异常(60.1%)、脑卒中家族史(45.7%)、糖尿病(38.2%)、明显超重(25.9%)、吸烟(23.3%)、房颤或瓣膜性心脏病(13.5%)。女性高危人群的血脂异常的暴露率高于男性，男性高危人群的吸烟率高于女性。高血压、房颤或瓣膜性心脏病、糖尿病的暴露率随着年龄的增长而升高，40～49岁和50～59岁年龄段人群的吸烟率和脑卒中家族史暴露率相对于其他年龄段更为突出。Logistic回归分析显示年龄、受教育程度、体育锻炼、睡眠障碍与脑卒中高危人群中脑卒中的发病存在回归关系(P＜0.05)。 结论 高危人群的危险因素暴露率处于较高水平。基于社区开展脑卒中危险因素防控，重点加强血压、血糖和血脂的管理，改变不良饮食和生活习惯，针对不同人群进行健康教育，对社区脑卒中的防控具有重要意义。 

Risk factors for stroke among high-risk community residents in Shanghai

Objective To understand the exposure level and distribution characteristics of risk factors in population at high-risk of stroke in a community in Shanghai,and to put forward ways to a comprehensive community intervention for risk factors. Methods From June to July in 2015,1 142 permanent residents aged 40 and above were random cluster sampled and investigated by using a questionnaire and physical examination. Results The prevalence of at high-risk of stroke was 74.7%.Hypertension,less movement,dyslipidemia,family history of stroke,diabetes,apparently overweight,smoking,atrial fibrillation or valvular heart disease were as risk factors for stroke in turn.There were differences between different gender and age patients in the exposure factor distribution.Women have a higher exposure rate in history of stroke,history of TIA and dyslipidemia than men.Men have a higher exposure rate in smoking than women.The exposure rate of the history of stroke,hypertension,atrial fibrillation or valvular heart disease,diabetes increased with age.The exposure rate of smoking and family history of stroke in 40-49 and 50-59 age groups were more outstanding as compared with other age groups.Logistic analyses showed that age,education level,physical exercise and sleep disorder were all correlated with the incidence of stroke(P<0.05). Conclusion The exposure rate of risk factors for stroke in high-risk population is high.The prevention and control of risk factors for stroke in community,strengthening the management of blood pressure,blood glucose and blood lipid,changing the poor diet and living habits,making health education according to different people is benefit to prevention and control of stroke in community.