上海市南汇区18271例脑卒中高危人群重点预防效果评价

王桂清; 黄久仪; 沈凤英; 王艳; 曹奕丰; 郭吉平; 俞学海; 牟维艳; 王素春; 杨永举; 林建明; 傅国辛

Abstract

王桂清,黄久仪,沈凤英,王艳,曹奕丰,郭吉平,俞学海,牟维艳,王素春,杨永举,林建明,傅国辛.上海市南汇区18271例脑卒中高危人群重点预防效果评价[J].Chinese journal of Epidemiology,2005,26(5):335-338

上海市南汇区18271例脑卒中高危人群重点预防效果评价

Effectiveness of Nao’an Capsule on stroke prevention among high risk population in Nanhui,Shanghai

Received:August 25, 2004

DOI：

KeyWord: 脑卒中干预血液动力学

English Key Word: Stroke Intervention Hemodynamic

FundProject:上海市科研专项资金资助项目(99005)

Author Name	Affiliation
WANG Gui-qing	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
HUANG Jiu-yi	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
SHEN Feng-ying	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
WANG Yan	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
CAO Yi-feng	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
GUO Ji-ping	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
YU Xue-hai	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
MOU Wei-yan	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
WANG Su-chun	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
YANG Yong-ju	Shanghai Institute of Cerebral Vascular Disease Intervention and Cure, Shanghai 201318, China
LIN Jian-ming	上海市建工医院
FU Guo-xin	上海市南汇区卫生局

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Abstract:

目的评价脑卒中高危人群脑安胶囊重点预防措施的人群实施效果. 方法从上海市南汇区全区696558人群选择≥35岁具有脑卒中危险因素暴露者进行脑血管血液动力学检测, 筛选出脑血管血液动力学指标积分值低于70分的脑卒中高危个体18271例作为干预对象. 根据知情同意的原则, 在同样接受一般干预的基础上, 将10313例接受“脑安胶囊”干预者作为重点干预组, 另7958例未接受脑安胶囊干预者作为一般干预组. 随访监测干预后脑卒中的发病和死亡情况, 评价干预策略实施3年后的预防效果. 结果重点干预组脑卒中发病率显著低于一般干预组(P<0. 01), 男性下降53. 8%, 相对危险度为0. 46(0. 33～0. 64);女性下降58. 4%, 相对危险度为0. 39(0. 30～0. 50). 多因素分析logistic回归分析显示, 被筛选进入方程的因素分别为高血压病史、脑血管血液动力学指标积分值、年龄、性别和脑安胶囊干预, 其中脑安胶囊干预的相对危险度为0. 41, 在诸因素中作用最强. 结论干预策略实施3年后, 脑安胶囊重点干预组的脑卒中发病率显著低于一般干预组, 脑安胶囊干预是高危个体脑卒中发病最强的影响因素.

English Abstract:

Objective To evaluate the effectiveness of stroke prevention among high risk population,using Nao'an Capsules. Methods Participants were selected from 696 558 residents in Nanhui, using county of Shanghai city. Individuals aged 35 years old and over with at least one risk factor exposure to stroke, received cerebral vascular hemodynamic examination. 18 271 cases meeting the criteria of cerebral vascular hemodynamic indexes accumulative score below 70 points were defined as individuals with high-risk and targets to receive intervention. According to the willingness of the participants, 10 313 cases received Nao'an Capsules for intensive intervention based on general intervention measures compared to 7958 cases only receiving general intervention. After the implementation of intervention, incidence and mortality rates of stroke and the effectiveness of three-year intervention were studied. Results Incidence of stroke in Nao'an Capsules group was significantly lower than that of the general intervention(P 0.01)with 53.8 % in males and 58.4 % in females. The relative risk(RR)in two gender groups were 0.46(0.33- 0.64)and 0.39(0.30- 0.50)respectively. Multiple logistic regression analysis indicated that the history of hypertension, accumulative score of cerebral vascular hemodynamic indexes, age, gender and Nao'an Capsules intervention were the variables selected into the equation and significantly related to stroke. Among the variables, Nao'an Capsule was the strongest factor with a RR of 0.41. Conclusion Incidence of stroke in Nao'an Capsule intervention group was significantly lower than that in the general intervention group after 3 years of intervention,suggesting that Nao'an Capsule intervention was the strongest factor affecting stroke occurrence in individuals at high-risk.

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