摘要
目的评价脑卒中高危人群筛查全程化健康管理干预措施对缺血性脑卒中防治的初步效果,为完善和探索脑卒中高危人群健康管理防治策略提供参考和依据。方法2018—2022年在上海市嘉定区13个社区卫生服务中心基于信息化推送平台,采用方便抽样对社区居民进行脑卒中风险评估和健康干预随访,并按照健康干预措施和形式的不同分为全程组和常规干预组,分别追踪2组调查对象36个月内缺血性脑卒中发病情况。结果共52144人纳入研究。全程组共14227人,发病密度577.32/10万(556.49/10万~598.12/10万)低于常规干预组(共37917人)发病密度1485.47/10万(1464.99/10万~1505.94/10万)(χ^(2)=2490.212,P<0.001),相对危险度为0.39;危险因素由低到高相对危险度分别为0.43、0.45、0.33、0.49。男性全程组发病密度为660.76/10万(627.46/10万~694.05/10万),相对危险度为0.43;女性全程组发病密度为509.71/10万(483.37/10万~536.05/10万),相对危险度为0.35。<62岁组、62~75岁组、>75岁组人群全程组发病密度分别为197.45/10万(173.09/10万~221.80/10万)、608.36/10万(580.19/10万~636.54/10万)、1025.06/10万(958.51/10万~1091.61/10万),相对危险度分别为0.51、0.44、0.38。结论全程化健康管理措施能够有效降低缺血性脑卒中短期发病风险,应当进一步推进和完善全程化健康管理措施,提高脑卒中防控效果。
Objective To evaluate the short-term effects of comprehensive health management interventions for stroke highrisk population screening on the prevention and treatment of ischemic stroke,and to provide reference and basis for improving and exploring health management and prevention strategies for stroke high-risk population.Methods From 2018 to 2022,13 community health service centers in Jiading District,Shanghai were selected in the present study.Based on information push platform,stroke risk assessment and health intervention follow-up were conducted for community residents through convenience sampling.The residents were divided into a full course intervention group(intervention group)and a routine intervention group(control group)according to different health intervention measures and forms.The incidence of ischemic stroke in the two groups of survey subjects was tracked within 36 months.Results A total of 52144 subjects were included in the study.The total number of patients in the full course intervention group was 14227,with an incidence density of 577.32/100000(556.49/100000-598.12/100000),which was lower than that of the conventional intervention group(37917),with an incidence density of 1485.47/100000(1464.99/100000-1505.94/100000)(χ^(2)=2490.212,P<0.001).The relative risk of the full course intervention group was 0.39,and the relative risk of stroke risk factors in the full course intervention group from low to high was 0.33,0.43,0.45,and 0.49,respectively.The incidence density of males in the full course intervention group was 660.76(627.46/100000-694.05/100000),with a relative risk of 0.43,and the incidence density of female patients was 509.71/100000(483.37/100000-536.05/100000),with a relative risk of 0.35.The overall incidence density of the population under 62 years old gourp,62-75 years old group and over 75 years old group was 197.45/100000(173.09/100000-221.80/100000),608.36/100000(580.19/100000-636.54/100000),and 1025.06/100000(958.51/100000-1091.61/100000),with relative risks of 0.51,0.44,and 0.38,respectively.Conclusion Comprehensive health management measures can effectively reduce the short-term risk of ischemic stroke,and should be further promoted and improved to enhance the effectiveness of stroke prevention and control.
作者
朱帅
赵根明
张一英
梁冬妮
于宏杰
彭谦
向芳
王娜
ZHU Shuai;ZHAO Genming;ZHANG Yiying;LIANG Dongni;YU Hongjie;PENG Qian;XIANG Fang;WANG Na(Center for Disease Control and Prevention of Jiading District,Shanghai 201899,China;Fudan University,Shanghai 200032,China;Community Health Service Center of Huangdu Anting Town Jiading District,Shanghai 201804,China)
出处
《公共卫生与预防医学》
2026年第2期89-93,共5页
Journal of Public Health and Preventive Medicine
基金
复旦大学公共卫生学院—嘉定区卫健委公共卫生高质量发展重点学科和重点专项“基于社区成人队列的心脑血管疾病评估和综合干预”(GWGZLXK-2023-02)
嘉定区公共卫生优秀人才培养项目“嘉定区第二轮‘嘉医新星’青年人才培养项目”
嘉定区自然科学研究课题项目(JDKW-2024-0032)。
关键词
信息化
脑卒中高危人群筛查
全程化健康管理
缺血性脑卒中
Informatization
Screening of high-risk individuals for stroke
Full course health management
Ischemic stroke
