上海市青浦区某社区糖尿病高血压患者脑卒中发病风险评估

王森; 叶开友; 郁晞; 吴周理

doi:10.19428/j.cnki.sjpm.2017.09.004

上海市青浦区某社区糖尿病高血压患者脑卒中发病风险评估

Stroke risk assessment on patients with diabetic hypertension in a community in Qingpu District of Shanghai

摘要

摘要:
目的评估糖尿病、高血压患者的脑卒中发病风险，为实施精准干预提供依据。
方法在上海市青浦区某社区的高血压、糖尿病患者中，通过问卷调查、体格检查及实验室检测等方式，评估出55岁以上的脑卒中高危人群400例，采用Framingham脑卒中概率模型进行脑卒中风险评估。
结果高危人群中男、女性的10年脑卒中发病概率分别为18.4%和17.2%；患有糖尿病、高血压及同时患有2种疾病者10年脑卒中发病概率分别为9.8%、19.6%和20.1%；高血压患者中血脂异常、高同型半胱氨酸血症的比例高于糖尿病患者。
结论高血压患者10年脑卒中发病风险高于糖尿病患者，积极有效地控制血压，是延缓脑卒中发生的关键。对于男性而言，戒烟、控制同型半胱氨酸水平是降低脑卒中风险的重要措施。

Abstract:
ObjectiveTo make assessment on stroke risk in patients with hypertension, diabetes and provide the scientific basis for accurate intervention.
MethodsIn a certain community of Qingpu District of Shanghai, by means of questionnaire, physical examination and laboratory examination, from patients with hypertension and diabetes in the community, a series of 400 patients above 55 with high risk of stroke were assessed with Framingham stroke probability model.
ResultsIn the high risk population, the morbidity probabilities in 10 years for men and women were 18.4% and 17.2%and for those with high blood pressure, diabetes, or with the two diseases were 9.8%, 19.6% and 20.1% respectively. Proportions of blood lipids, hyperhomocystinemia in hypertensive patients were significantly higher than in those with diabetes.
ConclusionFor patients with hypertension, the risk of stroke is significantly higher than that for diabetic patients in 10 years, and active and effective control of hypertension is the key to delay stroke. For men, quitting smoking and controlling homocystinemia levels are important measures to reduce the risk of stroke.

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