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目的在上海市南汇区近70万框架人群中,评价“脑卒中高危人群筛检与干预”策略3年实施的效果。方法1999年初对上海市南汇区全区696558人进行脑卒中现况调查及1996/1998年间脑卒中发病和死亡情况的回顾性调查。从35岁以上人群中筛选出具有脑卒中危险因素暴露者实施一般干预措施,并进行脑血管血流动力学指标(CVHI)检测,以18271例CVHI积分值小于70分者作为高危人群,在一般干预的基础上服用“脑安胶囊”进行重点干预。随访监测干预后脑卒中的发病和死亡情况,评价实施干预策略3年后的预防效果。结果1996/1998年全区脑卒中的年平均发病率为138.4/10万,年平均死亡率为97.3/10万;1999/2001年实施综合干预措施后,脑卒中的发病率分别下降至95.18/10万、85.73/10万、65.95/10万,死亡率下降至72.09/10万、62.43/10万、55.62/10万;干预后3年的发病率比干预前分别下降了31.2%、38.2%、52.3%,病死率分别下降了25.9%、35.8%、42.8%。结论实施“脑卒中高危人群筛检与干预”策略3年后,脑卒中的发病和病死率比干预前有显著下降,干预效果良好。
Objective To evaluate the effect of three-year implementation of the screening and intervention strategy for high-risk stroke population among nearly 700,000 people in Nanhui District of Shanghai. Methods In early 1999, 696558 people in Nanhui District of Shanghai were investigated for stroke status and retrospective investigation of the incidence and death of stroke in 1996/98. From the age of 35 and above, the patients with stroke risk factors were screened out for general intervention and CVHI test. 18271 CVHI score less than 70 points were selected as the high risk group, Intervention based on taking “brain capsule” to focus on intervention. Follow-up monitoring of stroke morbidity and mortality after intervention, to evaluate the preventive effect of intervention strategies after 3 years. Results The annual average incidence rate of stroke in 1996/98 was 138.4 / 100 000 with an average annual mortality rate of 97.3 / 100 000. After the implementation of comprehensive interventions in 1999/2001, the incidence of stroke decreased to 95.18 / The death rate dropped to 72.09 / 100000, 62.43 / 100000, 55.62 / 100000; the incidence of three years after intervention decreased by 31.2% and 38.2% respectively compared with that before intervention, , 52.3%, the case fatality rate dropped by 25.9%, 35.8% and 42.8% respectively. Conclusions After 3 years of implementation of the strategy of screening and intervention for people at high risk of stroke, the incidence and mortality of stroke are significantly lower than those before intervention, and the intervention effect is good.