摘要
目的了解上海市宝山区居民脑卒中危险因素及不同特征人群的重点干预因素,为加强宝山区居民脑卒中的预防干预提供科学依据。方法 2018年7月—2019年3月采用分层抽样方法,对12 198名宝山区常住居民进行问卷调查、体格检查及快速血糖血脂检测等,最终获得有效问卷12 005份。使用exhaustive CHAID分类树与logistic回归联合分析宝山区居民脑卒中患病相关危险因素。结果共分析12 005人,其中男性3 858人(32.14%),女性8 147人(67.86%),平均年龄为(62.55±9.11)岁。共有464例患有脑卒中,患病率为3.87%。通过logistic回归分析发现,年龄(OR=7.070,95%CI=3.306~15.118)、教育程度(OR=0.879,95%CI=0.794~0.974)、低密度脂蛋白胆固醇(OR=1.265,95%CI=1.007~1.590)、疲劳乏力(OR=1.487,95%CI=1.195~1.849)、糖尿病(OR=1.765,95%CI=1.376~2.263)和高血压(OR=2.461,95%CI=1.982~3.055)均为脑卒中相关危险因素(均P<0.05)。Exhaustive CHAID分类树分层揭示,高血压和糖尿病对脑卒中贡献最大,其次是年龄、教育程度和低密度脂蛋白胆固醇等危险因素。Logistic回归分析和exhaustive CHAID分类树的模型拟合良好,相对工作特征曲线下面积分别为0.724和0.715。结论脑卒中的防制应在传统的控制高血压、糖尿病和血脂异常等危险因素的基础上,加强慢病患者分层管理与老年人群慢病早期筛查,对不同特征居民采用不同的针对性防制举措。
Objective To understand the risk factors of stroke and the key intervention factors of different characteristic population in Baoshan District of Shanghai,provide scientific basis for strengthening the prevention and intervention of stroke among residents in Baoshan District. Methods From July 2018 to March 2019,using stratified sampling,a questionnaire survey,physical examination and rapid detection of blood glucose and lipid were conducted among 12 198 residents of Baoshan District. 12 005 valid questionnaires were obtained finally. The combination of exhaustive CHAID decision tree and logistic regression was used to analyze the risk factors of stroke among residents of Baoshan District. Results A total of 12 005 people were analyzed,including3 858 males(32.14%) and 8 147 females(67.86%). The average age was(62.55±9.11) years old. A total of 464 people had stroke,with a prevalence of 3.87%. Logistic regression analysis showed that age(OR=7.070,95%CI=3.306-15.118),education(OR=0.879,95% CI =0.794-0.974),low density lipoprotein cholesterol(LDL-C)(OR=1.265,95%CI=1.007-1.590),fatigue(OR=1.487,95%CI=1.195-1.849),diabetes(OR=1.765,95%CI=1.376-2.263) and hypertension(OR=2.461,95%CI=1.982-3.055) were the risk factors of stroke. Exhaustive CHAID decision tree revealed hierarchically hypertension and diabetes had the largest contribution to the stroke,followed by age,education,LDL-C and other risk factors. The models of logistic regression analysis and exhaustive CHAID decision tree matched well,and the area under relative operating characteristic curve was 0.724 and 0.715 respectively.Conclusion For the prevention and treatment of stroke,based on controlling traditional risk factors such as hypertension,diabetes and dislipidemia,it is necessary to strengthen the hierarchical management of patients with chronic diseases and early screening of chronic diseases in the elderly,and adopt different targeted prevention and control measures for residents with different characteristics.
作者
万金豹
吴萃
陈秋艳
WAN Jin-bao;WU Cui;CHEN Qiu-yan(First Department of Chronic Disease Control,Baoshan District Center for Disease Control and Prevention,Shanghai,201901,China)
出处
《职业与健康》
CAS
2021年第4期490-494,共5页
Occupation and Health
基金
上海市宝山区科学技术委员会立项科研课题(18-E-34)。
关键词
脑卒中
回归分析
分类树
相对工作特征
危险因素
干预
Stroke
Logistic regression
decision tree
Relative operating characteristics
risk factors
intervention
