Fang Xiang-hua, Yang Qi-dong, Wu Sheng-ping, Liu Yun-hai, Du Xiao-li, Bao Qiu-ju, Wang Wen-zhi
Department of Epidemiology and Social Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2007 Jan;28(1):49-52.
To evaluate the effect of a long-term community-based intervention program on risk factors of stroke among people with different risk factors.
In 1987,2 geographically separated communities with 10 000 registered residents of each, were selected as either intervention or control communities in Beijing and Changsha. A cohort containing 2700 subjects at the age of 35 years or older,and free of stroke were sampled from each community. The baseline survey was conducted to screen the subjects at high risk for intervention and there were 5319 and 5506 subjects enrolled in intervention and control cohorts,respectively. Then,a program for controlling the risk factors of stroke was initiated in the intervention cohort and health education was provided to the whole intervention community. A follow-up survey was conducted in 1999. The information on incidence and mortality of stroke was collected.
Comparing with the control cohort, the risk of incidence and mortality of stroke decreased by 22 % ( HR = 0.78,95 % CI:0. 66-0.92) and 73 % (HR = 0.27,95 % CI:0. 17-0.42) in intervention cohort. The risks of stroke were lower in intervention cohort than in control cohort among almost all of the sub-groups with or without risk factors of stroke except for being male,current smokers and current alcohol drinkers. The risk of death caused by stroke decreased significantly in those with or without the risk factors of stroke.
The long-term community intervention on the risk factors of stroke could effectively reduce the risk of incidence and mortality of stroke among people with or without the risk factors of stroke. More attention should be paid to the males and those who smoke or drink alcohol.
评估一项基于社区的长期干预项目对具有不同危险因素人群中风危险因素的影响。
1987年，在北京和长沙选择了2个地理上分开的社区，每个社区有10000名登记居民，分别作为干预社区或对照社区。从每个社区抽取一个包含2700名35岁及以上且无中风的受试者的队列。进行基线调查以筛选出高风险干预受试者，干预队列和对照队列分别有5319名和5506名受试者。然后，在干预队列中启动了一项控制中风危险因素的项目，并对整个干预社区进行了健康教育。1999年进行了随访调查。收集了中风发病率和死亡率的信息。
与对照队列相比，干预队列中风的发病率和死亡率风险分别降低了22%（HR = 0.78，95%CI：0.66 - 0.92）和73%（HR = 0.27，95%CI：0.17 - 0.42）。在几乎所有有或无中风危险因素的亚组中，干预队列的中风风险均低于对照队列，但男性、当前吸烟者和当前饮酒者除外。有或无中风危险因素者因中风导致的死亡风险均显著降低。
对中风危险因素进行长期社区干预可有效降低有或无中风危险因素人群中风的发病率和死亡率风险。应更多关注男性以及吸烟或饮酒者。
