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中国东北农村地区中风的高患病率及未得到控制的相关危险因素是主要的公共卫生挑战:一项基于人群的研究。

High prevalence of stroke and uncontrolled associated risk factors are major public health challenges in rural northeast China: A population-based study.

作者信息

Xing Liying, Jing Li, Tian Yuanmeng, Liu Shiwei, Lin Min, Du Zhi, Ren Guocheng, Sun Qun, Shi Lei, Dai Dong, Liu Shuang

机构信息

Department of Cardiology, The First Hospital of China Medical University, Shenyang, People's Republic of China.

Disease Control and Prevention of Liaoning Province, Shenyang, People's Republic of China.

出版信息

Int J Stroke. 2020 Jun;15(4):399-411. doi: 10.1177/1747493019851280. Epub 2019 May 15.

Abstract

BACKGROUND

Stroke has become a major burden and public health problem in rural China. We aimed to comprehensively assess the current status of stroke burden as well as the associated risk factors in rural northeast China.

METHODS

This population-based, cross-sectional study was conducted in 10,926 adults (response rate 85.3%) aged ≥40 years residing in rural northeast China. A multistage cluster sampling method was used to select the representative sample. The prevalent stroke cases were considered as stroke survivors on 31 August 2017. Stroke was diagnosed according to the World Health Organization's recommendations and was classified as ischemic stroke and hemorrhagic stroke based on the results of computed tomography or magnetic resonance imaging. The status of related risk factors was also evaluated.

RESULTS

Of the 10,926 participants, 731 were diagnosed with stroke (602 patients with ischemic stroke, 151 with hemorrhage stroke, and 22 with both ischemic stroke and hemorrhage stroke). The crude prevalence of overall stroke, ischemic stroke, and hemorrhage stroke was 6690.5, 5509.8, and 1382.0 per 100,000 people, respectively, and the age-standardized rate was 4903.8, 4041.7, and 990.9 per 100,000 people. Among the overall stroke population, 13.4% were living with consequences of stroke. Hypertension (86.7%), dyslipidemia (37.2%), and diabetes (24.5%) were highly prevalent in stroke participants. However, most of those comorbidities remained uncontrolled (93.7, 44.7, and 88.9%, respectively).

CONCLUSION

The burden of stroke in rural northeast China was substantial, with a high prevalence of stroke, recurrence, and disabilities. Uncontrolled comorbidities will likely contribute to recurrence and worsening disabilities in the coming decades. Strategies of long-term management of stroke and related risk factors are urgently required in rural northeast China.

摘要

背景

中风已成为中国农村地区的一项主要负担和公共卫生问题。我们旨在全面评估中国东北农村地区中风负担的现状以及相关风险因素。

方法

本基于人群的横断面研究在居住于中国东北农村地区的10926名年龄≥40岁的成年人中进行(应答率85.3%)。采用多阶段整群抽样方法选取代表性样本。将2017年8月31日的现患中风病例视为中风幸存者。根据世界卫生组织的建议诊断中风,并根据计算机断层扫描或磁共振成像结果将其分为缺血性中风和出血性中风。还评估了相关风险因素的状况。

结果

在10926名参与者中,731人被诊断患有中风(602例缺血性中风患者,151例出血性中风患者,22例同时患有缺血性中风和出血性中风)。总体中风、缺血性中风和出血性中风的粗患病率分别为每10万人6690.5、5509.8和1382.0例,年龄标准化率分别为每10万人4903.8、4041.7和990.9例。在总体中风人群中,13.4%的人有中风后遗症。高血压(86.7%)、血脂异常(37.2%)和糖尿病(24.5%)在中风参与者中高度流行。然而,这些合并症大多仍未得到控制(分别为93.7%、44.7%和88.9%)。

结论

中国东北农村地区的中风负担很重,中风、复发和残疾的患病率很高。未得到控制的合并症可能会在未来几十年导致复发和残疾恶化。中国东北农村地区迫切需要中风及相关风险因素的长期管理策略。

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