Page 72 - 中国全科医学2022-18

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7.Chronic Non-communicable Disease Prevention and Control Section，Liaoyang Center for Disease Control and Prevention，
Liaoyang 111000，China
8.Chronic Non-communicable Disease Prevention and Control Section，Dandong Center for Disease Control and Prevention，
Dandong 118000，China
9.Chronic Non-communicable Disease Prevention and Control Section，Benxi Center for Disease Controland Prevention，Benxi
117000，China
*
Corresponding authors：XING Liying，Associate chief physician；E-mail：xly1983sy@163.com
YANG Zuosen，Professor，Chief physician；E-mail：yangzuosen985@126.com
【Abstract】 Background Stroke has become the 3rd leading cause of death among urban residents in China，
and the combined rate ofrisk factorssuch as hypertension，diabetes，and dyslipidemia is high among urban high-risk groups.
Liaoning Province is a high incidence area of stroke in China，however，there are a few studies on the recurrence of stroke and its
combined risk factors in the northern urban areas. Objective To explore the recurrence status of surviving stroke patients aged
over 40 and its combined risk factors in urban areas of Liaoning Province，in orderto provide a theoretical basis for formulating
effective secondary prevention strategies. Methods From September 2018 to December 2020，6 349 permanent urban residents
aged over 40 in Liaoyang，Dandong，Benxi，and Chaoyang Cities of Liaoning Province were selected according to the economic
and regional distribution using stratified cluster random samplingand investigated. A total of 488 surviving stroke patients were
included and their recurrence rate and associated risk factors were analyzed in this study. Results There were 244 males and
244 females among the 488 surviving stroke patients，the average age was （65.8±7.5） years old and the proportion of patients
aged 60-69 was the largest （43.7%）；There were 352（72.1%） first-onset stroke patients，136（27.9%） recurrent stroke
patients，and a recurrence rate of 27.9% among surviving stroke patients；The recurrence rates of male and female surviving
stroke patients were 29.5%（72 cases） and 26.2% （64 cases），respectively，and the difference was not statistically
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significant（χ =0.652，P=0.419）. The recurrence rate of stroke among people aged 40-49，50-59，60-69，70-79 and
≥ 80 years old was 4/11，23.4%（22/94），25.4%（54/213），35.9%（47/131） and 23.1%（9/39），respectively，there
was no significant difference in recurrence rate between male and female surviving stroke patients in different age groups（P>0.05）.
The current drinking rate of the relapsed patients was lower than that of the first-onset stroke patients，and the awareness rate
of hypertension，dyslipidemia，the treatment rate of dyslipidemia，and the control rate of dyslipidemia were higher than those
of the first-onset stroke patients，and the difference was statistically significant （P<0.05）. Conclusion The recurrence rate
of surviving stroke patients aged over 40 in urban areas of Liaoning Province is high，and patients with recurrence have higher
rates of smoking，physical inactivity，overweight or obesity，and poor control of combined risk factors such as hypertension and
diabetes mellitus，which require comprehensive and effective secondary prevention measures to reduce the risk of recurrence，
disability and death in stroke patients.
【Key words】 Stroke；Recurrence；Epidemiologic factors；Risk factors；Dyslipidemias；Hypertension

脑卒中是一组具有高发病率、高致残率、高死亡率、
本研究创新点：
高复发率的脑血管疾病，已成为我国居民致死及致残的 （1）首次阐述了辽宁省城市地区≥ 40 岁存活脑
主要原因之一，严重威胁居民健康 ［1］ 。中国慢性病前
卒中患者复发的现状及特征，为本地区脑卒中复发的
瞻性研究显示，我国脑卒中患者 1 年复发率为 17%，5 相关研究提供了全面的人群资料；（2）首次明确了
年复发率为 41% ［2］ 。高复发率可能导致患者肢体残疾
辽宁省城市地区≥ 40 岁初、复发缺血性脑卒中患者
加重、运动功能和认知功能障碍，进一步降低了患者的 合并危险因素的现状、存在的差异及特征，为脑卒中
生活质量，甚至导致患者死亡 ［3］ 。因此对脑卒中患者
复发患者及复发高危人群的综合管理提供理论依据和
进行有效的二级预防具有重要意义。
数据支持。
NESS-China 调查数据显示，我国 40 岁及以上人群
脑卒中及其危险因素的分布有明显的地域差别，呈现“北 辽宁省城市地区存活脑卒中患者的复发现状，明确脑卒
高南低”的特点 ［4］ 。2019 年，脑卒中已成为我国城市 中复发患者合并危险因素的特征，为制定有效的干预措
居民第 3 位死亡病因（粗死亡率为 129/10 万），且城 施、减少脑卒中复发提供理论依据和数据支撑。
市高危人群中高脂血症、糖尿病等危险因素的合并率明 1 对象与方法
显高于农村地区 ［5］ 。目前对北方城市地区的脑卒中复 1.1 研究对象 2018 年 9 月至 2020 年 12 月，根据经
发情况及其合并危险因素的研究较少，本研究旨在探究 济和地区分布情况，采用随机、整群、分层的抽样方法，