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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 326 -331. doi: 10.11817/j.issn.1673-9248.2022.05.007

论著

综合干预对社区脑卒中高危人群危险因素的控制效果
渠井泉1, 俞杨1, 吴佳莲1, 陈建2, 郝俊杰2,()   
  1. 1. 201508 上海市金山区山阳镇社区卫生服务中心全科
    2. 200120 上海,同济大学附属东方医院神经内科暨脑卒中临床救治中心
  • 收稿日期:2021-12-14 出版日期:2022-10-01
  • 通信作者: 郝俊杰
  • 基金资助:
    上海市金山区卫生健康委员会课题(JSKJ-KTSQ-2019-6)

Effect of comprehensive intervention on controlling risk factors in high-risk stroke population in community

Jingquan Qu1, Yang Yu1, Jialian Wu1, Jian Chen2, Junjie Hao2,()   

  1. 1. Department of General, Shanyang Town Community Health Service Center, Jinshan District, Shanghai 201508, China
    2. Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai 200120, China
  • Received:2021-12-14 Published:2022-10-01
  • Corresponding author: Junjie Hao
引用本文:

渠井泉, 俞杨, 吴佳莲, 陈建, 郝俊杰. 综合干预对社区脑卒中高危人群危险因素的控制效果[J/OL]. 中华脑血管病杂志(电子版), 2022, 16(05): 326-331.

Jingquan Qu, Yang Yu, Jialian Wu, Jian Chen, Junjie Hao. Effect of comprehensive intervention on controlling risk factors in high-risk stroke population in community[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(05): 326-331.

目的

观察综合干预对社区脑卒中高危人群危险因素的控制效果。

方法

2020年1月,在上海市金山区山阳镇社区脑卒中高危人群中选取120人为研究对象,随机分为综合干预组(60人)和普通干预组(60人),干预随访1年。综合干预组给予生活方式干预、心理干预、颈动脉超声检查(颈动脉斑块者给予一级预防用药)、高血压管理、糖尿病管理、血脂异常管理、规律强化的随访和健康教育;普通干预组1年内仅进行1次不定期电话随访,给予简单的健康教育和指导;干预1年后,采用配对设计两样本均数的t检验比较2组的收缩压、舒张压、血糖、糖化血红蛋白、胆固醇、低密度脂蛋白、体质量指数(BMI)、脑卒中健康知识测评分数等的差异;采用配对设计两样本率的χ2检验比较2组的健康生活方式率、颈动脉超声检查率和颈动脉斑块药物治疗率的差异。

结果

干预1年后,综合干预组的收缩压[(126.20±6.75)mmHg vs(137.40±13.07)mmHg]、舒张压[(74.65±7.58)mmHg vs(80.13±10.15)mmHg]、血糖[(5.89±0.83)mmol/L vs(6.82±1.62)mmol/L]、糖化血红蛋白[(6.21±0.59)% vs(6.78±1.46)%]、胆固醇[(4.08±0.78)mmol/L vs(4.96±1.53)mmol/L]、低密度脂蛋白(2.33±0.75)mmol/L vs(3.03±1.23)mmol/L]、BMI(23.76±1.41 vs 26.47±3.19)均低于普通干预组,差异具有统计学意义(t=5.915、3.353、3.991、2.802、3.989、3.757、6.029,P<0.001=0.001<0.001=0.006<0.001<0.001<0.001);综合干预组脑卒中健康知识测评分数[(79.77±8.63)分 vs(52.50±12.61)分]、健康生活方式率(68.33% vs 10.00%)、颈动脉超声检查率(93.33% vs 46.67%)和颈动脉斑块药物治疗率(100% vs 84.21%)均高于普通干预组,差异具有统计学意义(t=13.820,P<0.001;χ2=48.676,P<0.001;χ2=31.110,P<0.001;χ2=4.007,P=0.045)。

结论

通过综合干预,可有效控制社区脑卒中高危人群的脑卒中危险因素,提高其脑卒中健康知识,促使其采纳健康生活方式。

Objective

To observe the effect of comprehensive intervention on controlling risk factors in high-risk stroke population in community.

Methods

In January 2020, 120 persons with high-risk of stroke were included to participate in the study in Shanyang Town, Jinshan District, Shanghai. They were randomly divided into comprehensive intervention group (60 subjects) and general intervention group (60 subjects). The comprehensive intervention group was given lifestyle intervention, psychological intervention, carotid ultrasound examination (subjects with carotid artery plaques were given primary preventive medication), management for hypertension, diabetes and dyslipidemia, regular follow-ups, and health education. The general intervention group only received one casual telephone follow-up within one year, simple health education and guidance. After 1 years of intervention, t-test was used to compare the systolic blood pressure, diastolic blood pressure, blood glucose, glycosylated hemoglobin, cholesterol, low density lipoprotein, body mass index(BMI)and the stroke health knowledge evaluation score between the two groups; χ2-test of rates of the two samples was used to compare the healthy lifestyle rate, carotid ultrasound examination rate and carotid plaque drug treatment rate between the two groups.

Results

After 1 years of intervention, the systolic blood pressure [(126.20±6.75)mmHg vs (137.40±13.07)mmHg, t=5.915, P<0.001], diastolic blood pressure [(74.65±7.58)mmHg vs (80.13±10.15)mmHg, t=3.353, P=0.001], blood glucose [(5.89±0.83)mmol/L vs (6.82±1.62)mmol/L, t=3.991, P<0.001], glycosylated hemoglobin [(6.21±0.59)% vs (6.78±1.46)%, t=2.802, P=0.006], cholesterol [(4.08±0.78)mmol/L vs (4.96±1.53)mmol/L, t=3.989, P<0.001], low density lipoprotein [(2.33±0.75) mmol/L vs (3.03±1.23) mmol/L, t=3.757, P<0.001], BMI (23.76±1.41 vs 26.47±3.19, t=6.029, P<0.001) in the comprehensive intervention group were lower than those in the general intervention group. The stroke health knowledge evaluation score (79.77±8.63 vs 52.50±12.61, t=13.820, P<0.001), rate of healthy lifestyle (68.33% vs 10.00%, χ2=48.676, P<0.001), carotid ultrasound examination rate (93.33% vs 46.67%, χ2=31.110, P<0.001), and drug treatment rate of carotid plaque (100.00% vs 84.21%, χ2=4.007, P=0.045) in the comprehensive intervention group were higher than those in the general intervention group.

Conclusion

Comprehensive intervention can effectively control the risk factors in high-risk stroke population in community, improving their stroke health knowledge and promoting a healthy lifestyle.

表1 2组社区脑卒中高危人群干预前后脑卒中危险因素变化情况比较(
xˉ
±s
表2 2组社区脑卒中高危人群干预前后脑卒中健康知识测评分数比较(分,
xˉ
±s
表3 2组社区脑卒中高危人群干预前后健康生活方式率比较[人(%)]
表4 2组社区脑卒中高危人群颈动脉超声检查率和颈动脉斑块药物治疗率[人/人(%)]
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