目的

探讨山西省脑卒中危险因素与地域之间的相关性。

方法

应用2019 年山西省重点疾病监测数据，纳入研究对象10 087 人，通过现场问卷和体格检查收集信息。对脑卒中危险因素及脑卒中患病情况指标进行复杂加权。对脑卒中危险因素采用χ² 检验和Fisher 精确检验进行人口特征描述，对不同地域脑卒中危险因素和脑卒中关联采用多因素Logistic 回归模型分析。

结果

（1）纳入研究对象10 087 人中，太原市（山西中部地区）2000 人、大同市（山西北部地区）2100 人、运城市（山西省南部地区）5987 人，其中男性4482 人（44.4%）、女性5605 人（56.3%）。（2）3 个地区高血压病、糖尿病、心房颤动或瓣膜性心脏病、吸烟史、既往脑卒中、脑卒中家族史、缺乏运动等脑卒中危险因素患病率比较，差异均具有统计学意义（P＜0.05）。高血压病、缺乏运动、明显超重或肥胖、脑卒中家族史、心房颤动或瓣膜性心脏病患病率由北到南逐渐升高，糖尿病、血脂异常患病率由北到南逐渐降低。吸烟史人群占比由北到南逐渐减低。短暂性脑缺血发作大同市人群占比最高，血脂异常太原市人群占比最高，运城最低。（3）多因素Logistic 回归结果显示，在2 次调整混杂因素后，3 个地区危险因素中高血压病、年龄均与脑卒中患病呈正相关。另外太原市脑卒中危险因素中糖尿病、脑卒中家族史均与脑卒中患病呈正相关。相比于小学及以下的文化程度，初中文化程度与脑卒中患病呈负相关。大同市脑卒中危险因素中血脂异常、心房颤动或瓣膜性心脏病、缺乏运动与脑卒中患病呈正相关。运城市脑卒中危险因素中血脂异常、糖尿病、缺乏运动、脑卒中家族史、退休人群与脑卒中患病呈正相关，且相对于女性，男性与脑卒中患病呈正相关。

结论

山西省不同地域脑卒中危险因素及脑卒中的患病率存在明显差异，脑卒中患病率呈现出南高北低的趋势，3 个地区脑卒中患病率均受高血压病影响，其中太原市所受影响最大。脑卒中危险因素与地域有一定的相关性。

Objective

To investigate the relationship the correlation between stroke risk factors and geographical distribution within Shanxi Province， China.

Methods

Using the key disease surveillance data of Shanxi Province in 2019， this study included 10，087 study subjects. Data were gathered through on-site questionnaires and physical examinations， followed by a complex weighting of stroke risk factors and stroke prevalence indicators. Demographic characteristics associated with stroke risk were analyzed using the chi-square and Fisher's exact tests. Multifactorial logistic regression models were used to analyze stroke risk factors and associations across different geographic regions.

Results

（1） The study included 10，087 adults， with 2，000 from Taiyuan City （central region of Shanxi Province）， 2，100 from Datong City （northern region of Shanxi Province）， and 5，987 from Yuncheng City （southern region of Shanxi Province）. Of the participants， 4，482 （44.4%） were male and 5，605 （56.3%） were female. （2） There were significant regional differences in the prevalence of stroke risk factors， including hypertension， diabetes mellitus， atrial fibrillation or valvular heart disease， smoking history， previous stroke， family history of stroke， and lack of exercise，（P＜0.05）. The prevalence of hypertension， physical inactivity， significant overweight or obesity， family history of stroke， and atrial fibrillation or valvular heart disease increased in the same direction， while the prevalence of diabetes mellitus and dyslipidemia decreased gradually from north to south. The prevalence of smoking decreased gradually from north to south in the studied population. The Datong population had the highest percentage of transient ischemic attack， while the Taiyuan population had the highest percentage of dyslipidemia and Yuncheng had the lowest. （3） The study found that hypertension and age were positively associated with stroke incidence across all three regions， even after adjusting for confounders on two occasions. Additionally， diabetes mellitus and family history of stroke were positively associated with stroke incidence in Taiyuan， while middle school education was negatively associated with stroke incidence compared to elementary school education or lower. The risk factors for stroke in Datong include dyslipidemia， atrial fibrillation or valvular heart disease， and physical inactivity. In Yuncheng， the risk factors for stroke include dyslipidemia， diabetes mellitus， physical inactivity， family history of stroke， and retirement. The incidence of stroke in Yuncheng was positively associated with dyslipidemia， diabetes mellitus， physical inactivity， family history of stroke， retirement， and male gender relative to female gender.

Conclusion

The survey revealed significant regional differences in stroke risk factors and prevalence across Shanxi Province. The prevalence of stroke was highest in the south and lowest in the north， exceeding the national average. Hypertension was found to be a consistent significant factor across all three regions， with Taiyuan showing the highest impact.Stroke risk factors varied by region， highlighting the importance of region-specific preventative strategies.