Analysis Of Screening Results And Intervention Effect On High-Risk Population Of Stroke In Gansu Area

Part oneAnalysis of screening results of high-risk population of stroke in Gansu ProvinceObjective: To explore the prevalence of risk factors in high-risk population of stroke in Gansu Province.Methods: From January 1,2017 to December 31,2017,community health center and township hospital belonging to base hospital of screening stroke in Gansu Province used cluster sampling method to select the local residents over 40 years old.The questionnaires,laboratory tests,physical examinations were conducted for all residents to screen high-risk population of stroke,data were statistically analyzed lastly.Results: 1.This study screened a total of 43,262 residents,there were 5,764 cases(13.32%)at high risk of stroke.2.The detection rate of risk factors in high-risk population of stroke in descending order was hypertension(73.85%),hyperlipidemia(66.67%),lack of exercise(51.51%),severe overweight(32.04%),smoking.(29.29%),diabetes(26.16%),family history of stroke(20.32%),atrial fibrillation or valvular heart disease(4.51%).3.The detection rate of hyperlipidemia was higher in male than that in female,urban areas was higher than rural areas,elderly was higher than middle-aged,and the minority was higher than Han nationality,the difference was significant(P<0.05).The detection rate of smoking was higher in male than that in female,rural areas was higher than urban areas,and the Han nationality was higher than minority,the difference was significant(P<0.05).The detection rate of lack of exercise was higher in male than that in female,urban areas was higher than rural areas,the difference was significant(P<0.05).The incidence of severe overweight was higher in male than that in female,the difference was significant(P<0.05).The incidence of diabetes was higher in elderly than that in middle-aged,the differencewas significant(P<0.05).The difference of detection rate of hypertension,family history of stroke,atrial fibrillation or valvular heart disease among different characteristics was not significant(P>0.05).Conclusion: The risk factors of high-risk population of stroke in Gansu Province are mainly hypertension,hyperlipidemia and lack of exercise.The health department should strengthen the education and intervention in the future.The detection rate of smoking,lack of exercise,severe overweight is higher in male than that in female.The detection rate of diabetes and hyperlipidemia in elderly is higher than that in middle-aged.The detection rate of smoking in rural areas is higher than that in urban areas.The detection rate of hyperlipidemia and lack of exercise in urban areas is higher than that in rural areas.The detection rate of hyperlipidemia in minority is higher than that in Han nationality,and the detection rate of smoking in Han nationality is higher than that in minority.The incidence of risk factors in different characteristics is different,therefore,it is necessary to carry out targeted prevention in the future.Part two Analysis of intervention effect on high-risk population of strokeObjective: To investigate the intervention effect of community health center and township hospital belonging to Lanzhou University Second Hospital on high-risk population of stroke.Methods: Using a cluster sampling method,the community health center and township hospital belonging to Lanzhou University Second Hospital conducted questionnaire surveys,laboratory tests,physical examinations for local residents over40 years old,screened out high-risk population of stroke and reported the results to the Chinese Stroke Data Platform.The intervention were carried out for intervention population selected by exclusion criteria.The intervention effect was evaluated by laboratory indicators,control of lifestyle,and specification usage rate of drug two years later.Results: A total of 5,416 residents were screened,including 874 high-riskpopulation(16.1%),and 273 cases participated in follow-up.Finally,244 cases(24were lost to follow-up and 5 were dead)completed follow-up.The detection rate of risk factors in high-risk population of stroke in descending order were hypertension(60.66%),hyperlipidemia(55.74%),diabetes(54.10),lack of exercise(49.60%),severe overweight(43.85%),smoking(35.25%),atrial fibrillation or valvular heart disease(18.95%),family history of stroke(14.34%).Two years later,the systolic blood pressure(SBP),fasting blood glucose(FBG)and low density lipoprotein cholesterol(LDL-C)in the high-risk population were lower than that before the intervention,and the difference was statistically significant(P<0.05).The body mass index(BMI)did not decrease significantly compared with that before the intervention(P>0.05).The number of people taking exercise and non-smoking increased significantly compared with that before the intervention(P<0.05).The specification usage rate of antihypertensive drugs,hypoglycemic drugs and lipid-lowering drugs increased,the difference was statistically significant(P<0.05).Conclusion: The intervention has a good effect on control of chronic disease and specification usage of drugs,but the intervention effect on control of BMI and unreasonable diet is not good.In the future,it is necessary to improve the management plan,strengthen follow-up,and conduct targeted education.