| Part onePrevalence Rate Investigation and Risk Factor Analysis of StrokeObjective:To assess the prevalence rate of stroke in elderly of the invested area and to analyze the correlative risk factors through this epidemiological investigation.Method:By cluster and random sampling of elderly of Wanshoulu area, Beijing,2110 persons aged between 60 and 94 years old (71.623±6.581) were investigated. There were 851 male with average age of 72.738±6.905, accounting for 40.33% of total interviewee while there were 1259 female with average age of 70.869±6.244, accounting for 59.67% of the total interviewee. A structured questionnaire was used for every interviewee, including baseline information, smoking, alcohol consumption, history of main diseases and their treatment status. Blood pressure, height, weight, hip circumference and waistline of each interviewee were measured and everyone's BMI and WHR were calculated. Neurologic physician identified everyone interviewee with stroke by physical examination, history of stroke and medical records. Blood sample of each interviewee was taken to examine FBG, HbA1C, TC, TG, LDL-C, HDL-C, etc,.75g OGTT test was carried out to measure the 2hPBG of the interviewee when the interviewee denied his/her history of DM or his/her history of DM was unknown.The measure figures were tested by t test while the counting numbers were tested byχ2 test. Correlative risk factors were analyzed by multi-factor Logistic regression.Result:①There were 268 stroke cases in this investigation, the prevalence rate was 12.7%. The rate standardized by age of Beijing population was 12.37%.②There were 249 ischemic stroke cases, accounting for 92.91% of the total stroke cases (208 cases of cerebral thrombosis, accounting for 83.53%. 15 cases of cerebral embolism, accounting for 6.02%. 26 cases of lacunar infarction, accounting for 10.44%). There were 15 hemorrhagic stroke cases, accounting for 5.6% (12 cases of cerebral hemorrhage, accounting for 80%.3 cases of subarachnoid hemorrhage, accounting for 20%). There were 4 cases of undetermined subtype, accounting for 1.49%.③The male prevalence rate was 13.87%, the female prevalence rate was 11.91%. There was not significant difference between the two rates.④There was no correlation of blood type, occupation, education with stroke respectively.⑤As the age increased, the prevalence rate of stroke was higher. The average onset age of stroke was 64.076±9.526 years old. The number of patients aged between 60 and 69 was most, accounting for 37.69%.⑥The result of single factor analysis demonstrated that differences for HBP, DM, CHD, smoking, age, BMI, WHR, HDL-C, HbA1C, duration of HBP and DM were significant. HDL-C of non-stroke group is higher than that of stroke group, which meant high HDL-C might be the protective factor of stroke.⑦The result of multi-factor analysis demonstrated that there were significant correlation of CHD, HBP, age and duration of HBP, which meant age, CHD, HBP and long duration of HBP were the risk factor of stroke.Conclusion:The prevalence rate of elderly aged above 60 years old of stroke was 12.37%. There was no correlation of sex, occupation, blood type, education with stroke respectively. Correlative risk factors of stroke included HBP, DM, CHD, smoking, age, BMI, WHR, HbA1C, duration of HBP and DM. High HDL-C might be the protective factor of stroke. Part twoAnalysis on Prognosis and Medical Treatment of StrokeObjective:To assess the status of recovery, cognitive function and medical treatment of stroke in elderly of the invested area through this epidemiological investigation.Method:The investigated object was as same as Part one. All the interviewee were scored by MMSE and ADL. Neurologic physician scored every stroke case by NIHSS, recorded the age and smoking habit, questioned every stroke case of history of MI, AF, other heart disease, HBP, DM, peripheral vascular disease, transient ischemic attack, stroke attack and use of aspirin. Every stroke case was scored by Essen and estimated the present status by the score.Result:①The proportion (13.43%) of cognitive function damage of stroke group was obviously higher than that (6.3%) of non-stroke group and the difference was significant (χ2=16.767 P=0.0000). Quantitative Analysis demonstrated that there was no significant statistic difference on memory (P>0.05).②28.73% stroke patients suffered nervous system dysfunction at different levels. These nervous system dysfunctions were ordered by the prevalence rate from high to low as follow:sensory dysfunction (13.06%), limb movement disorder (11.94%), language dysfunction and dysarthria (7.46%), facial paralysis (7.09%), ataxia (3.73%), vision lesion (1.49%).③The ADL score of stroke group (96.996±8.426) was lower than that of non-stoke group. There was statistic difference between the two groups (t=4.350, P<0.001).④The prevalence and awareness rate of HBP were 70.9% and 77.01% respectively. The prevalence and awareness rate of DM were 35.12% and 73.82% respectively. The awareness rate of HBP in stroke group (84.71%) was obviously higher than that in non-stroke group (75.61%), there was significant difference between the two groups (x2=8.572 P=0.003). The awareness rate of DM in stroke group was 72.97% while that in non-stroke group was 73.97%, there was no statistic difference between the two groups (x2=0.011, P=0.918).⑤There were 13 cases of ischemic stroke with AF, anticoagulant therapy was not given to all these cases, but 6 of them took antiplatelet medicine for a long time, accounting for 46.15%.97 of 236 ischemic stroke patients without AF took antiplatelet medicine, accounting for 41.1%. The proportions of low risk group, high risk group and extremely high risk group were 25%,44.32% and 57.14% respectively, there were significant differences among the three groups (x2=6.25 P=0.0439). Conclusion:The prevalence and awareness rate of HBP were 70.9% and 77.01% respectively. The prevalence and awareness rate of DM were 35.12% and 73.82% respectively. The awareness rate of diseases in stroke group was higher than that in non-stroke group, especially for HBP.28.73% stroke patients suffered nervous system dysfunction at different levels. The prevalence rate of cognitive dysfunction in stroke group was higher than that in non-stroke group.41.1% ischemic stroke without AF took antiplatelet medicine. Higher the risk of relapse was, higher possibility patients would like to take medicine.
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