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[目的]了解影响上海市杨浦区脑卒中发病的危险因素及疾病负担现状。[方法]整群抽取杨浦区长白社区2007.1～2008.1年符合条件的所有脑卒中病例131例,随机选取年龄、性别构成一致的133例健康人群(非配偶)作为对照进行面对面的入户调查。利用χ2、t检验、多因素Logistic回归分析对病例组对照组的危险因素、卫生服务利用进行比较,描述脑卒中病人患病一年费用分布比例。[结果]在影响因素中,经多因素Logistic回归高血压史(χ2=96.137,P﹤0.0001,OR=171.67);饮酒(χ2=8.324,P=0.016)有意义;卫生服务利用中,看病常去医疗机构级别、看病人次数、看病的费用都存在差别(P﹤0.05),病例组看病人次数是对照组的8.9倍,总费用是对照组的29.1倍。其中因脑卒中看病花费占91.41%,占家庭平均收入77.21%。[结论]脑卒中高血压史、门急诊住院次数和费用与对照有大的差别,应加强脑卒中高血压预防和提高诊疗服务可及性,降低脑卒中治疗费用。
[Objective] To understand the risk factors and disease burden status of stroke in Yangpu District of Shanghai. [Methods] A total of 131 eligible stroke patients from 1981 to 1999 in Changbai Community of Yangpu District were enrolled. A total of 131 healthy population (non-spouse) with the same age and gender were randomly selected as the control. Chi-square test and multivariate logistic regression analysis were used to compare the risk factors and health service utilization of the control group, and to describe the proportion of the annual cost distribution of stroke patients. [Results] Among the influencing factors, the history of hypertension was significant (χ2 = 96.137, P <0.0001, OR = 171.67); drinking alcohol (χ2 = 8.324, P = 0.016) was significant by multivariate Logistic regression; There was a difference (P <0.05) in the level of medical institutions, the number of patients and the cost of seeing a doctor, 8.9 times of the patients in the case group and 29.1 times of the control group. Which accounted for 91.41% of stroke patients, accounting for 77.21% of the average family income. [Conclusion] The history of hypertension in stroke, the number of hospitalizations in outpatient and emergency department and the cost are different from the control. It is necessary to strengthen the prevention of hypertension in stroke and improve the accessibility of medical services and reduce the cost of stroke treatment.