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目的:分析与总结上海市某农村社区脑卒中一级预防方案实施情况，评价其预防效果。方法:选取上海市奉贤区某镇约5万名社区自然人群中的本地户籍常驻居民，分别于2008—2010年和2012—2015年对全人群进行脑卒中健康教育，并在50岁及以上的中老年人群中筛查脑卒中高危个体（2轮筛查对象无重复），进行治疗性干预与管理。每2个月随访干预措施实施情况。2008—2015年，动态监测首发脑卒中病例，每年对首发脑卒中病例进行1次审核，并进行脑卒中的分型诊断。通过发病率的动态变化，评价社区脑卒中一级预防方案实施的效果。结果:2008—2015年，累计监测总人数42.26万人，男性为20.50万人，女性为21.76万人。第1轮筛查7 828人，筛查出脑卒中高危个体2 129人，高危率为27.2%；第2轮筛查2 877人，筛查出脑卒中高危个体725人，高危率为25.2%。2008—2015年本社区的标准化脑卒中发病率分别为158.1/10万、105.4/10万、86.6/10万、77.6/10万、89.3/10万、77.4/10万、50.7/10万、42.3/10万，除2012年外，整体呈下降趋势（趋势检验n P<0.01），各年度男女脑卒中发病率差异均无统计学意义。脑卒中发病率随着年龄增长而呈显著上升趋势（趋势检验n P<0.001），脑卒中患者的年龄构成在不同性别间存在一定差异，70岁以下各年龄组男性脑卒中患者的构成比明显高于女性患者，而70岁以上各年龄组女性脑卒中患者的构成比则明显高于男性（n P<0.001）。脑出血、脑梗死、蛛网膜下腔出血分别占20.76%，75.14%和4.10%。n 结论:实施在生活方式干预和危险因素治疗与控制的基础上，筛查脑卒中高危个体进行治疗性干预的社区脑卒中一级预防方案，能够降低脑卒中的发病率。“,”Objective:This study aimed to analyze and summarize the implementation of the primary prevention program for stroke in Shanghai rural community and evaluate its preventive effect.Methods:A cluster sampling method was used to select approximately 50 000 community natural population from a town in Fengxian District of Shanghai. A primary stroke prevention program was established and implemented in the community from 2008 to 2010 and from 2012 to 2015. The prevention program inclueded stroken health education for the whole population, screening of high risk population of stroke, and therapeutic intervention and management plan for individuals aged≥50 years. The intervention measures were followed up every 2 months. From 2008 to 2015, new stroke cases were monitored dynamically and reviewed annually with classification of stroke diagnosis. The effect of community primary prevention of stroke program was evaluated by the dynamic changes in stroke incidence.n Results:From 2008 to 2015, a total of 422 600 individuals were monitored, including 20 500 men and 217 600 women. In 2008, 7 828 individuals were screened and 2 129 individuals were at high risk of stroke were screened, with a high risk rate of 27.2%. In 2012, 2 877 individuals were screened, and 725 individuals were at high risk of stroke were screened, with a high risk rate of 25.2%. The standardized incidence of stroke in this community was 158.1, 105.4, 86.6, 77.6, 89.3, 77.4, 50.7, and 42.3 per 100 000 respectively. The overall incidence image roughly showed a downward trend except 2012(trend testn P<0.01). There was no significant difference in the incidence of stroke between men and women in each year. The incidence of stroke increased significantly with age (trend test n P<0.01). The age composition of stroke patients is slightly different between different sexes. The proportion of male patients with stroke aged 70 years was significantly higher than that of male patients with stroke ( n P<0n .01). Cerebral hemorrhage, cerebral infarction, and subarachnoid hemorrhage accounted for 20.76%, 75.14%, and 4.10%, respectively.n Conclusion:Based on lifestyle intervention and treatment and control of risk factors, screening high-risk individuals for therapeutic intervention in community population can significantly reduce the incidence of stroke.