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目的探究社区达标降脂干预对脑卒中患者的影响。方法在北京市某社区卫生服务管理中心2011年4月—2013年9月社区脑卒中管理数据库中以健康筛查法选取446例脑卒中患者,采用随机数字表法分成对照组和干预组,每组223例。对照组采用日常社区慢性病管理模式,干预组在对照组的基础上采用社区达标降脂干预。两组患者均观察1年,比较两组患者血清LDL水平变化、观察期间死亡和再次发生脑卒中情况。结果对照组患者失访21例,干预组患者失访18例。两组患者入组前血清LDL-C水平比较,差异无统计学意义(P>0.05);入组1年后干预组患者血清LDL-C水平低于对照组(P<0.05)。两组患者观察期间均未出现死亡病例,对照组患者中再次发生缺血性脑卒中15例(7.4%),出血性脑卒中2例(1.0%);干预组患者中再次发生缺血性脑卒中5例(2.4%),出血性脑卒中1例(0.5%);对照组患者再次脑卒中发生率(8.4%)高于干预组(2.9%)(χ2=5.749,P<0.05)。结论社区达标降脂干预对脑卒中患者的管理效果明显,有助于降低脑卒中患者血清LDL水平,减少再次脑卒中的发生。
Objective To investigate the impact of community-based lipid-lowering intervention on stroke patients. Methods A total of 446 stroke patients were selected from a community stroke management database in Beijing Community Health Service Management Center from April 2011 to September 2013 by health screening method and divided into control group and intervention group by random number table Group of 223 cases. The control group adopted the routine community chronic disease management mode, the intervention group in the control group based on community-based lipid-lowering intervention. Two groups of patients were observed for 1 year, comparing the two groups of patients with serum LDL levels were observed during the death and re-occurrence of stroke. Results In the control group, 21 patients were lost and 18 patients in the intervention group were lost. There was no significant difference in serum LDL-C levels between the two groups before enrollment (P> 0.05). The level of serum LDL-C in the intervention group was lower than that of the control group (P <0.05) after one year. No deaths were observed during the observation period in both groups, with 15 (7.4%) ischemic stroke and 2 (1.0%) hemorrhagic stroke in the control group; ischemic brain reoccurrence occurred in the intervention group Stroke in 5 cases (2.4%) and hemorrhagic stroke in 1 case (0.5%). The incidence of stroke in control group (8.4%) was higher than that in intervention group (2.9%) (χ2 = 5.749, P <0.05). Conclusion Community-based lipid-lowering intervention has obvious effect on the management of patients with stroke, which can help reduce the level of serum LDL in stroke patients and reduce the incidence of recurrent stroke.