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Article(id=1320438024677213050, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438006813672182, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146271, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1730044800000, receivedDateStr=2024-10-28, revisedDate=1735747200000, revisedDateStr=2025-01-02, acceptedDate=1760284800000, acceptedDateStr=2025-10-13, onlineDate=1792746557635, onlineDateStr=2026-10-23, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746557635, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746557635, creator=13701087609, updateTime=1792746557635, updator=13701087609, issue=Issue{id=1320438006813672182, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='3', pageStart='257', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746553376, creator='13701087609', updateTime=1792748100383, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444495519404406, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438006813672182, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444495519404407, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438006813672182, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=277, endPage=283, ext={EN=ArticleExt(id=1320438025088254843, articleId=1320438024677213050, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Detection rate and influencing factors of carotid plaque and plaque burden in the population with the age ≥ 40 years and high stroke risk from 2017 to 2020 in Nanjing city: based on CNSSS data analysis, columnId=1320438008931795703, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Chronic Disease Prevention and Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the detection rate and influencing factors of carotid plaque and plaque burden in a population with the age ≥ 40 years and high stroke risk in Nanjing city, thereby providing evidence for stroke prevention and control.

Methods

As a part of the China National Stroke Screen Survey, the data were collected at 12 screening sites, which were selected from 4 districts (Pukou, Gaochun, Jiangning, and Liuhe) in Nanjing by Nanjing Drum Tower Hospital and Nanjing Brain Hospital from 2017 to 2020. A total of 5 636 residents aged 40 and above who were at high-risk for stroke and underwent ultrasound examination of carotid arteries were included in this study. The detection rates of carotid plaque and plaque burden were analyzed. Multivariate unconditional logistic regression was employed to analyze the influencing factors of carotid plaque and plaque burden.

Results

Among the 5 636 residents included, 1 801 (32.0%) and 966 (17.1%) were detected with carotid plaque and plaque burden, respectively. The results of multivariate unconditional logistic regression showed that age ≥ 50 years, educational background of college degree or above, smoking, hypertension, and diabetes increased the risk of carotid plaque, while living in rural areas, drinking alcohol, sufficient fruit intake, and obesity reduced the risk of carotid plaque. Moreover, age ≥ 50 years, hypertension and diabetes increased the risk of carotid plaque burden, while female, living in rural areas, drinking alcohol, sufficient fruit intake, and obesity reduced the risk of carotid plaque burden.

Conclusions

Although the detection rates of carotid plaque and plaque burden in population aged 40 and above and with high stroke risk in Nanjing were lower than that in other cities, the burden was still heavy. Age, residence, alcohol intake, fruit intake, hypertension, diabetes, and body mass index were the common influencing factors for carotid plaque and plaque burden in this population.

, authors=Shengxiang QI1, Zhenzhen QIN1, Lan CUI2, Jinyi ZHOU2, Xin HONG1, authorsList=Shengxiang QI, Zhenzhen QIN, Lan CUI, Jinyi ZHOU, Xin HONG, authorCompany=null, correspAuthors=Xin HONG, authorNote=null, correspAuthorsNote=
HONG Xin, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320438027273487232, articleId=1320438024677213050, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2017—2020年南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及影响因素：基于CNSSS数据分析, columnId=1320438009145705209, journalTitle=中国公共卫生, columnName=专题报道——慢性病预防与控制, runingTitle=null, highlight=null, articleAbstract=
目的

了解江苏省南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及其影响因素，为脑卒中的预防控制提供科学依据。

方法

收集中国国家脑卒中高危人群筛查和干预项目（CNSSS）中2017—2020年南京市鼓楼医院和南京市脑科医院2家基地医院在浦口区、高淳区、江宁区和六合区4个区抽取的12个筛查点筛查出的进行了颈动脉超声检查的5 636例≥40岁脑卒中高危人群相关数据，分析其颈动脉斑块和斑块负担检出情况，并应用多因素非条件logistic回归模型分析脑卒中高危人群颈动脉斑块和斑块负担的主要影响因素。

结果

南京市5 636例≥40岁脑卒中高危人群中，检出颈动脉斑块和斑块负担者分别为1 801和966例，检出率分别为32.0%和17.1%。多因素非条件logistic回归分析结果显示，年龄≥50岁、文化程度大专及以上、吸烟、高血压和糖尿病的南京市≥40岁脑卒中高危人群发生颈动脉斑块的风险较高，居住在农村、饮酒、水果摄入充足和肥胖的南京市≥40岁脑卒中高危人群发生颈动脉斑块的风险较低；年龄≥50岁、高血压和糖尿病的南京市≥40岁脑卒中高危人群发生颈动脉斑块负担的风险较高，女性、居住在农村、饮酒、水果摄入充足和肥胖的南京市≥40岁脑卒中高危人群发生颈动脉斑块负担的风险较低。

结论

南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出率相对较低但疾病负担仍较重，年龄、居住地、饮酒情况、是否水果摄入不足、是否患高血压、是否患糖尿病和体质量指数为该地区≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出的共同影响因素。

, authors=戚圣香1, 秦真真1, 崔岚2, 周金意2, 洪忻1, *, *, authorsList=戚圣香, 秦真真, 崔岚, 周金意, 洪忻, authorCompany=null, correspAuthors=洪忻, authorNote=

戚圣香（1988—），副主任医师，硕士，研究方向：慢性病预防与控制

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洪忻，E-mail：
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Detection rates of carotid plaque in the population with the age ≥ 40 years and high stroke risk in Nanjing by characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查例数颈动脉斑块检出例数颈动脉斑块检出率/%χ2值P值
性别男性3 1461 01732.30.4520.501
女性2 49078431.5
年龄/岁<501 05414213.5462.304<0.001
50～591 62436722.6
60～691 66464338.6
≥701 29464950.2
文化程度小学及以下2 54496437.978.266<0.001
中学/中专/技校2 69674527.6
大专及以上3969223.2
居住地城市2 7131 10240.6180.587<0.001
农村2 92369923.9
吸烟情况不吸烟36831 21032.93.9450.047
吸烟1 95359130.3
饮酒情况不饮酒39151 34334.332.526<0.001
饮酒1 72145826.6
体力活动充足否2 62382331.40.7560.384
是301397832.5
蔬菜摄入充足否1 32345834.65.6380.018
是43131 34331.1
水果摄入充足否37341 28934.533.488<0.001
是1 90251226.9
高血压否93721022.447.073<0.001
是46991 59133.9
糖尿病否35971 05029.234.940<0.001
是2 03975136.8
血脂异常否1 82262834.57.8150.005
是38141 17330.8
体质量指数体重过轻672943.320.470<0.001
体重正常1 68358034.5
超重2 26873832.5
肥胖1 61845428.1
), ArticleFig(id=1320438031966913455, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=CN, label=表1, caption=

南京市不同特征≥40岁脑卒中高危人群颈动脉斑块检出情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查例数颈动脉斑块检出例数颈动脉斑块检出率/%χ2值P值
性别男性3 1461 01732.30.4520.501
女性2 49078431.5
年龄/岁<501 05414213.5462.304<0.001
50～591 62436722.6
60～691 66464338.6
≥701 29464950.2
文化程度小学及以下2 54496437.978.266<0.001
中学/中专/技校2 69674527.6
大专及以上3969223.2
居住地城市2 7131 10240.6180.587<0.001
农村2 92369923.9
吸烟情况不吸烟36831 21032.93.9450.047
吸烟1 95359130.3
饮酒情况不饮酒39151 34334.332.526<0.001
饮酒1 72145826.6
体力活动充足否2 62382331.40.7560.384
是301397832.5
蔬菜摄入充足否1 32345834.65.6380.018
是43131 34331.1
水果摄入充足否37341 28934.533.488<0.001
是1 90251226.9
高血压否93721022.447.073<0.001
是46991 59133.9
糖尿病否35971 05029.234.940<0.001
是2 03975136.8
血脂异常否1 82262834.57.8150.005
是38141 17330.8
体质量指数体重过轻672943.320.470<0.001
体重正常1 68358034.5
超重2 26873832.5
肥胖1 61845428.1
), ArticleFig(id=1320438032075965360, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=EN, label=Tab.2, caption=

Detection rates of carotid plaque burden in the population with the age ≥ 40 years and high stroke risk in Nanjing by characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类调查例数颈动脉斑块负担检出例数颈动脉斑块负担检出率/%χ2值P值
性别男性3 14657718.37.2310.007
女性2 49038915.6
年龄/岁<501 054615.8392.737<0.001
50～591 6241489.1
60～691 66433820.3
≥701 29441932.4
文化程度小学及以下2 54454021.261.552<0.001
中学/中专/技校2 69639014.5
大专及以上396369.1
居住地城市2 71358121.467.334<0.001
农村2 92338513.2
吸烟情况不吸烟368364317.50.7600.383
吸烟1 95332316.5
饮酒情况不饮酒391573618.824.867<0.001
饮酒1 72123013.4
体力活动充足否2 62344416.90.1560.693
是301352217.3
蔬菜摄入充足否1 32326019.77.6840.006
是431370616.4
水果摄入充足否373471319.129.776<0.001
是1 90225313.3
高血压否93711011.723.077<0.001
是469985618.2
糖尿病否359755615.519.817<0.001
是2 03941020.1
血脂异常否1 82234619.06.4900.011
是381462016.3
体质量指数体重过轻671826.923.321<0.001
体重正常1 68331919.0
超重2 26840818.0
肥胖1 61822113.7
), ArticleFig(id=1320438032201794481, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=CN, label=表2, caption=

南京市不同特征≥40岁脑卒中高危人群颈动脉斑块负担检出情况比较

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特征分类调查例数颈动脉斑块负担检出例数颈动脉斑块负担检出率/%χ2值P值
性别男性3 14657718.37.2310.007
女性2 49038915.6
年龄/岁<501 054615.8392.737<0.001
50～591 6241489.1
60～691 66433820.3
≥701 29441932.4
文化程度小学及以下2 54454021.261.552<0.001
中学/中专/技校2 69639014.5
大专及以上396369.1
居住地城市2 71358121.467.334<0.001
农村2 92338513.2
吸烟情况不吸烟368364317.50.7600.383
吸烟1 95332316.5
饮酒情况不饮酒391573618.824.867<0.001
饮酒1 72123013.4
体力活动充足否2 62344416.90.1560.693
是301352217.3
蔬菜摄入充足否1 32326019.77.6840.006
是431370616.4
水果摄入充足否373471319.129.776<0.001
是1 90225313.3
高血压否93711011.723.077<0.001
是469985618.2
糖尿病否359755615.519.817<0.001
是2 03941020.1
血脂异常否1 82234619.06.4900.011
是381462016.3
体质量指数体重过轻671826.923.321<0.001
体重正常1 68331919.0
超重2 26840818.0
肥胖1 61822113.7
), ArticleFig(id=1320438032285680562, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=EN, label=Tab.3, caption=

Multivariate unconditional logistic regression analysis of influencing factors of carotid plaque in the population with the age ≥ 40 years and high stroke risk in Nanjing

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
年龄/岁50～59<500.6010.11228.661<0.0011.8241.464～2.272
60～691.2890.113131.025<0.0013.6312.912～4.528
≥701.7850.118228.168<0.0015.9624.729～7.516
文化程度中学/中专/技校小学及以下0.0850.0691.5080.2191.0890.951～1.246
大专及以上0.4460.1459.5020.0021.5631.177～2.076
居住地农村城市–0.6380.064100.75<0.0010.5280.467～0.599
吸烟情况吸烟不吸烟0.1970.0747.1660.0071.2181.054～1.406
饮酒情况饮酒不饮酒–0.1850.0775.8410.0160.8310.715～0.966
水果摄入充足是否–0.3530.07224.264<0.0010.7030.610～0.808
高血压是否0.4420.0924.225<0.0011.5561.305～1.856
糖尿病是否0.2590.06316.912<0.0011.2951.145～1.465
体质量指数体重过轻正常体重0.4350.2722.5630.1091.5450.907～2.631
超重–0.0990.0731.8550.1730.9050.785～1.045
肥胖–0.2460.0819.1350.0030.7820.667～0.917
), ArticleFig(id=1320438032386343859, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=CN, label=表3, caption=

南京市≥40岁脑卒中高危人群颈动脉斑块检出情况影响因素多因素非条件logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
年龄/岁50～59<500.6010.11228.661<0.0011.8241.464～2.272
60～691.2890.113131.025<0.0013.6312.912～4.528
≥701.7850.118228.168<0.0015.9624.729～7.516
文化程度中学/中专/技校小学及以下0.0850.0691.5080.2191.0890.951～1.246
大专及以上0.4460.1459.5020.0021.5631.177～2.076
居住地农村城市–0.6380.064100.75<0.0010.5280.467～0.599
吸烟情况吸烟不吸烟0.1970.0747.1660.0071.2181.054～1.406
饮酒情况饮酒不饮酒–0.1850.0775.8410.0160.8310.715～0.966
水果摄入充足是否–0.3530.07224.264<0.0010.7030.610～0.808
高血压是否0.4420.0924.225<0.0011.5561.305～1.856
糖尿病是否0.2590.06316.912<0.0011.2951.145～1.465
体质量指数体重过轻正常体重0.4350.2722.5630.1091.5450.907～2.631
超重–0.0990.0731.8550.1730.9050.785～1.045
肥胖–0.2460.0819.1350.0030.7820.667～0.917
), ArticleFig(id=1320438032474424244, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=EN, label=Tab.4, caption=

Multivariate unconditional logistic regression analysis of influencing factors of carotid plaque burden in the population with the age ≥ 40 years and high stroke risk in Nanjing

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
性别女性男性–0.5280.08736.782<0.0010.5900.497～0.699
年龄/岁50～59<500.4590.1618.1380.0041.5831.155～2.171
60～691.3160.15472.587<0.0013.7272.754～5.045
≥701.9260.157150.542<0.0016.8635.045～9.335
居住地农村城市–0.3780.07823.400<0.0010.6850.588～0.799
饮酒情况饮酒不饮酒–0.3570.09514.122<0.0010.7000.581～0.843
水果摄入充足是否–0.3750.09017.331<0.0010.6880.576～0.820
高血压是否0.3280.1148.2230.0041.3881.109～1.736
糖尿病是否0.2120.0767.7370.0051.2361.065～1.436
体质量指数体重过轻正常体重0.4220.3031.9390.1641.5240.842～2.760
超重–0.0430.0880.2390.6250.9580.807～1.138
肥胖–0.2900.1018.2080.0040.7490.614～0.913
), ArticleFig(id=1320438032554116021, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438024677213050, language=CN, label=表4, caption=

南京市≥40岁脑卒中高危人群颈动脉斑块负担检出情况影响因素多因素非条件logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
性别女性男性–0.5280.08736.782<0.0010.5900.497～0.699
年龄/岁50～59<500.4590.1618.1380.0041.5831.155～2.171
60～691.3160.15472.587<0.0013.7272.754～5.045
≥701.9260.157150.542<0.0016.8635.045～9.335
居住地农村城市–0.3780.07823.400<0.0010.6850.588～0.799
饮酒情况饮酒不饮酒–0.3570.09514.122<0.0010.7000.581～0.843
水果摄入充足是否–0.3750.09017.331<0.0010.6880.576～0.820
高血压是否0.3280.1148.2230.0041.3881.109～1.736
糖尿病是否0.2120.0767.7370.0051.2361.065～1.436
体质量指数体重过轻正常体重0.4220.3031.9390.1641.5240.842～2.760
超重–0.0430.0880.2390.6250.9580.807～1.138
肥胖–0.2900.1018.2080.0040.7490.614～0.913
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2017—2020年南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及影响因素：基于CNSSS数据分析
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戚圣香 1 , 秦真真 1 , 崔岚 2 , 周金意 2 , 洪忻 1, *, *
中国公共卫生 | 专题报道——慢性病预防与控制 2026,42(3): 277-283
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中国公共卫生 |专题报道——慢性病预防与控制 2026 , 42 (3) : 277 -283
2017—2020年南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及影响因素：基于CNSSS数据分析
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戚圣香1, 秦真真1, 崔岚2, 周金意2, 洪忻1, *, *
作者信息
  • 1南京市疾病预防控制中心，南京 210003
  • 2江苏省疾病预防控制中心慢性非传染病防制所，南京 210009
通讯作者:
洪忻，E-mail：
作者简介:

戚圣香（1988—），副主任医师，硕士，研究方向：慢性病预防与控制

Detection rate and influencing factors of carotid plaque and plaque burden in the population with the age ≥ 40 years and high stroke risk from 2017 to 2020 in Nanjing city: based on CNSSS data analysis
Shengxiang QI1, Zhenzhen QIN1, Lan CUI2, Jinyi ZHOU2, Xin HONG1
Affiliations
  • 1Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
  • 2Department of Chronic Non-communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
    • Corresponding Author:
    HONG Xin, E-mail:
出版时间: 2026-03-10 doi: 10.11847/zgggws1146271
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摘要
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目的

了解江苏省南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及其影响因素，为脑卒中的预防控制提供科学依据。

方法

收集中国国家脑卒中高危人群筛查和干预项目（CNSSS）中2017—2020年南京市鼓楼医院和南京市脑科医院2家基地医院在浦口区、高淳区、江宁区和六合区4个区抽取的12个筛查点筛查出的进行了颈动脉超声检查的5 636例≥40岁脑卒中高危人群相关数据，分析其颈动脉斑块和斑块负担检出情况，并应用多因素非条件logistic回归模型分析脑卒中高危人群颈动脉斑块和斑块负担的主要影响因素。

结果

南京市5 636例≥40岁脑卒中高危人群中，检出颈动脉斑块和斑块负担者分别为1 801和966例，检出率分别为32.0%和17.1%。多因素非条件logistic回归分析结果显示，年龄≥50岁、文化程度大专及以上、吸烟、高血压和糖尿病的南京市≥40岁脑卒中高危人群发生颈动脉斑块的风险较高，居住在农村、饮酒、水果摄入充足和肥胖的南京市≥40岁脑卒中高危人群发生颈动脉斑块的风险较低；年龄≥50岁、高血压和糖尿病的南京市≥40岁脑卒中高危人群发生颈动脉斑块负担的风险较高，女性、居住在农村、饮酒、水果摄入充足和肥胖的南京市≥40岁脑卒中高危人群发生颈动脉斑块负担的风险较低。

结论

南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出率相对较低但疾病负担仍较重，年龄、居住地、饮酒情况、是否水果摄入不足、是否患高血压、是否患糖尿病和体质量指数为该地区≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出的共同影响因素。

脑卒中  /  高危人群  /  颈动脉斑块  /  斑块负担  /  检出情况  /  影响因素  /  南京市
Objective

To investigate the detection rate and influencing factors of carotid plaque and plaque burden in a population with the age ≥ 40 years and high stroke risk in Nanjing city, thereby providing evidence for stroke prevention and control.

Methods

As a part of the China National Stroke Screen Survey, the data were collected at 12 screening sites, which were selected from 4 districts (Pukou, Gaochun, Jiangning, and Liuhe) in Nanjing by Nanjing Drum Tower Hospital and Nanjing Brain Hospital from 2017 to 2020. A total of 5 636 residents aged 40 and above who were at high-risk for stroke and underwent ultrasound examination of carotid arteries were included in this study. The detection rates of carotid plaque and plaque burden were analyzed. Multivariate unconditional logistic regression was employed to analyze the influencing factors of carotid plaque and plaque burden.

Results

Among the 5 636 residents included, 1 801 (32.0%) and 966 (17.1%) were detected with carotid plaque and plaque burden, respectively. The results of multivariate unconditional logistic regression showed that age ≥ 50 years, educational background of college degree or above, smoking, hypertension, and diabetes increased the risk of carotid plaque, while living in rural areas, drinking alcohol, sufficient fruit intake, and obesity reduced the risk of carotid plaque. Moreover, age ≥ 50 years, hypertension and diabetes increased the risk of carotid plaque burden, while female, living in rural areas, drinking alcohol, sufficient fruit intake, and obesity reduced the risk of carotid plaque burden.

Conclusions

Although the detection rates of carotid plaque and plaque burden in population aged 40 and above and with high stroke risk in Nanjing were lower than that in other cities, the burden was still heavy. Age, residence, alcohol intake, fruit intake, hypertension, diabetes, and body mass index were the common influencing factors for carotid plaque and plaque burden in this population.

stroke  /  high-risk population  /  carotid plaque  /  plaque burden  /  detection rate  /  influencing factors  /  Nanjing city
戚圣香, 秦真真, 崔岚, 周金意, 洪忻. 2017—2020年南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及影响因素：基于CNSSS数据分析. 中国公共卫生, 2026 , 42 (3) : 277 -283 . DOI: 10.11847/zgggws1146271
Shengxiang QI, Zhenzhen QIN, Lan CUI, Jinyi ZHOU, Xin HONG. Detection rate and influencing factors of carotid plaque and plaque burden in the population with the age ≥ 40 years and high stroke risk from 2017 to 2020 in Nanjing city: based on CNSSS data analysis[J]. Chinese Journal of Public Health, 2026 , 42 (3) : 277 -283 . DOI: 10.11847/zgggws1146271
正文
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全球疾病负担研究结果显示，2021年脑卒中导致了全球725.3万人死亡和1.6亿伤残调整生命年（disability adjusted life years, DALYs）损失，分别较1990年增长了221.9万人和3 905.2万人年[1–2]。脑卒中是中国的居民主要死亡原因，2021年造成我国259.2万人死亡和5 319.1万人年DALYs损失，约占全球疾病负担的1/3，其中缺血性卒中可导致117.7万人死亡和2 343.0万人年DALYs损失[3]。颈动脉粥样硬化是缺血性卒中的主要病因，其病理过程包括早期的内膜增厚和晚期的动脉斑块、狭窄和闭塞，既往研究表明，相较于颈动脉内膜增厚，斑块形成对脑卒中和心脑血管疾病更有预测价值，脑卒中发病风险随着斑块数量的增加明显增加[4–6]。为了解江苏省南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出情况及其影响因素，为脑卒中的预防控制提供科学依据，本研究收集中国国家脑卒中高危人群筛查和干预项目（China National Stroke Screen Survey, CNSSS）中2017—2020年南京市鼓楼医院和南京市脑科医院2家基地医院在浦口区、高淳区、江宁区和六合区4个区抽取的12个筛查点筛查出的进行了颈动脉超声检查的5 636例≥40岁脑卒中高危人群相关数据，分析其颈动脉斑块和斑块负担检出情况，并应用多因素非条件logistic回归模型分析脑卒中高危人群颈动脉斑块和斑块负担的主要影响因素。结果报告如下。
1　资料与方法
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1.1　资料来源
收集CNSSS项目中2017—2020年南京市鼓楼医院和南京市脑科医院2家基地医院在浦口区、高淳区、江宁区和六合区4个区抽取的12个筛查点筛查出的进行了颈动脉超声检查的5 636例≥40岁脑卒中高危人群相关数据，内容包括性别、年龄、文化程度、居住地、吸烟情况、饮酒情况、体力活动是否充足、蔬菜摄入是否充足、水果摄入是否充足、是否高血压、是否糖尿病、是否血脂异常、体质量指数、颈动脉斑块和斑块负担检出情况等。根据《脑卒中筛查与防治技术规范》[7]，脑卒中高危人群指具有高血压、糖尿病、血脂异常、房颤或瓣膜性心脏病、吸烟、运动缺乏、肥胖或脑卒中家族史中 ≥ 3 项危险因素或既往在二级及以上医院明确诊断的短暂性脑缺血发作或脑卒中者；吸烟指连续或累积吸烟≥6个月[7]；饮酒指少量饮酒或经常大量饮酒（白酒≥3次/周且≥2两/次）[7]；体力活动充足指进行中等及以上强度运动（相当于快步走的运动强度）≥3次/周且≥30分钟/次，或从事中度和重度体力劳动（如锯木头、锻造、粉刷、搬运重物、农业劳作等）[7]；蔬菜摄入充足指摄入蔬菜≥5天/周且≥6两/天；水果摄入充足指摄入水果≥5天/周且≥4两/天[7]；高血压指调查对象自报曾在二级及以上医院确诊为高血压或收缩压≥140 mmHg（1 mmHg=0.133 3 kPa）和/或舒张压≥90 mmHg[8]；糖尿病指调查对象自报曾在二级及以上医院确诊为糖尿病或空腹血糖≥7.0 mmol/L[9]；血脂异常指调查对象自报曾在二级及以上医院确诊为血脂异常或具有总胆固醇≥6.22 mmol/L、甘油三酯≥2.26 mmol/L、低密度脂蛋白胆固醇≥4.14 mmol/L和高密度脂蛋白胆固醇<1.04 mmol/L中任意一项者[10]；体质量指数根据高危人群的身高和体重进行计算，即体质量指数=体重（kg）/[身高（m）]2，体质量指数<18.5 kg/m2为体重过轻，18.5～23.9 kg/m2为正常体重，24.0～27.9 kg/m2为超重，≥28.0 kg/m2为肥胖[11]；颈动脉斑块和斑块负担由基地医院接受过国家卫生健康委员会脑卒中防治工程委员会办公室组织的颈部血管超声检查培训且考核合格的超声医生测量筛查对象左右两侧颈总动脉、窦部和颈内动脉共6段血管的内–中膜厚度（intima-media thickness, IMT），颈部左右两侧6段血管中任一部位局限性IMT≥1.5 mm或狭窄≥50%定义为颈动脉斑块形成，颈动脉斑块数量≥2个为颈动脉斑块负担[12]。本研究经首都医科大学附属宣武医院伦理委员会审查批准（批号：临研审〔2015〕24号），且所有调查对象均签署了知情同意书。
1.2　统计分析
应用SPSS 27.0统计软件进行一般描述性分析、χ2检验和多因素非条件logistic回归分析，以P<0.05为差异有统计学意义。
2　结　果
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2.1　一般情况
南京市5 636名≥40岁脑卒中高危人群中，男性3 146人（55.8%），女性2 490人（44.2%）；年龄<50岁1 054人（18.7%），50～59岁1 624人（28.8%），60～69岁1 664人（29.5%），≥70岁1 294人（23.0%）；文化程度小学及以下2 554人（45.1%），中学/中专/技校2 696人（47.8%），大专及以上396人（7.0%）；居住在城市2 713人（48.1%），农村2 923人（51.9%）；不吸烟3 683人（65.3%），吸烟1 953人（34.7%）；不饮酒3 915人（69.5%），饮酒1 721人（30.5%）；体力活动不充足2 623人（46.5%），体力活动充足4 313人（76.5%）；蔬菜摄入不充足1 323例（23.5%），充足4 313例（76.5%）；水果摄入不充足3 734例（66.3%），充足1 902例（33.7%）；非高血压者937人（16.6%），高血压者4 699例（83.4%）；非糖尿病者3 597人（63.8%），糖尿病者2 039例（36.2%）；非血脂异常者1 822人（32.3%），血脂异常者3 814例（67.7%）；体重过轻67人（1.2%），正常体重1 683人（29.9%），超重2 268人（40.2%），肥胖1 618例（28.7%）。
2.2　南京市≥40岁脑卒中高危人群颈动脉斑块检出情况（表1）
南京市5 636例≥40岁脑卒中高危人群中，检出颈动脉斑块者1 801例，颈动脉斑块检出率为32.0%；南京市不同特征≥40岁脑卒中高危人群比较，不同年龄、文化程度、居住地、吸烟情况、饮酒情况、体质量指数以及蔬菜摄入是否充足、水果摄入是否充足、是否高血压、是否糖尿病和是否血脂异常≥40岁脑卒中高危人群颈动脉斑块检出率不同，差异均有统计学意义（均P<0.05）。
2.3　南京市≥40岁脑卒中高危人群颈动脉斑块负担检出情况（表2）
南京市5 636名≥40岁脑卒中高危人群中，检出颈动脉斑块负担者966例，颈动脉斑块负担检出率为17.1%；南京市不同特征≥40岁脑卒中高危人群比较，不同性别、年龄、文化程度、居住地、饮酒情况、体质量指数以及蔬菜摄入是否充足、水果摄入是否充足、是否高血压、是否糖尿病和是否血脂异常≥40岁脑卒中高危人群颈动脉斑块负担检出率不同，差异均有统计学意义（均P<0.05）。
2.4　南京市≥40岁脑卒中高危人群颈动脉斑块检出情况影响因素多因素非条件logistic回归分析（表3）
以南京市≥40岁脑卒中高危人群是否检出颈动脉斑块为因变量（0=否，1=是），以年龄、文化程度、居住地、吸烟情况、饮酒情况、蔬菜摄入是否充足、水果摄入是否充足、是否高血压、是否糖尿病、是否血脂异常和体质量指数共11个因素为自变量进行多因素非条件logistic回归分析。结果显示，年龄≥50岁、文化程度大专及以上、吸烟、高血压和糖尿病南京市≥40岁脑卒中高危人群发生颈动脉斑块的风险较高；居住在农村、饮酒、水果摄入充足和肥胖南京市≥40岁脑卒中高危人群发生颈动脉斑块的风险较低。
2.5　南京市≥40岁脑卒中高危人群颈动脉斑块负担检出情况影响因素多因素非条件logistic回归分析（表4）
以南京市≥40岁脑卒中高危人群是否检出颈动脉斑块负担为因变量（0=否，1=是），以性别、年龄、文化程度、居住地、饮酒情况、蔬菜摄入是否充足、水果摄入是否充足、是否高血压、是否糖尿病、是否血脂异常和体质量指数共11个因素为自变量进行多因素非条件logistic回归分析。结果显示，年龄≥50岁、高血压和糖尿病南京市≥40岁脑卒中高危人群发生颈动脉斑块负担的风险较高；女性、居住在农村、饮酒、水果摄入充足和肥胖南京市≥40岁脑卒中高危人群发生颈动脉斑块负担的风险较低。
3　讨　论
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本研究结果显示，南京市≥40岁脑卒中高危人群颈动脉斑块检出率为32.0%，低于江苏省苏州市脑卒中高危人群颈动脉斑块检出率的39.3%[13]；南京市≥40岁脑卒中高危人群颈动脉斑块负担检出率为17.1%，低于天津市脑卒中高危人群颈动脉斑块负担检出率的20.1%[14]和江苏省6个市心血管病高危人群颈动脉斑块负担检出率的21.3%[15]。提示南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出率虽低于其他地区，但疾病负担仍然较重。
与既往研究[16–18]结果一致，本研究发现，年龄≥50岁、高血压和糖尿病南京市≥40岁脑卒中高危人群发生颈动脉斑块和斑块负担的风险较高。一项纳入全球59项研究的meta分析结果显示，无论男性还是女性，颈动脉内膜厚度、斑块和狭窄的患病率均随着年龄的增长呈上升趋势[17]。Fu J Z等[19]对2017—2022年中国31个省（自治区、直辖市）10 772 091名成年人体检数据的分析结果显示，颈动脉内膜厚度、斑块和狭窄患病率分别从20～29岁的3.4%、2.9%和0.2%增长到≥80岁的92.7%、87.3%和3.9%。考虑到我国人口老龄化趋势，颈动脉粥样硬化相关疾病负担更加沉重，因此，对于高血压和糖尿病等动脉粥样硬化可改变的代谢危险因素，应进行综合管理。本研究还发现，与不吸烟组相比，吸烟组颈动脉斑块检出率较高。顾亦斌等[20]研究表明，曾经吸烟和现在吸烟者颈动脉异常风险分别为不吸烟者的1.195和1.391倍；Song P G等[17]研究亦表明，曾经吸烟和现在吸烟者颈动脉斑块风险分别为不吸烟者的1.58和1.70倍。提示不吸烟和戒烟均可以降低颈动脉斑块的发生风险。值得注意的是，本研究多因素logistic分析结果显示，文化程度大专及以上组颈动脉斑块检出率较文化程度小学及以下组高（OR=1.563，95%CI=1.177～2.076），与相关研究[15]结果不一致，具体原因尚有待进一步探讨。
中国慢性病前瞻性研究结果显示，居住在农村和城市居民的颈动脉斑块检出率分别为43%和49%[21]。田小草等[22]研究显示，增加水果摄入频率能降低脑卒中的发病风险，提示颈动脉斑块可能是水果摄入与脑卒中关系的中间机制之一。毕媛等[15]研究表明，体质量指数每增加1个标准差，斑块和斑块负担的患病风险分别降低5.2%和11.0%；Song P G等[17]研究发现，体质量指数每增加1个标准差，可降低3%的颈动脉斑块发生风险；Fu J Z等[19]研究亦表明，体重过轻会增加颈动脉狭窄风险，而超重和肥胖则可分别降低8%和18%的颈动脉狭窄。本研究结果也显示，居住在农村、水果摄入充足和肥胖南京市≥40岁脑卒中高危人群发生颈动脉斑块和斑块负担的风险较低。周锦辉等[23]研究结果显示，高龄老年人体质量指数水平较低，且随年龄增加总体呈下降趋势。因此，高龄老年人应维持体重以降低颈动脉斑块和斑块负担的发生风险。此外，有研究表明，饮酒与颈动脉斑块和斑块负担均呈J型关系；与不饮酒者相比，偶尔饮酒者颈动脉斑块和斑块负担发生风险较低，而戒酒和每周饮酒者颈动脉斑块和斑块负担发生风险则较高，且每周饮酒者中存在酒精摄入量和颈动脉斑块发生的剂量–反应关系[24]。本研究中，饮酒可降低颈动脉斑块发生和斑块负担的检出风险，可能与本研究未进一步区分偶尔饮酒、戒酒和每周饮酒有关。与Song P G等[17]研究结果一致，本研究发现南京市≥40岁女性脑卒中高危人群颈动脉斑块负担检出率较低，这可能与女性的生活和饮食习惯较好有关。
综上所述，南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出率相对较低但疾病负担仍较重，年龄、居住地、饮酒情况、是否水果摄入不足、是否高血压、是否糖尿病和体质量指数为南京市≥40岁脑卒中高危人群颈动脉斑块和斑块负担检出的共同影响因素。早期危险因素精准识别和积极干预有助于预防颈动脉粥样硬化的进展，从而实现脑卒中防控“减少百万新发残疾工程”的目标[25]。本研究主要采用社区招募的方式获取对象，健康意识高或者行动便利者更容易参加调查，因此难以避免志愿者偏倚，但筛查对象覆盖筛查点≥40岁常住人口的>85%，结果仍具可靠性。此外，本研究仅考虑了颈动脉斑块的数量，而忽略了斑块体积和稳定性对心血管疾病风险的影响，因此在后续研究中应进一步加以完善。

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2026年第42卷第3期
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doi: 10.11847/zgggws1146271
  • 接收时间：2024-10-28
  • 首发时间：2026-10-23
  • 出版时间：2026-03-10
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  • 收稿日期：2024-10-28
  • 修回日期：2025-01-02
  • 录用日期：2025-10-13
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    1南京市疾病预防控制中心，南京 210003
    2江苏省疾病预防控制中心慢性非传染病防制所，南京 210009

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洪忻，E-mail：
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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