上海城市居民5年脑卒中发病与死亡监测

Surveillance of Stroke Incidence and Case Fatality in Shanghai,China

目的 分析上海市区居民人群脑卒中发病与死亡的监测结果。方法 在上海市 2个区 3个街道以居委会为单位整群抽样选取社区人群 9万余人进行的脑卒中疾病监测。结果 5年共发现脑卒中 967例 [平均年龄为( 72 .5 6± 9.3 9)岁 ]。发作类型依次为脑梗死 649例 ( 67.1% ) ,脑出血 2 88例 ( 2 9.8% ) ,蛛网膜下腔出血 9例 ( 0 .9% ) ,未分类脑卒中 2 1例 ( 2 .2 % )。 5年脑卒中年均发病率为 2 12 .3 10万 ,按照 1998年WHO世界标准人口计算年龄标化发病率为 12 9.7 10万。男性与女性的发病率均随着年龄的增大而升高。其中 2 8d内脑卒中总死亡 3 3 4例 ,病死率为 3 4 .5 % ;男性病死率为 3 5 .9% ,女性为 3 3 .1% ,两性之间无明显差别。脑梗死 2 8d病死率为 2 1.3 % ,脑出血为 5 9.7%。首次脑卒中 2 8d病死率为 3 1.5 % ,复发性脑卒中病死率为 4 1.5 %。结论 上海地区城市居民脑卒中发病与世界上其他研究相比居中等偏高水平 ,脑梗死的比例相对较低 ,而脑出血的比例则较高。

Purpose: To analysis the stroke incidence and case fatality by surveillance in Shanghai. Methods: Community-based study was implemented over 90 000 urban residents in Shanghai during 1996 to 2000. Results: A total of 967 stroke events[mean age, (72.56 ± 9.39) years] were registered during 5 years. 92.8 percent patients were scanned by CT, the numbers of cerebral infarction was 649(67.1%), followed by intracerebral hemorrhage 288 (29.8%), subarachnoid hemorrhage 9(0.9%), and unspecified stroke 21(2.2%). The annual average stroke incidence was 212.3/100 000 in five years,age standardized to the 1998 WHO world standard population, the stroke incidence was 129.7/100 000. The stroke incidence increased with aging in both men and women. 334 fatal events died within 28 days, case fatality rates was 34.5%, for men it was 35.9 %, and women 33.1%, there were no significant difference between them. Patients with intracerebral hemorrhage had a higher case fatality rates(59.7%), compared with 21.3% for those with cerebral infarction. The case fatality rates for first-ever stroke was 31.5%, and for recurrent stroke it was 41.5 %. Conclusions: The incidence of stroke in our population-based study rank middle or higher part compared other studies in the world, the proportion of cerebral infarction was higher than that of other studies, on the contrary, the intracerebral hemorrhage was lower.