Heaney Dominic C, MacDonald Bridget K, Everitt Alex, Stevenson Simon, Leonardi Giovanni S, Wilkinson Paul, Sander Josemir W
Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London WC1N 3BG.
BMJ. 2002 Nov 2;325(7371):1013-6. doi: 10.1136/bmj.325.7371.1013.
To determine the incidence of epilepsy in a general practice population and its variation with socioeconomic deprivation.
Prospective surveillance for new cases over an 18 or 24 month period.
All patients on practice registers categorised for deprivation with the Carstairs score of their postcode.
20 general practices in London and south east England.
Confirmed diagnosis of epilepsy.
190 new cases of epilepsy were identified during 369 283 person years of observation (crude incidence 51.5 (95% confidence interval 44.4 to 59.3) per 100 000 per year). The incidence was 190 (138 to 262) per 100 000 in children aged 0-4 years, 30.8 (21.3 to 44.6) in those aged 45-64 years, and 58.7 (42.5 to 81.0) in those aged > or =65 years. There was no apparent difference in incidence between males and females. The incidence showed a strong association with socioeconomic deprivation, the age and sex adjusted incidence in the most deprived fifth of the study population being 2.33 (1.46 to 3.72) times that in the least deprived fifth (P=0.001 for trend across fifths). Adjustment for area (London v outside London) weakened the association with deprivation (rate ratio 1.62 (0.91 to 2.88), P=0.12 for trend).
The incidence of epilepsy seems to increase with socioeconomic deprivation, though the association may be confounded by other factors.
确定普通人群中癫痫的发病率及其与社会经济剥夺状况的差异。
对18或24个月期间的新病例进行前瞻性监测。
根据其邮政编码的卡斯尔斯评分按剥夺状况分类的诊所登记册上的所有患者。
伦敦和英格兰东南部的20家普通诊所。
确诊的癫痫诊断。
在369283人年的观察期内，共识别出190例癫痫新病例（粗发病率为每年每10万人51.5例（95%置信区间44.4至59.3））。0至4岁儿童的发病率为每10万人190例（138至262），45至64岁人群为30.8例（21.3至44.6），65岁及以上人群为58.7例（42.5至81.0）。男性和女性的发病率没有明显差异。发病率与社会经济剥夺状况密切相关，研究人群中最贫困五分之一人群经年龄和性别调整后的发病率是最不贫困五分之一人群的2.33倍（1.46至3.72）（五分之一人群间趋势的P = 0.001）。对地区（伦敦与伦敦以外地区）进行调整后，与剥夺状况的关联减弱（率比1.62（0.91至2.88），趋势的P = 0.12）。
癫痫的发病率似乎随着社会经济剥夺状况的增加而上升，尽管这种关联可能受到其他因素的混淆。
