Gusev E I, Zavalishin I A, Boĭko A N, Khoroshilova N L, Iakovlev A P
Zh Nevrol Psikhiatr Im S S Korsakova. 2002;Suppl:3-6.
An increase in multiple sclerosis (MS) frequency was registered in several countries including Russia. This may be associated with better MS diagnosis and treatment, better data collection and real increase in MS incidence. Previous local studies sometimes were based on mainly hospital cases, so the real prevalence was underestimated. Several population-based studies showed that Russia is in the zone of medium MS risk. In 1999-2000, 24 local medical committees collected the "official" data on the number of resident MS patients, which varied greatly. Statistical analyses showed a significant negative association (R = -0.68) between estimated level of MS prevalence and the percent of severe cases among these MS patients. It is proposed that in several regions the number of mild MS cases had been underestimated and thus the percent of severe cases was high. Using the rates, received in large population-based studies in different countries, we re-calculated the data using the 33% rate of severe MS cases as a model. The calculated "model" indexes using "official" data in two Russian cities Moscow and Orel (40.8 and 64.8 cases per 100,000 of population) were very close to what had been found in these populations in population-based epidemiological studies (37.8 and 66.1 cases, respectively). Recalculation of the "official" data from all 24 regions showed, that the "model" MS prevalence in different regions of Russia varied from 35 till 70 cases per 100,000 of population, which seems real taking into consideration the geographical factor and the ethnic origin of these populations (percents of European residents). These "model" numbers may be used before the already started all-over-country epidemiological study will be finished.
包括俄罗斯在内的几个国家都出现了多发性硬化症(MS)发病率上升的情况。这可能与MS诊断和治疗水平的提高、数据收集的改善以及MS发病率的实际上升有关。以往的局部研究有时主要基于医院病例,因此实际患病率被低估了。几项基于人群的研究表明,俄罗斯处于MS中等风险区域。1999 - 2000年,24个地方医学委员会收集了常住MS患者数量的“官方”数据,这些数据差异很大。统计分析表明,MS患病率的估计水平与这些MS患者中重症病例的百分比之间存在显著的负相关(R = -0.68)。有人提出,在几个地区,轻度MS病例的数量被低估了,因此重症病例的百分比很高。利用在不同国家大规模基于人群的研究中获得的发病率,我们以33%的重症MS病例率为模型重新计算了数据。使用莫斯科和奥廖尔这两个俄罗斯城市的“官方”数据计算出的“模型”指标(每10万人口中分别为40.8例和64.8例)与在这些人群中基于人群的流行病学研究中发现的结果(分别为37.8例和66.1例)非常接近。对所有24个地区的“官方”数据进行重新计算表明,俄罗斯不同地区的“模型”MS患病率从每10万人口35例到70例不等,考虑到这些人群的地理因素和种族起源(欧洲居民的百分比),这似乎是合理的。在全国范围内已经启动的流行病学研究完成之前,可以使用这些“模型”数字。