Zhang Lin-Feng, Yang Jun, Hong Zhen, Yuan Guang-Gu, Zhou Bei-Fan, Zhao Lian-Cheng, Huang Yi-Ning, Chen Jie, Wu Yang-Feng
Department of Epidemiology, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei Li Shi Rd 167, Beijing, 100037, People's Republic of China.
Stroke. 2003 Sep;34(9):2091-6. doi: 10.1161/01.STR.0000087149.42294.8C. Epub 2003 Aug 7.
The goal of this article is to clarify the proportion of stroke subtypes in China, where stoke is the most common cause of death.
A total of 16,031 first-ever strokes in subjects >or=25 years of age were identified in 1991 to 2000 from 17 Chinese populations through a community-based cardiovascular disease surveillance program in the China Multicenter Collaborative Study of Cardiovascular Epidemiology. World Health Organization diagnosis criteria were used for classification of stroke subtypes.
CT scan rate of stroke cases reached a satisfactorily high level only after 1996 in the study populations. In 8268 first-ever stroke events from 10 populations with CT scan rate >75% in 1996 to 2000, 1.8% were subarachnoid hemorrhage, 27.5% were intracerebral hemorrhage, 62.4% were cerebral infarction, and 8.3% were undetermined stroke. The proportion of intracerebral hemorrhage varied from 17.1% to 39.4% and that for cerebral infarction varied from 45.5% to 75.9% from population to population. The ratio of ischemic to hemorrhagic stroke ranged from 1.1 to 3.9 and averaged 2.0). The 28-day fatality rate was 33.3% for subarachnoid hemorrhage, 49.4% for intracerebral hemorrhage, 16.9% for cerebral infarction, and 64.6% for undetermined stroke.
In our study, ischemic stroke was more frequent and its proportion was higher than hemorrhagic stroke in Chinese populations. Although hemorrhagic stroke was more frequent in Chinese than in Western populations, the variation in the proportion of stroke subtypes among Chinese populations could be as large as or larger than that between Chinese and Western populations.
本文旨在明确在中国（卒中是最常见死因）卒中亚型的比例。
1991年至2000年期间，通过中国心血管病流行病学多中心协作研究中的社区心血管病监测项目，在17个中国人群中识别出16031例年龄≥25岁的首发卒中患者。采用世界卫生组织的诊断标准对卒中亚型进行分类。
研究人群中卒中病例的CT扫描率在1996年后才达到较高水平。在1996年至2000年CT扫描率>75%的10个群体的8268例首发卒中事件中，蛛网膜下腔出血占1.8%，脑出血占27.5%，脑梗死占62.4%，未定型卒中占8.3%。脑出血比例在不同群体间从17.1%至39.4%不等，脑梗死比例从45.5%至75.9%不等。缺血性卒中与出血性卒中的比例在1.1至3.9之间，平均为2.0。蛛网膜下腔出血的28天病死率为33.3%，脑出血为49.4%，脑梗死为16.9%，未定型卒中为64.6%。
在我们的研究中，中国人群中缺血性卒中更为常见，其比例高于出血性卒中。尽管中国人群中出血性卒中比西方人群更常见，但中国人群中卒中亚型比例的差异可能与中国和西方人群之间的差异一样大或更大。
