Saposnik Gustavo, Del Brutto Oscar H
Stroke Unit, Department of Neurology, Ramos Mejia Hospital, Buenos Aires University, Argentina.
Stroke. 2003 Sep;34(9):2103-7. doi: 10.1161/01.STR.0000088063.74250.DB. Epub 2003 Aug 7.
Stroke is a leading cause of mortality and disability in South America because of an increase in life expectancy and changes in the lifestyle of the population. Because epidemiological and clinical characteristics of stroke vary according to regional factors, we need to know the peculiarities of stroke on this continent.
We performed a systematic review of articles on stroke in South America, with emphasis on those providing information on the incidence and prevalence of stroke (community-based studies) and the pattern of stroke subtypes (hospital-based studies).
Seven papers provided information on stroke epidemiology; 11 gave data on the pattern of stroke subtypes. Community-based studies showed crude stroke prevalence rates ranging from 1.74 to 6.51 per 1000 and annual incidence rates from 0.35 to 1.83 per 1000. Hospital-based stroke registries consistently reported a high frequency of intracranial hemorrhages, which accounted for 26% to 46% of all strokes. Among patients with cerebral infarctions, intracranial atherosclerotic lesions and small-vessel disease have been common pathogenic mechanisms underlying the stroke. In most studies, hypertensive arteriolopathy was the most common cause of both infarctions and hemorrhages.
Stroke has been poorly studied in South America. Available data suggest that the prevalence and incidence of stroke are lower than in developing countries. The pattern of stroke subtypes seems to be different from that reported in other regions of the world, with a higher frequency of cerebral hemorrhages, small-vessel disease, and intracranial atherosclerotic lesions. Such differences may be related to genetic, environmental, or sociocultural factors and to differences in the control of stroke risk factors.
由于预期寿命的增加和人口生活方式的改变，中风是南美洲死亡和残疾的主要原因。由于中风的流行病学和临床特征因地区因素而异，我们需要了解该大陆中风的特点。
我们对南美洲有关中风的文章进行了系统综述，重点关注那些提供中风发病率和患病率信息的文章（基于社区的研究）以及中风亚型模式的文章（基于医院的研究）。
七篇论文提供了中风流行病学信息；11篇给出了中风亚型模式的数据。基于社区的研究显示，粗中风患病率为每1000人中有1.74至6.51例，年发病率为每1000人中有0.35至1.83例。基于医院的中风登记处一直报告颅内出血的频率很高，占所有中风的26%至46%。在脑梗死患者中，颅内动脉粥样硬化病变和小血管疾病是中风的常见致病机制。在大多数研究中，高血压性小动脉硬化是梗死和出血的最常见原因。
南美洲对中风的研究较少。现有数据表明，中风的患病率和发病率低于发展中国家。中风亚型模式似乎与世界其他地区报告的不同，脑出血、小血管疾病和颅内动脉粥样硬化病变的频率更高。这些差异可能与遗传、环境或社会文化因素以及中风危险因素控制的差异有关。
