Deschamps R, Olindo S, Cabre P, Elysée S, Fournerie P, Smadja D
Service de Neurologie, CHU Fort de France, Martinique.
Rev Neurol (Paris). 2004 Mar;160(3):313-9. doi: 10.1016/s0035-3787(04)70906-6.
Few data are available regarding stroke among young black patients. We have conducted, in Martinique, a prospective study among young Afro-Caribbeans aged 15 to 45 Years, from June 1994 through May 1999. We identified 60 cerebral infarcts (CI) and 20 cases of intracerebral hemorrhage (ICH). Annual incidence and case fatality rate at 30 days were 7.6/100000/Year (95p.cent confidence interval, 3.13 to 11.35) and 8.3p.cent respectively for CI, and 2.42/100000/Year (95p.cent confidence interval, 0.06 to 4.7) and 25p.cent for ICH. Hypertension was the most prevalent stroke risk factor: 35p.cent in CI and 68p.cent in ICH. According to the TOAST criteria, a probable cause of ischemic stroke was identified in 61.3p.cent. Atherosclerosis, lacunar infarcts and cardioembolism were the main causes of CI (13.3p.cent for each etiology). Spontaneous cervical arterial dissection was found in only 6.7p.cent. Hypertensive ICH (60p.cent) was the most common subtype of ICH. In Martinique, high frequencies of ICH and lacunar infarcts are characteristic of stroke in young Afro-Carribeans. These suggest the role of the high prevalence of hypertension in the black population. We confirm the heterogeneity of stroke etiologies and the low prevalence of cervical arterial dissection in black people.
关于年轻黑人患者中风的可用数据很少。1994年6月至1999年5月，我们在马提尼克岛对15至45岁的年轻非洲加勒比人进行了一项前瞻性研究。我们确定了60例脑梗死（CI）和20例脑出血（ICH）病例。CI的年发病率和30天病死率分别为7.6/100000/年（95%置信区间，3.13至11.35）和8.3%，ICH的年发病率和30天病死率分别为2.42/100000/年（95%置信区间，0.06至4.7）和25%。高血压是最常见的中风危险因素：CI患者中占35%，ICH患者中占68%。根据TOAST标准，61.3%的缺血性中风可能病因得以确定。动脉粥样硬化、腔隙性梗死和心源性栓塞是CI的主要病因（每种病因各占13.3%）。仅6.7%的患者发现自发性颈内动脉夹层。高血压性ICH（60%）是ICH最常见的亚型。在马提尼克岛，ICH和腔隙性梗死的高发生率是年轻非洲加勒比人中风的特征。这些表明高血压在黑人人群中的高患病率所起的作用。我们证实了中风病因的异质性以及黑人中颈内动脉夹层的低患病率。
