Kitamura Akihiko, Nakagawa Yuko, Sato Minoru, Iso Hiroyasu, Sato Shinichi, Imano Hironori, Kiyama Masahiko, Okada Takeo, Okada Hiroshi, Iida Minoru, Shimamoto Takashi
Osaka Medical Center for Health Science and Promotion, Osaka, Japan.
Stroke. 2006 Jun;37(6):1374-8. doi: 10.1161/01.STR.0000221714.96986.5f. Epub 2006 May 11.
Higher proportions of hemorrhagic stroke and lacunar infarction were reported in rural Japan compared with those in Western countries. We examined the relative proportions of stroke subtypes in an urban Japanese city where westernized lifestyles are more common than in rural areas.
Stroke registration was performed in 1992, 1997, and 2002 for residents > or =40 years of age who were admitted with acute strokes to all of the 10 hospitals with > or =90 beds in Yao City, Osaka, Japan. Strokes were classified as intraparenchymal hemorrhage, subarachnoid hemorrhage, or ischemic strokes (embolic infarction, large-artery occlusive infarction, lacunar infarction, and unclassified thrombotic infarction) by criteria using computed tomography or MRI.
A total of 650 first-ever strokes were registered. The age-adjusted proportion of each stroke subtype was not significantly different among the 3 study periods in both men and women. Throughout the 3 periods, intraparenchymal hemorrhage, subarachnoid hemorrhage, and ischemic stroke accounted for 26%, 7%, and 65% in men, respectively. In women, the respective proportions were 29%, 21%, and 44%. The proportion of each subtype for total ischemic strokes was as follows: 51% to 61% lacunar infarction, 25% to 26% large-artery occlusive infarction, and 11% to 17% embolic infarction.
Our study showed that hemorrhagic stroke represented a large proportion of all strokes, especially among women, and lacunar infarction was the most common subtype of ischemic stroke among both men and women in Yao City, which differed from findings in Western countries.
与西方国家相比，日本农村地区出血性卒中及腔隙性梗死的比例更高。我们对日本一个城市的卒中亚型相对比例进行了研究，该城市的生活方式比农村地区更为西化。
1992年、1997年和2002年，对日本大阪八尾市所有拥有90张及以上床位的10家医院收治的40岁及以上急性卒中患者进行卒中登记。根据计算机断层扫描或磁共振成像标准，将卒中分为脑实质内出血、蛛网膜下腔出血或缺血性卒中（栓塞性梗死、大动脉闭塞性梗死、腔隙性梗死和未分类的血栓性梗死）。
共登记了650例首发卒中。在男性和女性中，各卒中亚型的年龄调整比例在3个研究期间无显著差异。在这3个时期，男性脑实质内出血、蛛网膜下腔出血和缺血性卒中分别占26%、7%和65%。在女性中，相应比例分别为29%、21%和44%。总缺血性卒中各亚型的比例如下：腔隙性梗死占51%至61%，大动脉闭塞性梗死占25%至26%，栓塞性梗死占11%至17%。
我们的研究表明，出血性卒中在所有卒中中占很大比例，尤其是在女性中，腔隙性梗死是八尾市男性和女性缺血性卒中最常见的亚型，这与西方国家的研究结果不同。
