Benatru Isabelle, Rouaud Olivier, Durier Jérôme, Contegal Fabienne, Couvreur Grégory, Bejot Yannick, Osseby Guy Victor, Ben Salem Douraïeb, Ricolfi Frédéric, Moreau Thibault, Giroud Maurice
Stroke Registry of Dijon (Inserm and Institut de Veille Sanitaire), Faculty of Medicine and University Hospital of Dijon, France.
Stroke. 2006 Jul;37(7):1674-9. doi: 10.1161/01.STR.0000226979.56456.a8. Epub 2006 May 25.
With the progress in stroke prevention, it is important to evaluate the epidemiological trends of strokes over a long period and from a nonselected population-based perspective.
We estimated changes in incidence, case-fatality rates, severity, risk factors and prestroke use of preventive treatments for first-ever strokes, from a continuous 20-year well-defined population-based registry, from 1985 to 2004.
We recorded 3142 ischemic strokes, 341 primary cerebral hemorrhages and 74 subarachnoid hemorrhages. During the 20-year study, the age at first stroke onset increased by 5 years in men and 8 years in women. Comparing the 1985 to 1989 and the 2000 to 2004 periods, age- and sex-standardized incidences of first-ever strokes were stable except for lacunar strokes whose incidence significantly increased (P=0.01) and for cardioembolic stroke whose incidence significantly decreased (P=0.01). Twenty-eight-day case-fatality rates decreased significantly mainly for lacunar strokes (P=0.05) and for primary cerebral hemorrhages (P=0.03). The proportion of hypercholesterolemia and diabetes significantly increased (P<0.01). In contrast, the proportion of myocardial infarction significantly decreased (P=0.02). Prestroke antiplatelets and anticoagulants treatment significantly increased (P<0.01).
The age- and sex-standardized incidences of first strokes in Dijon have been stable over the past 20 years and were associated with an increase in age at stroke onset, a decrease in case-fatality rates, and an increased use of antiplatelet treatments.
随着中风预防领域的进展，从长期且基于未选定人群的角度评估中风的流行病学趋势十分重要。
我们从1985年至2004年一个连续20年定义明确的基于人群的登记系统中，估算首次中风的发病率、病死率、严重程度、危险因素以及中风前预防性治疗的使用情况的变化。
我们记录了3142例缺血性中风、341例原发性脑出血和74例蛛网膜下腔出血。在20年的研究期间，男性首次中风发病年龄增加了5岁，女性增加了8岁。比较1985年至1989年和2000年至2004年这两个时期，除腔隙性中风发病率显著增加（P=0.01）和心源性栓塞性中风发病率显著下降（P=0.01）外，年龄和性别标准化的首次中风发病率保持稳定。28天病死率主要在腔隙性中风（P=0.05）和原发性脑出血（P=0.03）中显著下降。高胆固醇血症和糖尿病的比例显著增加（P<0.01）。相比之下，心肌梗死的比例显著下降（P=0.02）。中风前抗血小板和抗凝治疗显著增加（P<0.01）。
在过去20年里，第戎地区年龄和性别标准化的首次中风发病率保持稳定，且与中风发病年龄增加、病死率下降以及抗血小板治疗使用增加有关。
