Flynn R W V, MacWalter R S M, Doney A S F
Stroke Studies Centre, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
Neuropharmacology. 2008 Sep;55(3):250-6. doi: 10.1016/j.neuropharm.2008.05.031. Epub 2008 Jun 5.
Cerebral ischaemia is a major cause of disability and death globally and has a profoundly negative impact on the individuals it affects, those that care for them and society as a whole. The most common and familiar manifestation is stroke, 85% of which are ischaemic and which is the second leading cause of death and most common cause of complex chronic disability worldwide. Stroke survivors often suffer from long-term neurological disabilities significantly reducing their ability to integrate effectively in society with all the financial and social consequences that this implies. These difficulties cascade to their next of kin who often become caregivers and are thus indirectly burdened. A more insidious consequence of cerebral ischaemia is progressive cognitive impairment causing dementia which although less abrupt is also associated with a significant long-term disability. Globally cerebrovascular diseases are responsible for 5.4 million deaths every year (1 in 10 of total). Approximately 3% of total healthcare expenditure is attributable to cerebral ischaemia with cerebrovascular diseases costing EU healthcare systems 21 billion euro in 2003. The cost to the wider economy (including informal care and lost productivity) is even greater with stroke costing the UK 7-8 billion pound in 2005 and the US $62.7 billion in 2007. Cerebrovascular disease cost the EU 34 billion euro in 2003. From 2005 to 2050 the anticipated cost of stroke to the US economy is estimated at $2.2 trillion. Given the global scale of the problem and the enormous associated costs it is clear that there is an urgent need for advances in the prevention of cerebral ischaemia and its consequences. Such developments would result in profound benefits for both individuals and their wider societies and address one of the world's most pre-eminent public health issues.
脑缺血是全球致残和致死的主要原因，对其影响的个体、照顾他们的人以及整个社会都产生了极其负面的影响。最常见且为人熟知的表现是中风，其中85%为缺血性中风，它是全球第二大致死原因和最常见的复杂慢性残疾原因。中风幸存者常常患有长期神经功能残疾，这显著降低了他们有效融入社会的能力，并带来了所有相关的经济和社会后果。这些困难会波及他们的近亲，这些近亲往往成为照顾者，从而间接承受负担。脑缺血更隐匿的后果是导致痴呆的进行性认知障碍，尽管其发病不那么突然，但也与严重的长期残疾相关。全球范围内，脑血管疾病每年导致540万人死亡（占总死亡人数的十分之一）。医疗总支出中约3%归因于脑缺血，2003年脑血管疾病给欧盟医疗系统造成了210亿欧元的损失。对更广泛经济的成本（包括非正式护理和生产力损失）甚至更高，2005年中风给英国造成了70 - 80亿英镑的损失，2007年给美国造成了627亿美元的损失。2003年，脑血管疾病给欧盟造成了340亿欧元的损失。从2005年到2050年，预计中风给美国经济造成的成本估计为2.2万亿美元。鉴于该问题的全球规模以及巨大的相关成本，显然迫切需要在预防脑缺血及其后果方面取得进展。这样的进展将给个人及其更广泛的社会带来深远益处，并解决世界上最突出的公共卫生问题之一。
