North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear.
S Afr Med J. 2011 May;101(5):338-44. doi: 10.7196/samj.4511.
We aimed to establish the pathological types of stroke in two incident populations in Tanzania, one rural and one urban, and to examine the clinical utility of the Siriraj and Allen scores in identifying stroke sub-types.
This prospective community-based study identified cases as part of a stroke incidence study. Each patient underwent a full assessment including recording demographic information, taking a medical and drug history, and physical examination. A computed tomography (CT) head scan was used to classify strokes as resulting from a cerebral haemorrhage or ischaemia. The results were compared with the Siriraj and Allen scores, obtained from clinical findings.
One hundred and thirty-two incident stroke cases were identified in the rural Hai demographic surveillance site (DSS) and 69 in the urban Dar-es-Salaam DSS; 63 patients with stroke due to ischaemia or cerebral haemorrhage from Hai and 17 from Dares-Salaam had a CT scan within 15 days of the stroke. Stroke was identified as due to ischaemia in 52 cases (82.5%) and to cerebral haemorrhage in 11 (17.5%) in Hai, and as due to ischaemia in 14 cases (82.4%) and to cerebral haemorrhage in 3 (17.6%) in Dar-es-Salaam. In both sites Siriraj and Allen scores were found to be of little value in predicting stroke sub-type.
The ratio of ischaemic to haemorrhagic stroke is much higher in our cohort than previously reported in sub-Saharan Africa, and is closer to that in high-income countries.
我们旨在确定坦桑尼亚两个发病群体（一个农村群体和一个城市群体）的中风病理类型，并检验 Siriraj 和 Allen 评分在确定中风亚型方面的临床应用价值。
这项前瞻性基于社区的研究确定了病例作为中风发病率研究的一部分。每位患者都接受了全面评估，包括记录人口统计学信息、采集医疗和药物史以及体格检查。头颅计算机断层扫描（CT）用于将中风分类为脑溢血或缺血性中风。结果与从临床发现中获得的 Siriraj 和 Allen 评分进行了比较。
在农村 Hai 人口监测点（DSS）中发现了 132 例新发中风病例，在城市达累斯萨拉姆 DSS 中发现了 69 例；Hai 有 63 例因缺血或脑溢血引起的中风患者和 17 例来自 Dares-Salaam 的中风患者在中风后 15 天内进行了 CT 扫描。在 Hai，中风被确定为缺血性中风 52 例（82.5%），脑溢血 11 例（17.5%）；在达累斯萨拉姆，中风被确定为缺血性中风 14 例（82.4%），脑溢血 3 例（17.6%）。在两个地点，Siriraj 和 Allen 评分都被发现对预测中风亚型的价值不大。
与以前在撒哈拉以南非洲的报告相比，我们的队列中缺血性中风与出血性中风的比例要高得多，与高收入国家更接近。
