From the Department of Epidemiology (J.W., J.T., C.Z., X.N.), Tianjin Neurological Institute; the Department of Neurology (J.W., L.Y., J.T., C.Z., X.N.), Tianjin Medical University General Hospital; the Departments of Neurology (Z.A.) and Ultrasound (B.L.), Tianjin Huanhu Hospital; the Department of Neurology (B.L., H.G.), Tianjin Dagang Oilfield General Hospital; the Department of Neuro-Immunology (L.Y.), Tianjin Neurological Institute; and the Department of Internal Medicine and Cardiovascular Center (T.-C.S.), National Taiwan University Hospital, Taipei, Taiwan.
Neurology. 2015 Jan 27;84(4):374-81. doi: 10.1212/WNL.0000000000001175. Epub 2014 Dec 24.
We investigated secular trends in incidence of first-ever stroke and the prevalence of stroke risk factors within the same population in rural China.
In 1985, 15,438 residents from a township of Tianjin, China, were recruited to the Tianjin Brain Study, a population-based stroke surveillance study. Stroke events and all deaths were registered annually. Because imaging technology was first available in 1992, we analyzed the incidence of first-ever stroke over 3 study periods-1992-1998, 1999-2005, and 2006-2012-from 1992 to 2012. Risk factor surveys were conducted in 1991 and 2011.
The age-standardized incidence of first-ever stroke per 100,000 person-years increased rapidly from 124.5 in 1992-1998 to 190.0 in 1999-2005 and to 318.2 in 2006-2012; incidence increased annually by 6.5% overall and by 12% among men aged 45-64 years (p < 0.05). From 1992 to 2012, the age at first-ever stroke in men was earlier by 3.3 years overall, but a similar trend was not observed in women. Concurrently, the prevalence of high fasting glucose and alcohol consumption increased significantly in both men and women, especially in men aged <45 years; the prevalence of obesity and high fasting glucose increased by 8.8-fold and 11-fold, respectively, from 1992 to 2012.
The incidence of stroke in rural China increased rapidly, particularly among middle-aged adults, along with a concurrent increase in risk factor prevalence. These findings suggest that without controlling these risk factors, stroke incidence will continue to increase over future decades in China.
我们旨在调查同一人群中中国农村首次中风发病率和中风危险因素流行率的长期变化趋势。
1985 年，中国天津市一个乡镇的 15438 名居民被招募到天津大脑研究中，这是一项基于人群的中风监测研究。每年登记中风事件和所有死亡。由于影像学技术于 1992 年首次应用，因此我们分析了 1992 年至 2012 年 3 个研究期间（1992-1998 年、1999-2005 年和 2006-2012 年）首次发生中风的发病率。危险因素调查于 1991 年和 2011 年进行。
标准化发病率为每 100000 人年 124.5 例，在 1992-1998 年至 1999-2005 年期间迅速增加到 190.0 例，在 2006-2012 年期间增加到 318.2 例；总发病率每年增长 6.5%，45-64 岁男性每年增长 12%（p<0.05）。从 1992 年到 2012 年，男性首次中风的年龄总体上提前了 3.3 岁，但女性没有观察到类似的趋势。同时，高空腹血糖和饮酒的患病率在男性和女性中均显著增加，尤其是 45 岁以下的男性；肥胖和高空腹血糖的患病率分别从 1992 年增加到 2012 年增加了 8.8 倍和 11 倍。
中国农村地区的中风发病率迅速增加，尤其是在中年人群中，同时危险因素的流行率也在增加。这些发现表明，如果不控制这些危险因素，未来几十年中国的中风发病率将继续上升。
