Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen-Nürnberg, Germany.
Neuroepidemiology. 2015;44(1):24-9. doi: 10.1159/000371353. Epub 2015 Jan 31.
Population-based data, which continuously monitors time trends in stroke epidemiology are limited. We investigated the incidence of pathological and etiological stroke subtypes over a 16 year time period.
Data were collected within the Erlangen Stroke Project (ESPro), a prospective, population-based stroke register in Germany covering a total study population of 105,164 inhabitants (2010). Etiology of ischemic stroke was classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.
Between January 1995 and December 2010, 3,243 patients with first-ever stroke were documented. The median age was 75 and 55% were females. The total stroke incidence decreased over the 16 year study period in men (Incidence Rate Ratio 1995-1996 vs. 2009-2010 (IRR) 0.78; 95% CI 0.58-0.90) but not in women. Among stroke subtypes, a decrease in ischemic stroke incidence (IRR 0.73; 95% CI 0.57-0.93) and of large artery atherosclerotic stroke (IRR 0.27; 95% CI 0.12-0.59) was found in men and an increase of stroke due to small artery occlusion in women (IRR 2.33; 95% CI 1.39-3.90).
Variations in time trends of pathological and etiological stroke subtypes were found between men and women that might be linked to gender differences in the development of major vascular risk factors in the study population.
人口统计学数据对中风流行病学的时间趋势进行了持续监测，但此类数据十分有限。我们研究了在 16 年的时间内病理和病因性中风亚型的发病率。
数据来自德国埃朗根中风项目（ESPro），这是一项前瞻性、基于人群的中风登记研究，覆盖了总计 105164 名居民（2010 年）的总体研究人群。根据急性中风治疗试验（TOAST）标准对缺血性中风的病因进行分类。
1995 年 1 月至 2010 年 12 月，共记录了 3243 例首次发生的中风患者。患者的中位年龄为 75 岁，55%为女性。在 16 年的研究期间，男性的总中风发病率呈下降趋势（1995-1996 年与 2009-2010 年的发病率比值（IRR）为 0.78；95%置信区间（CI）为 0.58-0.90），但女性没有这种趋势。在中风亚型中，男性的缺血性中风发病率（IRR 0.73；95%CI 0.57-0.93）和大动脉粥样硬化性中风（IRR 0.27；95%CI 0.12-0.59）有所下降，而女性的小动脉闭塞性中风发病率则有所上升（IRR 2.33；95%CI 1.39-3.90）。
在男性和女性中发现了病理和病因性中风亚型的时间趋势变化，这可能与研究人群中主要血管危险因素的发展存在性别差异有关。
