Guan Tianjia, Ma Jing, Li Mei, Xue Tao, Lan Zongmin, Guo Jian, Shen Ying, Chao Baohua, Tian Geyuan, Zhang Qiang, Wang Longde, Liu Yuanli
From the School of Public Health (T.G., J.G., G.T., Y.L.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Brigham & Women's Hospital (J.M.), Harvard Medical School, Boston, MA; National Health and Family Planning Commission of the People's Republic of China (M.L., B.C.); Center for Earth System Science (T.X., Q.Z.), Tsinghua University; Development Research Center of the State Council (Z.L.); Xuanwu Hospital (Y.S.), Capital Medical University; and School of Public Health (L.W.), Peking University Health Science Center, Peking University, Beijing, China.
Neurology. 2017 Jul 4;89(1):53-61. doi: 10.1212/WNL.0000000000004056. Epub 2017 May 31.
To estimate the current prevalence, temporal incidence trends, and contribution of risk factors for stroke in China.
The China National Stroke Screening Survey (CNSSS) is an ongoing nationwide population-based program. A representative sample of 1,292,010 adults over 40 years old with 31,188 identified stroke cases from the 2013 and 2014 CNSSS database was analyzed to provide descriptive statistics of the prevalence and risk factors for stroke in 2014. In addition, a retrospective evaluation of 12,526 first-ever stroke cases in 2002-2013 and stroke mortality data from the 2002-2013 China Public Health Statistical Yearbook was conducted to estimate the incidence rates.
In 2014, the adjusted stroke prevalence was 2.06% in adults aged 40 years and older. After full adjustments, all risk factors assessed showed significant associations with stroke ( < 0.01); the largest contributor was hypertension (population-attributable risk 53.2%), followed by family history, dyslipidemia, atrial fibrillation, diabetes, physical inactivity, smoking, and overweight/obesity. The incidence of first-ever stroke in adults aged 40-74 years increased from 189/100,000 individuals in 2002 to 379/100,000 in 2013-an overall annual increase of 8.3%. Stroke-specific mortality in adults aged 40-74 years has remained stable, at approximately 124 deaths/100,000 individuals in both 2002 and 2013.
In 2002-2013, the incidence of stroke in China increased rapidly. Combined with a high prevalence, a trend toward a younger age, and stable mortality, this finding suggests that additional clinical and behavioral interventions for metabolic and lifestyle risk factors are necessary to prevent stroke, particularly in certain populations.
评估中国目前中风的患病率、发病时间趋势以及危险因素的影响。
中国国家中风筛查调查（CNSSS）是一项正在进行的全国性基于人群的项目。对2013年和2014年CNSSS数据库中1292010名40岁以上成年人的代表性样本进行分析，其中有31188例确诊中风病例，以提供2014年中风患病率和危险因素的描述性统计数据。此外，对2002 - 2013年12526例首次中风病例进行回顾性评估，并利用2002 - 2013年《中国公共卫生统计年鉴》中的中风死亡率数据来估算发病率。
2014年，40岁及以上成年人中经调整后的中风患病率为2.06%。经过全面调整后，所有评估的危险因素均与中风存在显著关联（<0.01）；最大的危险因素是高血压（人群归因风险为53.2%），其次是家族病史、血脂异常、心房颤动、糖尿病、缺乏身体活动、吸烟以及超重/肥胖。40 - 74岁成年人首次中风的发病率从2002年的189/10万增加到2013年的379/10万，总体年增长率为8.3%。40 - 74岁成年人的中风特异性死亡率保持稳定，2002年和2013年约为124/10万。
2002 - 2013年，中国中风发病率迅速上升。结合高患病率、发病年龄趋于年轻化以及死亡率稳定的情况，这一发现表明，有必要针对代谢和生活方式危险因素采取更多临床和行为干预措施来预防中风，尤其是在某些人群中。
