Amiri Amin, Kapral Moira K, Thrift Amanda G, Sposato Luciano A, Saber Hamidreza, Behrouz Reza, Erfanian Mahdiyeh, Farzadfard Mohammad Taghi, Mokhber Naghmeh, Azarpazhooh Mahmoud Reza
Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences and Toronto General Research Institute, Toronto, Ontario, Canada.
J Stroke Cerebrovasc Dis. 2018 Mar;27(3):547-554. doi: 10.1016/j.jstrokecerebrovasdis.2017.09.050. Epub 2017 Oct 31.
Population-based data regarding stroke among women are scarce in developing countries. This study was designed to determine whether sex differences exist in stroke incidence, mortality, and recurrence.
The Mashhad Stroke Incidence Study is a population-based cohort study in Iran. For a period of 1 year, all patients with stroke in 3 geographical regions in Mashhad were recruited and then followed up for 5 years. Age- and sex-specific crude incidence rates were standardized to the World Health Organization New World Population. Male-to-female incidence rate ratios were assessed for all age groups and all subtypes of first-ever stroke (FES).
The annual crude incidence rate of FES (per 100,000 population) was similar in men (144; 95% confidence interval [CI]: 129-160) and women (133; 95% CI: 119-149). Standardized FES annual incidence rates were 239 (95% CI: 213-267) for men and 225 (95% CI 200-253) for women, both greater than in most western countries. There were no significant differences in stroke recurrence or case-fatality between women and men during early and long-term follow-up.
The similar incidence of stroke between men and women highlights the importance of equally prioritizing adequate preventive strategies for both sexes. The greater relative incidence of stroke in women in Mashhad compared with other countries warrants improvement of primary and secondary stroke prevention.
在发展中国家，关于女性中风的基于人群的数据稀缺。本研究旨在确定中风发病率、死亡率和复发率是否存在性别差异。
马什哈德中风发病率研究是伊朗一项基于人群的队列研究。在1年的时间里，招募了马什哈德3个地理区域内所有中风患者，然后进行了5年的随访。按年龄和性别划分的粗发病率根据世界卫生组织新世界人口进行了标准化。评估了所有年龄组和所有首次中风（FES）亚型的男性与女性发病率比值。
FES的年粗发病率（每10万人）在男性（144；95%置信区间[CI]：129 - 160）和女性（133；95%CI：119 - 149）中相似。男性的标准化FES年发病率为239（95%CI：213 - 267），女性为225（95%CI：200 - 253），两者均高于大多数西方国家。在早期和长期随访期间，女性和男性之间的中风复发率或病死率没有显著差异。
男性和女性中风发病率相似，这凸显了对两性同等重视适当预防策略的重要性。与其他国家相比，马什哈德女性中风相对发病率较高，这需要改进一级和二级中风预防措施。
