Department of Neurology, Peking University Third Hospital, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
Sci Rep. 2018 Mar 22;8(1):5037. doi: 10.1038/s41598-018-23356-9.
Rapid economic development in China has caused marked changes in people's lifestyles and medical technology. Exploration of stroke subtype trends is necessary to provide physicians with vital insight for early diagnosis and treatment. We included stroke patients admitted from 2006 to 2015. Trends in stroke subtypes and vascular risk factors were investigated. There were 5521 patients, including 4534 (82.1%) ischemic stroke (IS), 813 (14.7%) intracerebral hemorrhage (ICH) and 174 (3.2%) subarachnoid hemorrhage (SAH) patients. The proportion of IS was increasing and proportions of ICH and SAH were decreasing (P < 0.001). Onset age and hypertension remained stable in stroke subtypes. In IS patients, large artery atherosclerosis (LAA) strokes increased from 17.0% to 30.8% in the first 7 years and ultimately decreased to 24.1%. Small vessel disease (SVD) strokes increased from 15.5% to 39.6%, undetermined etiology (UE) strokes decreased from 52.7% to 26.0%, others remained stable. The levels of low-density lipoprotein declined significantly, and an increased number of patients underwent intracranial artery examinations (P < 0.001). In conclusion, proportions of stroke subtypes changed significantly. Anti-hypertension therapy needs to be reinforced to control ICH, SAH and SVD ischemic stroke incidences. The etiologic detection of IS increased and lipid-lowing therapy was effective, cardioembolism detections should be reinforced.
中国经济的快速发展导致了人们生活方式和医疗技术的显著变化。探索脑卒中亚型的趋势对于医生进行早期诊断和治疗至关重要。我们纳入了 2006 年至 2015 年期间收治的脑卒中患者。研究了脑卒中亚型和血管危险因素的变化趋势。共纳入 5521 例患者，其中 4534 例（82.1%）为缺血性脑卒中（IS），813 例（14.7%）为脑出血（ICH），174 例（3.2%）为蛛网膜下腔出血（SAH）。IS 的比例呈上升趋势，ICH 和 SAH 的比例呈下降趋势（P < 0.001）。在脑卒中亚型中，发病年龄和高血压保持稳定。在 IS 患者中，大动脉粥样硬化性脑卒中（LAA）从第 1 年的 17.0%增加到第 7 年的 30.8%，最终降至 24.1%。小血管疾病（SVD）脑卒中从 15.5%增加到 39.6%，不明原因的脑卒中从 52.7%降至 26.0%，其他病因保持稳定。低密度脂蛋白水平显著下降，更多的患者接受了颅内动脉检查（P < 0.001）。结论：脑卒中亚型的比例发生了显著变化。需要加强抗高血压治疗以控制 ICH、SAH 和 SVD 缺血性脑卒中的发生率。IS 的病因学检测增加，降脂治疗有效，应加强心源性栓塞的检测。
