Tian Xiaobing, Liu Jie, Yu Changshen, Hou Yabing, Zhan Changqing, Lin Qiuxing, Zhang Xinyu, Zhang Xin, Guo Dandan, Yang Qiaoxia, Tu Jun, Wang Yaogang, Ning Xianjia, Wang Jinghua
Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.
Front Neurol. 2021 Oct 22;12:720962. doi: 10.3389/fneur.2021.720962. eCollection 2021.
Although an increasing number of studies are considering sex-related differences in stroke burden, the trends in stroke burden and management among women in China, especially among low-income women, remain unclear. This study evaluated the long-term trends in stroke management and burden among low-income Chinese women during the period between 1992 and 2019. Stroke burden was assessed using the age-adjusted incidence of first-ever stroke, whereas stroke management was assessed using the rates of neuroimaging diagnoses, hospitalizations, case fatalities, and stroke recurrence. Stroke burden and management were analyzed during four study periods: 1992-1998, 1999-2004, 2005-2012, and 2013-2019. During the 193,385 person-years of surveillance in this study, 597 female stroke patients were identified. The stroke incidences per 100,000 person-years were 88.1 cases during 1992-1998, 145.4 cases during 1999-2004, 264.3 cases during 2005-2012, and 309.8 cases during 2013-2019 ( < 0.001). Between 1992 and 2019, the incidence of stroke significantly increased (6.4% annually) as did the incidence of ischemic stroke (7.8% annually; both, < 0.001). The rates of neuroimaging diagnoses and hospitalizations significantly increased during the four periods, while the case fatality rates and 1-year recurrence rates decreased significantly for both overall strokes and ischemic strokes, especially among patients ≥45 years old (all, < 0.001). Among low-income women in China, stroke management is gradually improving, despite the increasing stroke burden. Thus, improved healthcare coverage is needed to further reduce the stroke burden among low-income Chinese women.
尽管越来越多的研究开始关注中风负担方面的性别差异，但中国女性，尤其是低收入女性的中风负担及治疗趋势仍不明确。本研究评估了1992年至2019年期间中国低收入女性中风治疗及负担的长期趋势。中风负担采用首次中风的年龄调整发病率进行评估，而中风治疗则通过神经影像学诊断率、住院率、病例死亡率和中风复发率进行评估。在四个研究阶段（1992 - 1998年、1999 - 2004年、2005 - 2012年和2013 - 2019年）对中风负担和治疗情况进行了分析。在本研究193,385人年的监测期间，共识别出597名女性中风患者。每10万人年的中风发病率在1992 - 1998年为88.1例，1999 - 2004年为145.4例，2005 - 2012年为264.3例，2013 - 2019年为309.8例（<0.001）。1992年至2019年期间，中风发病率显著上升（每年上升6.4%），缺血性中风发病率也是如此（每年上升7.8%；两者均<0.001）。在这四个阶段中，神经影像学诊断率和住院率显著上升，而总体中风和缺血性中风的病例死亡率和1年复发率均显著下降，尤其是在45岁及以上的患者中（均<0.001）。在中国低收入女性中，尽管中风负担不断增加，但中风治疗正在逐步改善。因此，需要扩大医疗覆盖范围，以进一步减轻中国低收入女性的中风负担。
