Benedikz J, Magnússon H, Guthmundsson G
Department of Neurology, Landspitalinn, Reykjavik, Iceland.
Ann Neurol. 1994 Dec;36 Suppl 2:S175-9. doi: 10.1002/ana.410360804.
The profile of multiple sclerosis (MS) in Iceland based on a total population study from 1900 to 1990 is reviewed. The first survey in the late 1950s was a retrospective one. Since then, there has been a continuous prospective study that extends over a period of 40 years. The incidence of MS, which was 2.5/100,000 in the 1930s, rose to 3.5 to 4.1/100,000 between 1975 and 1990, but the data from the 1930s must be considered unreliable. There was a similar stepwise increase in prevalence from 30 to approximately 100/100,000 in 1990. It is most likely that the changes in prevalence are the result of improved case ascertainment, the growing number of well-trained neurologists in the country, and the greater awareness of the disease due to the activities of the Icelandic MS Society. No local or regional clusters were identified, but from 1900 to 1980 there was a steady and unexpected increase in the number of cases in rural areas, both by date of clinical onset and date of putative disease acquisition. No evidence was found to support the hypothesis that an epidemic of MS had occurred in Iceland following the arrival of British, Canadian, and American troops during the Second World War. The proposed epidemic in the Faroe Islands was also reexamined, in particular because of the identical ethnic, historical, demographic, and geographical similarities with Iceland. The available data are not supportive of that idea.
本文回顾了基于1900年至1990年冰岛总人口研究得出的多发性硬化症（MS）概况。20世纪50年代后期的首次调查是回顾性的。从那时起，开展了一项持续40年的前瞻性研究。MS的发病率在20世纪30年代为2.5/10万，在1975年至1990年间升至3.5至4.1/10万，但20世纪30年代的数据被认为不可靠。患病率也有类似的逐步上升，从30/10万升至1990年的约100/10万。患病率的变化很可能是由于病例确诊率提高、该国训练有素的神经科医生数量增加以及冰岛MS协会的活动使人们对该疾病的认识提高所致。未发现局部或区域聚集现象，但从1900年至1980年，农村地区的病例数量无论是按临床发病日期还是假定患病日期均呈稳定且意外的增加。没有证据支持第二次世界大战期间英国、加拿大和美国军队抵达冰岛后MS曾在冰岛流行的假说。法罗群岛拟议中的疫情也进行了重新审视，特别是因为其与冰岛在种族、历史、人口统计学和地理方面具有相同的相似性。现有数据不支持这一观点。
