Hong Y, Bots M L, Pan X, Hofman A, Grobbee D E, Chen H
Shanghai Institute of Cardiovascular Diseases, Zhong Shan Hopsital, Shanghai Medical University, People's Republic of China.
Stroke. 1994 Jun;25(6):1165-9. doi: 10.1161/01.str.25.6.1165.
Mortality from stroke has declined in many countries. This decline may result from a fall in incidence of stroke or a decrease in case fatality from stroke. The present study was conducted to investigate the temporal trends of incidence rate, mortality rate, and case fatality of stroke in an urban and rural Chinese population.
A community-based registry study was established in 1983 in defined rural and urban areas of Shanghai with a population aged 35 to 74 years of approximately 86,000 subjects, adhering to the methods and definitions of the World Health Organization MONICA protocol. All stroke events occurring in the population aged 35 to 74 years in these areas were registered by a special three-level case-registration system.
From 1984 through 1991, 1391 stroke cases were identified. No significant change in the incidence rate of stroke was observed from 1984 through 1991 in men and women living in rural and urban areas. Age-standardized mortality rates (per 100,000 person years) of stroke declined significantly during this period, except for rural women. The annual changes and 95% confidence intervals of age-standardized mortality rates were: for rural men -4.6% (-5.4, -3.9), for rural women -0.6% (-1.6, 0.5), for urban men -2.5% (-3.5, -1.6), and for urban women -4.7% (-5.2, -4.2). A significant decrease in case fatality from stroke from 1984 through 1991 was found among men living in rural areas (from 62.4% to 46.0%) and among women living in urban areas (from 48.4% to 33.3%). Overall case fatality, however, showed a nonsignificant decline over time.
We observed a decline in stroke mortality rate in a rural and urban Chinese population. No significant changes in stroke incidence were found in this study, whereas case fatality appeared to have decreased, in particular among men living in rural areas and women living in urban areas.
许多国家中风死亡率已有所下降。这种下降可能是由于中风发病率降低或中风病死率下降所致。本研究旨在调查中国城乡人群中风发病率、死亡率和病死率的时间趋势。
1983年在上海特定的农村和城市地区建立了一项基于社区的登记研究，研究对象为年龄在35至74岁之间的约86,000名受试者，遵循世界卫生组织MONICA方案的方法和定义。这些地区35至74岁人群中发生的所有中风事件均通过特殊的三级病例登记系统进行登记。
1984年至1991年期间，共识别出1391例中风病例。1984年至1991年期间，农村和城市地区的男性和女性中风发病率均未观察到显著变化。在此期间，除农村女性外，中风的年龄标准化死亡率（每10万人年）显著下降。年龄标准化死亡率的年度变化及95%置信区间为：农村男性-4.6%（-5.4，-3.9），农村女性-0.6%（-1.6，0.5），城市男性-2.5%（-3.5，-1.6），城市女性-4.7%（-5.2，-4.2）。1984年至1991年期间，农村男性（从62.4%降至46.0%）和城市女性（从48.4%降至33.3%）的中风病死率显著下降。然而，总体病死率随时间呈非显著下降。
我们观察到中国城乡人群中风死亡率有所下降。本研究未发现中风发病率有显著变化，而病死率似乎有所下降，尤其是农村男性和城市女性。
