Lidegaard O
Gynaekologisk obstetrisk afdeling, Amtssygehuset i Herlev.
Ugeskr Laeger. 1996 Oct 14;158(42):5933-9.
The aim of this study was to analyze age specific incidence rates (IRs) of cerebral thromboembolic attacks (CTA) among women and men 15-44 years of age in Denmark from 1980 through 1993 and quantify possible influences from oral contraceptives (OC) on the incidence figures. The discharge diagnoses ICD 432-436 from all Danish neurological, neurosurgical and medical departments during the period 1980-1993 were identified in a central diagnosis register. The use of OC was achieved from complete sale statistics during the study period and cross-sectional studies assessing the type-specific use of OC at different ages. During the 14-year study period, 2100 female and 2552 male attacks were registered. Men had an exponentially increasing IR with increasing age. Compared with men in the period 1980-1986, women had more attacks in the 20-35-year age group and fewer attacks above the age of 35. After 1987 the sex differences below the age of 35 were not significant. From the first half (1980-1986) to the last half (1987-1993) of the study period, women below 30 years had a significantly falling CTA IR of -20.4%, compared with a nonsignificant fall of -9.5% among men below 30 years. In the age group above 30 years, women experienced a non significant increase of 4.2%, men a significant increase of 11.4%. Assuming that use of OC implied an average relative risk of CTA of 2.5 and pregnancy a relative risk of 4, a correction was made for the contribution of incident cases among women. The corrected IRs had a close co-variation with the IRs of men up to the age of 35. Thereafter, men had higher IR as is the case for older age groups. It is concluded that women's pregnancies and use of OC may explain the higher IRs of CTA in young fertile age compared to those of men. The more pronounced fall in IRs among young women compared with young men through the last 14 years may be a consequence of the reduced hormonal content of OC.
本研究的目的是分析1980年至1993年丹麦15至44岁男女脑栓塞发作（CTA）的年龄特异性发病率（IRs），并量化口服避孕药（OC）对发病率数据可能产生的影响。1980 - 1993年期间丹麦所有神经科、神经外科和内科部门的出院诊断ICD 432 - 436在一个中央诊断登记处被识别出来。OC的使用情况是通过研究期间完整的销售统计数据以及评估不同年龄组OC特定类型使用情况的横断面研究获得的。在为期14年的研究期间，登记了2100例女性发作和2552例男性发作。男性的IR随着年龄增长呈指数上升。与1980 - 1986年期间的男性相比，女性在20 - 35岁年龄组发作更多，35岁以上发作更少。1987年之后，35岁以下的性别差异不显著。从研究期间的前半期（1980 - 1986年）到后半期（1987 - 1993年），30岁以下女性的CTA IR显著下降了20.4%，而30岁以下男性下降了9.5%，不显著。在30岁以上年龄组，女性有4.2%的不显著增加，男性有11.4%的显著增加。假设使用OC意味着CTA的平均相对风险为2.5，怀孕的相对风险为4，则对女性中发病病例的贡献进行了校正。校正后的IRs与35岁以下男性的IRs有密切的共变关系。此后，男性的IR更高，老年组也是如此。结论是，女性怀孕和使用OC可能解释了年轻育龄期女性CTA的IR高于男性。在过去14年中，年轻女性的IRs下降比年轻男性更明显，这可能是OC激素含量降低的结果。
