Huang Z S, Chiang T L, Lee T K
Department of Internal Medicine, College of Medicine, Taiwan, Republic of China.
Stroke. 1997 Aug;28(8):1579-84. doi: 10.1161/01.str.28.8.1579.
Stroke has been the second leading cause of death for all ages in Taiwan since 1983. However, despite the severity of the threat, stroke prevalence in Taiwan has not yet been addressed in a nationwide survey. In this study, the stroke prevalence in Taiwan was investigated using data from the 1994 National Health Interview Survey.
This nationwide survey sought to obtain a nationally representative sample of households in Taiwan by using three-stage stratified random sampling with a probability proportional to size. In the first stage, 58 townships were selected, from the 359 townships in Taiwan, according to their administrative structure and level of socioeconomic development. In the second stage, 149 basic administrative regions (tsun or li) were selected from the selected 58 townships. Finally, 3814 households were selected from the 149 selected tsuns or lis. Field interviews were carried out between October 1994 and December 1994. Follow-up interviews with families of stroke patients were made 2 years later.
Of the selected households 3119, or 81.8%, responded. A total of 11925 persons were interviewed, and 71 of them were stroke patients, with a crude point prevalence rate of 5.95 per 1000. The stroke prevalence increased steadily with age, from 0.51 per 1000 in persons aged 35 to 44 years to 113.6 per 1000 in persons aged 85 years or over. There was a weak association with higher stroke prevalence for persons living in eastern Taiwan or those of lower educational level. The overall male/female prevalence ratio was 1.17. The results of follow-up interviews showed a cumulative mortality rate of 25.4% within the 2-year period and an ischemic/hemorrhagic stroke ratio of 1.33 in 35 patients whose stroke type could be validated.
Age was the most important factor correlating to stroke prevalence. On the basis of this result, planning policies and programs for stroke prevention in Taiwan should give a higher priority to (1) aggressive primary prevention for aged people who are apparently at higher risk of stroke and (2) early reduction of stroke risk factors in younger aged people whose immediate risk of stroke is lower but would increase significantly with age.
自1983年以来，中风一直是台湾各年龄段人群的第二大死因。然而，尽管中风威胁严重，但台湾尚未进行过全国性的中风患病率调查。在本研究中，利用1994年国民健康访问调查的数据对台湾的中风患病率进行了调查。
这项全国性调查旨在通过三阶段分层随机抽样，以与规模成比例的概率获取台湾具有全国代表性的家庭样本。第一阶段，根据台湾359个乡镇的行政结构和社会经济发展水平，选取了58个乡镇。第二阶段，从所选的58个乡镇中选取了149个基本行政区（村或里）。最后，从所选的149个村或里中选取了3814户家庭。1994年10月至1994年12月进行了现场访谈。两年后对中风患者的家属进行了随访访谈。
在所选家庭中，3119户（81.8%）作出了回应。共访谈了11925人，其中71人为中风患者，粗点患病率为每1000人5.95例。中风患病率随年龄稳步上升，从35至44岁人群中的每1000人0.51例升至85岁及以上人群中的每1000人113.6例。居住在台湾东部或教育水平较低的人群中风患病率略高。总体男女患病率之比为1.17。随访访谈结果显示，在2年期间累积死亡率为25.4%，在35例中风类型可得到验证的患者中，缺血性/出血性中风比例为1.33。
年龄是与中风患病率相关的最重要因素。基于这一结果，台湾中风预防政策和项目的规划应优先考虑：（1）对明显中风风险较高的老年人积极开展一级预防；（2）对中风即时风险较低但随着年龄增长风险会显著增加的年轻人尽早降低中风风险因素。
