Ischemic stroke subtypes - A population-based study of incidence and risk factors
Ischemic stroke subtypes - A population-based study of incidence and risk factors
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DOI：
10.1161/01.str.30.12.2513
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发表时间：
1999-12-01
期刊：
影响因子：
8.3
通讯作者：
Wiebers, DO
中科院分区：
文献类型：
--
作者：
Petty, GW;Brown, RD;Wiebers, DO
背景和目的-缺血性卒中亚型的发病率和危险因素的人群基础信息很少。方法-我们从罗切斯特流行病学项目病历链接系统中确定了明尼苏达州罗切斯特所有454名1985年至1989年首次缺血性卒中的居民。在回顾了病历和脑成像后，我们使用卒中数据库标准来分配梗死亚型。我们根据年龄和性别调整了美国1990年人群的平均年发病率，并比较了缺血性卒中亚型中卒中危险因素的年龄调整频率，结果-年龄和性别调整的发病率颈动脉或颅内大血管狭窄>50%的27例，心源性栓塞40例，腔隙性病变25例，脑血管病20例。不确定的原因，52;其他或不常见的原因，4。仅在动脉粥样硬化伴狭窄患者中检测到发病率的性别差异（男性47 [95%CI，34 - 61];女性12 [95%CI，7 - 17]）。既往短暂性脑缺血发作和高血压在各亚型之间无差异，糖尿病在腔隙性脑梗死患者中并不比其他常见亚型更常见。结论：经年龄校正的因头颈部大血管狭窄所致卒中的发病率男性比女性高近4倍。既往短暂性脑缺血发作与卒中机制之间无相关性。糖尿病和高血压在骨陷窝患者中并不常见。该人群中缺血性卒中亚型的年龄和性别校正的发病率可以与其他人群中类似确定的发病率进行比较。
Background and Purpose-There is scant population-based information on incidence and risk factors for ischemic stroke subtypes,Methods-We identified all 454 residents of Rochester, Minn, with a first ischemic stroke between 1985 and 1989 from the Rochester Epidemiology Project medical records linkage system. We used Stroke Data Bank criteria to assign infarct subtypes after reviewing medical records and brain imaging. We adjusted average annual incidence rates by age and sex to the US 1990 population and compared the age-adjusted frequency of stroke risk factors across ischemic stroke subtypes,Results-Age- and sex-adjusted incidence rates (per 100 000 population) were as follows: large-vessel cervical or intracranial atherosclerosis with >50% stenosis, 27; cardioembolic, 40; lacuna, 25; uncertain cause, 52; other or uncommon cause, 4. Sex differences in incidence rates were detected only for atherosclerosis with stenosis (47 [95% CI, 34 to 61] for men; 12 [95% CI, 7 to 17] for women). There was no difference in prior transient ischemic attack and hypertension among subtypes, and diabetes was not more common among patients with lacunar infarction than other common subtypes,Conclusions-The age-adjusted incidence rate of stroke due to stenosis of the large cervicocephalic vessels is nearly 4 times higher for men than for women. There is no association between preceding transient ischemic attack and stroke mechanism. Diabetes and hypertension are not more common among patients with lacunae. Age- and sex-adjusted incidence rates for ischemic stroke subtypes in this population can be compared with similarly determined rates from other populations.