Change in Incidence and Long-term Prognosis of Stroke and Acute Myocardial Infarction in Large Scale Population

1988年4月1日至1991年3月31日，冲绳县共发生脑卒中4756例(4511例，急性心肌梗死1059例)，1990年人口普查122万人。使用死亡证明和/或居民卡确认他们的存活。受试者包括4363名中风患者(96.7%)和958名急性心肌梗死患者(96.6%)。对2218例脑梗塞(BI)和1589例脑出血(BH)患者的预后进行了分析，脑梗塞患者的平均发病年龄为70岁(男68岁，女73岁)，脑梗塞患者的平均发病年龄为岁(男61岁，女67岁)，急性心肌梗死患者的平均发病年龄为67岁(男63岁，女75岁)。BI患者10年累计生存率为39%(男性39例，女性38例)，BH患者为43%(男性44例，女性42例)，急性心肌梗死患者为41%(男性48例，女性27例)。50%的存活率为7.8年(男性7.9%为…采用COX比例风险模型对BI患者死亡的显著预测因素为发病年龄(风险比1.07，95%可信区间1.06-1.08)、男性(VS女性1.25，1.05-1.48)、复发(VS首次发病1.63、房颤(1.56，1.26-1.93)，起病时意识障碍(1.50，1.25-1.79)，皮质梗塞(vs腔隙1.31，1.09-1.56)。BH患者中年龄(1.05，1.04-1.06)，男性(1.33，1.09-1.60)，复发(vs1.43，1.13-1.81)，意识障碍(1.83，1.50-2.23)，病灶直径>6 cm(3.03，2.39-3.83)。发病年龄(危险比1·06，95%可信区间1·05~1·08)，男性(1·11，0·86~1·43)，高血压病史(1·68，1·32~2·14)，Q波脑梗死史(与非Q波脑梗死组比较，0·60，0·48~0·77)，Killip分级(每1级增加1·51，1·36~1·66)。1991年为141人(男性187人，女性108人)，32人(男性52人，女性16人)。而1999年的案件现在正在进行案件确认程序。较少

A total of 4,756 strokes cases (4,511 patients and 1,059 acute myocardial infarction (AMI) cases 1992 patients) were registered between April 1, 1988 and March 31, 1991 in Okinawa (1990 census population: 1.22 million).Follow-up survey was done at March 1, 1999. Their survival was confirmed using the death certificate and/or resident card.The subjects followed were 4,363 patients (96.7%) in stroke patients and 958 patients (96.6%) in AMI. Among stroke patients, 2,218 patients with brain infarction (BI) and 1,589 patients with brain hemorrhage (BH) were analyzed for prognosis.The mean age at onset was 70 years (men 68 and women 73) in patients with BI, 64 years (men 61 and women 67) in patients with BH and 67 years (men 63, women 75) in patients with AMI. The cumulative survival rate at 10-years was 39% (men 39 and women 38) in patients with BI, 43% (men 44 and women 42) in patients with BH and 41% (men 48, women 27) in patients with AMI. Fifty percent survival was 7.8 years (men 7.9 an … More d women 7.3) in patients with BI, 8.1 years with BH (men 8.7 and women 7.3) in patients with BH, and 7.5 years (men 9.8, women 3.8) in patients with AMI.COX proportional hazard model was applied for analysis.Significant predictors of death in patients with BI were age at onset (Risk Ratio 1.07, 95% confidence interval 1.06-1.08), men (vs women 1.25, 1.05-1.48), recurrence (vs first-ever 1.63, 1.35-1.98), atrial fibrillation (1.56, 1.26-1.93), any consciousness disturbance at onset (1.50, 1.25-1 .79), and cortical infarction (vs lacuna 1.31, 1.09-1.56). That in patients with BH were age (1.05, 1.04-1.06), men (1.33, 1.09-1.60), recurrence (vs firtst-ever 1.43, 1.13-1.81), any consciousness disturbance (1.83, 1.50-2.23), and size of lesion lager than 6cm in diameter (3.03, 2.39-3.83). And that in patients with AMI were age at onset (Risk Ratio 1.06, 95% confidence interval 1.05-1.08), men (1.11, 0.86-1.43), history of hypertension (1.68, 1.32-2.14), Q wave infarction (vs non-Q 0.60, 0.48-0.77), and Killip class (every one class up 1.51, 1.36-1.66).Age-adjusted incidence rate (per 1000000 per year) of stroke and AMI between Apr 1, 1988 and Mar 31, 1991 were 141 (men 187, women 108), 32 (men 52, women 16). And that of 1999 was now on case confirming process. Less