The Magnitude of Stroke-Related Problems Worldwide

世界有關腦中風問題之重要性

洪祖培(Tsu-Pei Hung)

《Mid-Taiwan Journal of Medicine》 4卷1期 (1999/03) Pp. 1-8

https://doi.org/10.6558/MTJM.1999.4(1).1

摘要

在全球許多國家，腦中風是最常見的神經系統疾病，它不但危害生命，也會導致長期殘廢的主要原因。以世界人口年齡標準化計算的年間死亡率，最高（東歐國家）與最低（大多數西方國家、美國、加拿大）之間相差六倍。許多已開發國家，隨著醫療水準的進步，1980年以後的腦中風致死率普遍減低，但年間腦中風發生率未必下降。腦中風乃多發於老年人，其發生率每多一歲約增加10%。在先進國家，因老年人口一直增加，罹患腦中風或冠狀動脈疾病後的存活機會也增大，反而導致腦中風發生率及盛行率之上昇。雖然許多流行病學專家認為高血壓的治療可減低腦中風的死亡率及發生率，但1980以前已經施行有效的高血壓治療之先進國家中，缺血性腦中風發生率仍有增加的趨勢。在開發中國家，未經治療或未有效控制的高血壓仍是腦中風（尤其是腦出血）的最主要危險因素。不管在開發中國家或先進國家，腦中風存活者所需的長期醫療、復健、居家護理顧帶來很大的社會、經濟的負擔，造成重要公共衛生問題。

關鍵字

流行病學 ； 高血壓 ； 社會經濟衝擊 ； 腦中風 ； 時代變遷

並列摘要

Stroke is the most common life-threatening neurologic disease, and is also a major cause of long-term disability in many countries worldwide. Age-standardized stroke mortality rates show a sixfold difference between the highest (eastern Europe) and the lowest (most western European countries, the United States, Canada). With improved medical standards since 1980, a significant decline in the case-fatality rate has been observed in developed countries regardless of the direction of trend in stroke incidence. As stroke is predominantly a disease of the elderly, its incidence increases exponentially at a rate of about 10% per year of age. In developed countries, continuing aging of the population, and improved survival after stroke or coronary artery disease, contribute to the increase in the incidence and prevalence of stroke at older ages. Although many epidemiologists consider that treatment of hypertension is the major contributor to the decline in stroke incidence and mortality, increases in the incidence of ischemic stroke have been observed in developed countries where effective antihypertensive treatment was implemented before 1980. However, hypertension is still the most important risk factor for stroke, especially for primary brain hemorrhage, in countries where treatment and control of hypertension are inadequate. In both developing and developed countries, increases in the number of nonfatal stroke patients requiring long-term medical treatment, rehabilitation, and home care create serious socio-economic problems.

並列關鍵字

epidemiology ； hypertension ； socio-economic impact ； stroke ； time trends