台灣年輕人腦中風病因及季節變異因素

Etiology and Seasonal Variation for Young Stroke Patients in Taiwan

陳盈方(Ying-Fang Chen) ； 楊百嘉(Baii-Jia Yang) ； 姜義彬(Yi-Pin Chiang)

《台灣復健醫學雜誌》 36卷4期 (2008/12) Pp. 217-226

https://doi.org/10.6315/2008.36(4)03

摘要

本研究對象爲自民國九十三年至民國九十五年間，因腦中風於台北地區一醫學中心住院的患者3852人。其中腦梗塞2500人佔64.9%，腦出血1352人佔35.1%。年齡在15至45歲之間共計227位，爲年輕人腦中風患者，佔全體腦中風患者5.89%。回溯性探討其中風種類、年齡分布、病因、及發生月份之狀況。結果顯示年輕人腦中風的發生率隨著年齡而增加，男性發生腦中風較多，佔67.4%，住院中死亡率爲13.2%。腦出血較腦梗塞之發生率為高，其比率爲56.3% (128/227)：43.7% (99/227)，此結果與45歲以上腦中風之發生率不同。腦出血病因中，以高血壓(62.5%, 80/128)爲第一位，且其比例較台灣之前的研究有漸漸增加的趨勢。腦梗塞病因中，大血管動脈硬化佔30.3%，小血管阻塞則佔29.3%，兩者十分接近，與台灣之前的研究有所不同；大血管動脈硬化引起的腦梗塞也在增加中，以上這兩個現象值得注意。
年輕人中風與氣候變異的關係中，若依發生的月份來看，發生腦中風最多的月份爲八月，若依發生的季節區分，發生腦中風最多的季節為夏天，春秋冬三季的中風發生率則無顯著差異。顯示年輕人腦中風的發生受到氣候炎熱的影響。
由於生活方式不同的推演及醫療的進步，疾病的樣貌也在改變。本研究針對年輕人中風患者做探討，希望能了解在台灣地區此類患者近年之狀況，以及各種特質是否有變動，提供將來在預防與治療上之參考。

關鍵字

年輕人腦中風 ； 病因 ； 季節變異

並列摘要

Over a 3-year period, 3852 patients with the first stroke were admitted to a medical center in Taiwan, of whom 227 (5.89%) were 15 to 45 years old. The diagnosis of stroke was confirmed by either MRI or CT scan. The incidence was skewed toward the older end of the age range, and men predominated (153/227, 67.4%). The stroke was the hemorrhagic type in 56.3% (128/227) versus the infarction type in 43.7% (99/227), a reversal of the ratio usually seen in patients over 45 years with infarction 64.9% (2500) versus hemorrhage 35.1% (1352). The case-fatality rate was 13.2% (30/227), including 26 patients with hemorrhage and 4 with infarction. Hypertension (62.5%, 80/128) was the most common cause of intra-cerebral hemorrhage, while large-vessel atherosclerosis (30.3%, 30/99) was the most common cause of infarction. However, small-vessel occlusion (29.3%, 29/99), the second most common cause of infarction in the young, was about as equally common as large vessel atherosclerosis (30.3%, 30/99).
Strokes, both hemorrhagic and infarction type, were most likely to occur in the summer, especially in August, indicating a clear seasonal predilection for stroke in young patients. This study of stroke in young patients in Taiwan thus demonstrates a slight predominance of hemorrhagic stroke over infarction and a seasonal variation with a higher incidence in summer. The above information provides a basis for further studies of stroke prevention and treatment.

並列關鍵字

young stroke ； etiology ； seasonal variation