| 摘要: | 中風是全球主要死因之一，在台灣是第二大死因。中風是多致病因子的疾病，包括遺傳因子與環境因子。高血壓目前是中風最大的危險因子，幾乎有70%的中風病患都有高血壓病史。而中風後的醫療花費對於家庭與社會來說都是一個很大的負擔。本研究報導2000年台灣中風發生率與盛行率。 我們使用2000年台灣全民健康保險抽樣歸人檔，依年齡、性別、中風型態與都市化程度，估計腦血管疾病的發生率與盛行率。抽樣檔總計共有200,000位民眾，年齡都在一歲以上。而中風病例是根據國際疾病分類法第9版來定義，包括住院病患及門診病患。 本研究結果顯示，腦血管疾病的粗盛行率與發生率分別為19.8/1,000及6.87/1,000，男性的中風盛行率比女性的來得高(20.7/1,000 vs. 18.9/1,000, p=0.003)。而經過年齡校正後的中風發生率卻是女性稍高於男性(6.64/1,000 vs. 6.71/1,000)。在3,964位中風病患中，腦動脈阻塞佔了最大的比例(27.4%)，尤其是老年人。在羅吉斯回歸分析中，與其他都市化地區民眾相較，住在低都市化地區的民眾有較高的中風危險(OR=1.32, CI=1.22-1.43)。而在多變項羅吉斯回歸中，與年輕的民眾相較，年齡在45-64歲(OR=6.9, CI=5.9-8.0)、65-79歲(OR=19.2, CI=16.5-22.3)及≧80歲(OR=20.8, CI=19.6-25.7)的民眾有較高的中風發生率。 本研究發現，台灣2000年的中風盛生率偏高，男女發生率相近。而如一般所預期的，較高年齡者其中風的危險性也高。; Stroke is one of the leading causes of death worldwide, and the second lethal death in Taiwan. Most common stroke events are of multi-factorial causes involving both genetic variants and environmental factors. Hypertension is currently the most consistently perceived powerful predictor of stroke, involving nearly 70% of strokes. The cost of medical support for stroke is a burden for the family and for the society as well. Therefore, we should take it seriously. This study reported the prevalence and incidence of stroke in Taiwan in 2000. We used the data of 2000 cohort sample of National Health Insurance, Taiwan to estimate the prevalence and incidence of cerebrovascular disease. Data for information on age, sex, disease status, urbanization were used in this study. This cohort consists of 200,000 persons aged one year and above. Cases of cerebrovascular disease were identified according to International Classification of Disease 9 edition (ICD9) for both inpatient and out patients. The crude prevalence and incidence of cerebrovascular disease were 19.8/1,000 and 6.87/1,000, respectively, in 2000. Men had a higher prevalence than women did (20.7/1,000 vs. 18.9/1,000, p=0.003). However, the age-adjusted incidence of stroke was slightly higher in women than in men (6.71/1,000 vs. 6.64/1,000, p=0.23). Among 3,964 prevalent cases, the occlusion of cerebral arteries was most prevalent (27.4%) in cerebrovascular disease particularly the elderly. The results of logistic regression analysis showed that people lived in the least urbanized area were also at higher risk (OR=1.32, CI=1.22-1.43), compared with those lived in the highest urbanized area. Compared with youngers, in the multivariate logistic regression, people had higher risk of stroke incidence were those aged 45-64 (OR=6.9, CI=5.9-8.0), 65-79 (OR=19.2, CI=16.5-22.3), and ≧80 (OR=20.8, CI=19.6-25.7) years. Our findings suggested that there was a high prevalence of stroke in Taiwan in 2000. As we expected, an increased age leaded to the elevated risk of stroke. However, the risk of stroke is approximately similar for both males and females. |
