| 摘要: | 目的：中風是全球主要死因之一，在台灣是第二大死因。本研究報導2000年台灣中風發生率與盛行率。方法：我們使用2000年台灣全民健康保險承保抽樣歸人檔，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。結果：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對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(6.64/1,0002對6.71/1,000)。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=1.32，95%CI=1.22-1.43)，但在多變項羅吉斯回歸中並不顯著。與年輕的民眾相較，中風危險在45-64歲即開始大幅增加(OR=6.9，95%CI=5.9-8.0)、65-79歲 (OR=19.2，95%CI=16.5-22.3)及≧80歲(OR=20.8，95%CI=19.6-25.7)。結論：本研究發現，台灣2000年的中風盛生率偏高，男女發生率相近，城鄉差異小，較高年齡者其中風的危險性也高。應對特定年齡族群進行適切的介入，推動中風防治措施如高血壓等，以減少中風之發生。
Objectives: Stroke is one of the leading causes of death worldwide, and the second most lethal cause of death in Taiwan. This study reported the urban and rural difference in prevalence and incidence of stroke in Taiwan. Methods: We used the data of 2000 cohort sample of National Health Insurance to estimate the prevalence and incidence of stroke. Data for information on age, sex, disease status, and urbanization were used in this study. This cohort consists of 200,000 persons of all ages except infants. Cases of stroke were identified according to International Classification of Disease 9th edition (ICD9) for both inpatient and out patients. Results: The crude prevalence and incidence of stroke were 19.8/1,000 and 6.87/1,000, respectively, in 2000. Men had a higher prevalence than women had (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). The results of logistic regression analysis showed that people lived in the least urbanized area were also at higher risk of stroke (OR=1.32, 95%CI=1.22-1.43), compared with those lived in the highest urbanized area. This disparity disappeared in the multivariate logistic regression. Compared with those younger, people had higher risk of stroke incidence were those aged 45-64 (OR=6.9, 95%CI=5.9-8.0), 65-79 (OR=19.2, 95%CI=16.5-22.3), and ≧80 (OR=20.8, 95%CI=19.6-25.7) years. Conclusion: Our findings suggest that there is a high prevalence of stroke in Taiwan in 2000, but no risk differences between males and females, and between urban and rural areas. Age-specific intervention approaches are necessary to halt the incidence of stroke events and associated risk such as hypertension prevention for the elderly. |
