Neurology : 加拿大新移民,中风发病率更低

2021-08-29 Freeman MedSci原创

移民的卒中或TIA发生率低于长期居民,并因年龄、卒中类型和原籍国而有差异

2019年,全世界有2.72亿人是国际移民。欧洲(8200万)和北美(5900万)在接纳移民人口方面处于世界领先地位,预计这些数字在未来几十年内将会上升。2016年,移民占安大略省总人口的30%,该省是加拿大人口最多的省份。移民往往比长期居民有更好的健康,这是因为存在着健康移民效应,即那些健康的人更有可能移民。

与长期居民相比,移民的癌症、精神障碍和心肌梗塞的发病率较低。然而,目前还不清楚作为残疾的主要原因之一的中风的发病率在移民中是否也较低。与诸如癌症等需要考虑时间长短的疾病不同,或者与诸如心力衰竭等经常在门诊处理的疾病不同,中风的症状通常需要及时评估和住院治疗,至少部分地消除了移民和东道国人口之间寻求医疗服务模式的差异。

此外,移民的原籍国与种族、文化和生物因素密切相关,可以影响高血压和代谢综合征卒中危险因素的发生率,移民等级(难民与技术移民;refugee vs. skilled migrant)和文化适应也是如此。此外,缺血性中风和脑内出血等中风亚型发病率的种族差异以前也有报道,需要考虑。


藉此,加拿大多伦多大学的Manav V. Vyas等人,进行了一项基于人口的回顾性队列研究,以评估移民身份与中风(缺血性中风、脑内出血或蛛网膜下腔出血)或短暂性脑缺血发作(TIA)的发生率和中风类型之间的关系。

核心假设:与长期居民相比,移民的中风发病率较低,但这种关联会根据年龄、原籍国和移民等级而有所不同。

他们对2003年1月1日居住在加拿大安大略省的800万成年人(15%为移民)进行了回顾性队列研究,他们之前没有中风或短暂性脑缺血发作(TIA)史。受试者被随访至2018年3月31日,以确定事件性中风或TIA,定义为住院或急诊室就诊。他们使用特定病因的危险模型计算了移民与长期居民相比发生中风或TIA的调整危险比(HR),调整了人口统计学和合并症。并评估了这种关联是否因移民的年龄、卒中类型或原籍国而变化。

在1.09亿人年(person-years)的随访中,他们观察到235,336起卒中或TIA事件。

与长期居民相比,移民的中风或TIA发生率较低(10.9 vs. 23.4/10000人-年,HR 0.67;0.66-0.68)。

所有年龄组和中风类型都是如此,移民与长期居民相比,缺血性中风的HR为0.71(0.69-0.72),脑内出血为0.89(0.85-0.93),蛛网膜下腔出血为0.85(0.81-0.91),而TIA为0.53(0.51-0.54)。

来自加勒比海(HR 0.95;0.91-1.00)、拉丁美洲(HR 0.85;0.82-0.91)和非洲(HR 0.80;0.74-0.85)的移民,与来自世界其他地区的移民相比,与移民身份相关的卒中风险降低的幅度不太明显。

这个研究的重要意义在于发现了:移民的卒中或TIA发生率低于长期居民,并因年龄、卒中类型和原籍国而有差异。这些知识对制定有针对性的初级卒中预防策略可能是有用的。


原文出处:
Vyas MV, Austin PC, Pequeno P, et al. Incidence of Stroke in Immigrants to Canada: A Province-wide Retrospective Analysis.Neurology. Published online August 18, 2021:10.1212/WNL.0000000000012555. doi:10.1212/WNL.0000000000012555

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1823745, encodeId=91ba1823e4538, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Mar 29 16:39:48 CST 2022, time=2022-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001448, encodeId=fafd200144827, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Nov 19 12:39:48 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312675, encodeId=801713126e5f3, content=<a href='/topic/show?id=1aa333006b4' target=_blank style='color:#2F92EE;'>#加拿大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33006, encryptionId=1aa333006b4, topicName=加拿大)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Tue Aug 31 20:39:48 CST 2021, time=2021-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1012788, encodeId=d8f81012e8864, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42811511609, createdName=wuxinsmile, createdTime=Mon Aug 30 10:25:53 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046116, encodeId=ab92104611686, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Aug 30 08:39:48 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1823745, encodeId=91ba1823e4538, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Mar 29 16:39:48 CST 2022, time=2022-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001448, encodeId=fafd200144827, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Nov 19 12:39:48 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312675, encodeId=801713126e5f3, content=<a href='/topic/show?id=1aa333006b4' target=_blank style='color:#2F92EE;'>#加拿大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33006, encryptionId=1aa333006b4, topicName=加拿大)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Tue Aug 31 20:39:48 CST 2021, time=2021-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1012788, encodeId=d8f81012e8864, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42811511609, createdName=wuxinsmile, createdTime=Mon Aug 30 10:25:53 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046116, encodeId=ab92104611686, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Aug 30 08:39:48 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
    2021-11-19 yinhl1978
  3. [GetPortalCommentsPageByObjectIdResponse(id=1823745, encodeId=91ba1823e4538, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Mar 29 16:39:48 CST 2022, time=2022-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001448, encodeId=fafd200144827, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Nov 19 12:39:48 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312675, encodeId=801713126e5f3, content=<a href='/topic/show?id=1aa333006b4' target=_blank style='color:#2F92EE;'>#加拿大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33006, encryptionId=1aa333006b4, topicName=加拿大)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Tue Aug 31 20:39:48 CST 2021, time=2021-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1012788, encodeId=d8f81012e8864, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42811511609, createdName=wuxinsmile, createdTime=Mon Aug 30 10:25:53 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046116, encodeId=ab92104611686, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Aug 30 08:39:48 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1823745, encodeId=91ba1823e4538, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Mar 29 16:39:48 CST 2022, time=2022-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001448, encodeId=fafd200144827, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Nov 19 12:39:48 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312675, encodeId=801713126e5f3, content=<a href='/topic/show?id=1aa333006b4' target=_blank style='color:#2F92EE;'>#加拿大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33006, encryptionId=1aa333006b4, topicName=加拿大)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Tue Aug 31 20:39:48 CST 2021, time=2021-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1012788, encodeId=d8f81012e8864, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42811511609, createdName=wuxinsmile, createdTime=Mon Aug 30 10:25:53 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046116, encodeId=ab92104611686, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Aug 30 08:39:48 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
    2021-08-30 wuxinsmile

    很好

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1823745, encodeId=91ba1823e4538, content=<a href='/topic/show?id=b2873e9220e' target=_blank style='color:#2F92EE;'>#发病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37922, encryptionId=b2873e9220e, topicName=发病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa0e14, createdName=lifestar, createdTime=Tue Mar 29 16:39:48 CST 2022, time=2022-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001448, encodeId=fafd200144827, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Fri Nov 19 12:39:48 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1312675, encodeId=801713126e5f3, content=<a href='/topic/show?id=1aa333006b4' target=_blank style='color:#2F92EE;'>#加拿大#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33006, encryptionId=1aa333006b4, topicName=加拿大)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=279b407, createdName=shanyongle, createdTime=Tue Aug 31 20:39:48 CST 2021, time=2021-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1012788, encodeId=d8f81012e8864, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42811511609, createdName=wuxinsmile, createdTime=Mon Aug 30 10:25:53 CST 2021, time=2021-08-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046116, encodeId=ab92104611686, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Mon Aug 30 08:39:48 CST 2021, time=2021-08-30, status=1, ipAttribution=)]
    2021-08-30 guging

    中风是俗称,应该称为缺血性卒中吧

    0

相关资讯

Stroke:急性脑卒中后,胰岛B细胞功能如何影响预后?

在非糖尿病急性缺血性卒中患者中,β细胞功能障碍与短期不良临床结局明显相关,与胰岛素抵抗无关。

Neurology:轻症的脑中风,溶栓和取栓联合治疗效果更好

轻症的脑中风,溶栓和取栓联合治疗效果更好

Stroke:冠脉硬化,和脑白质病变有何关系?

在健康的高危人群中,冠状动脉斑块的存在和体积与较大的WMH体积有关,在PVWMH中表现得最为强烈。

JAHA:先天性心脏病患者缺血性脑卒中负担

CHD患者发生IS的风险比对照组高5倍。然而,CHD患者的卒中复发风险和全因死亡率分别比对照组低34%和47%。

重磅:脑中风幸存者,多运动,可大幅度减低全因死亡率

在既往卒中患者中,尤其是年轻的卒中幸存者中,PA与较低的全因死亡率有明显的剂量依赖关系

拓展阅读

中风伴神经功能恶化?JAMA子刊:这种疗法或可降低相关风险

这些发现表明,在治疗急性轻中度脑卒中患者时,双重抗血小板治疗可能是比单独阿司匹林治疗更好的选择。

European Radiology:急性缺血性脑卒中或短暂性脑缺血发作患者冠状动脉疾病的新兴影像预测因子

心脑血管疾病的常见危险因素,如糖尿病、高血压、高脂血症和吸烟史,可加重ALS和TIA后的心脏损伤。这些因素导致了动脉粥样硬化,是一种常见于心脑血管系统的病理改变。

好文推荐 | 线粒体自噬对缺血性脑卒中的作用及其机制研究进展

本文就线粒体自噬的发生机制及其在缺血脑组织中的作用进行综述,以期为缺血性脑卒中的治疗提供新的思路。

好文推荐 | 缺血性脑卒中代谢组学发病机制及药物干预的研究进展

代谢组学的不断发展一直使其在阐释IS的发生发展机制上发挥重要作用。运用代谢组学的方法,有助于系统发掘可能对IS诊断和预测有重要作用的代谢物及通路,以期寻找潜在的治疗靶点。

CT读片低密度篇:缺血性脑卒中图文解析:

阅片需要注意的内容包括:脑梗死的CT改变、ASPECTS(指导治疗)、供血区,MCA供血区梗死约占75%,其他供血区梗死、急性期or慢性期,演变过程、并发症。

Phytomedicine:中草药天然成分对缺血性脑卒中小胶质细胞反应的调控机制

总结中草药(TCHMs)天然化合物对缺血性脑卒中动物模型小胶质细胞反应的调控机制。

缺血性脑卒中(大动脉粥样硬化型)治未病干预指南

北京中医药大学东方医院 · 2023-08-30

缺血性脑卒中复发预防的最佳证据总结

广州医科大学护理学院 · 2023-06-10

缺血性脑卒中患者高血糖管理的最佳证据总结

华中科技大学同济医学院附属同济医院神经内科 · 2023-02-10