Lancet:我国中风患者复发情况严峻!中国慢病前瞻性研究9年随访:四成中风患者5年内复发

2020-04-07 朱朱 中国循环杂志

目前,中风是我国国民的第一位死亡病因。

目前,中风是我国国民的第一位死亡病因。

覆盖50万名成年人的中国慢病前瞻性研究9年随访结果表明,我国患者首次出现中风发作5年内,中风复发或死亡的风险均很高。

在首次中风发作后28天时仍存活的患者中,5年时四成再次出现中风,17%死亡。

研究者指出,尽管我国的脑卒中治疗取得了明显进展,但患者的短期和长期预后仍很差,因此亟需进一步改善脑卒中二级预防,以降低复发和死亡风险。

同时,脑卒中一级预防也仍需加强,主要是生活方式调节。

该研究显示,在我国首次出现中风发作的患者中,脑出血患者的28天死亡率高达47%,其中蛛网膜下腔出血患者的28天死亡率为19%;待分类中风患者的28天死亡率为24%,缺血性中风患者中为3%。

城乡差距非常明显,以蛛网膜下腔出血为著,城市和农村患者的28天死亡率分别为32%和52%。

在我国首次出现中风发作、28天时仍存活的患者中,5年时中风复发率高达41%;其中,缺血性中风、脑出血、蛛网膜下腔出血、待分类中风患者的复发率分别为41%、44%、22%、40%。

在所有首次中风发作28天时存活的患者中,5年死亡率为17%;脑出血患者5年死亡率最高,为28%,其中蛛网膜下腔出血患者5年死亡率为16%;缺血性中风、待分类中风患者的5年死亡率分别为16%和15%。

不同类型中风患者首次发作28天后中风复发(A)、主要血管事件(B)、血管性死亡(C)、全因死亡(D)的估算累积发生率

在首次发生缺血性中风的患者中,91%的中风复发类型仍未缺血性中风。

在首次出现脑出血的患者中,56%的中风复发类型仍为脑出血,但有41%为缺血性中风。

中国慢病前瞻性研究共纳入512 715名35~74岁的成年人,其中489 586人基线无缺血性心脏病或中风,接受随访9年。

研究期间,45 732人(9.3%)首次出现中风发作,其中缺血性中风、脑出血、蛛网膜下腔出血、待分类中风分别占80%、16%、2%、2%。

中风患者和未出现中风者的平均年龄分别为59.3岁和50.8岁。

原始出处:
Yiping Chen,et al.Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0.5 million Chinese adults. The Lancet Global Health, 2020, 8(40): PE580-E590.

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    2020-11-23 howi
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    2020-04-08 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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