种族的不同与中风亚型的关联性：奥克兰社区中风研究，2002-2003
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Ethnic disparities in incidence of stroke subtypes: Auckland Regional Community Stroke Study, 2002–2003
Valery Feigin PhDa, , , Associate Prof, Kristie Carter MSca, b, Maree Hackett MAa, b, P Alan Barber PhDc, Harry McNaughton PhDd, Lorna Dyall PhDe, Mei-hua Chen MSca, ProfCraig Anderson PhDa, b and for the Auckland Regional Community Stroke Study Group
aClinical Trials Research Unit, Department of Medicine and School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, New Zealand
bThe George Institute for International Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia
cNeuroservices, Auckland City Hospital, and Department of Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
dMedical Research Institute of New Zealand, Wellington, New Zealand
eDepartment of Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
The Lancet Neurology, Volume 5, Issue 2, February 2006
Summary
Background
Limited population-based data exist on differences in the incidence of major pathological stroke types and ischaemic stroke subtypes across ethnic groups. We aimed to provide such data within the large multi-ethnic population of Auckland, New Zealand.
Methods
All first-ever cases of stroke (n=1423) in a population-based register in 940 000 residents (aged 15 years) in Auckland, New Zealand, for a 12-month period in 2002–2003, were classified into ischaemic stroke, primary intracerebral haemorrhage (PICH), subarachnoid haemorrhage, and undetermined stroke, according to standard definitions and results of neuroimaging/necropsy (in over 90% of cases). Ischaemic stroke was further classified into five subtypes. Ethnicity was self-identified and grouped as New Zealand (NZ)/European, Maori/Pacific, and Asian/other. Incidence rates were standardised to the WHO world population by the direct method, and differences in rates between ethnic groups expressed as rate ratios (RRs), with NZ/European as the reference group.
Findings
In NZ/European people, ischaemic stroke comprised 73%, PICH 11%, and subarachnoid haemorrhage 6%, but PICH was higher in Maori/Pacific people (17%) and in Asian/other people (22%). Compared with NZ/European people, age-adjusted RRs for PICH were 2·7 (95% CI 1·8–4·0) and 2·3 (95% CI 1·4–3·7) among Maori/Pacific and Asian/other people, respectively. The corresponding RR for ischaemic stroke was greater for Maori/Pacific people (1·7 [95% CI 1·4–2·0]), particularly embolic stroke, and for Asian/other people (1·3 [95% CI 1·0–1·7]). The onset of stroke in Maori/Pacific and Asian/other people began at significantly younger ages (62 years and 64 years, respectively) than in NZ/Europeans (75 years; p<0·0001). There were ethnic differences in the risk factor profiles (such as age, sex, hypertension, cardiac disease, diabetes, hypercholesterolaemia, smoking status, overweight) for the stroke types and subtypes.
Interpretation
Compared to NZ/Europeans, Maori/Pacific and Asian/other people are at higher risk of ischaemic stroke and PICH, whereas similar rates of subarachnoid haemorrhage were evident across ethnic groups. The ethnic disparities in the rates of stroke types could be due to substantial differences found in risk factor profiles between ethnic groups. This information should be considered when planning prevention and stroke-care services in multi-ethnic communities.
种族的不同与中风亚型的关联性：奥克兰社区中风研究，2002-2003
摘要
背景
基于有限的人口数量的数据显示（？）中风的主要病理类型和缺血性中风的亚型在不同的种族分组之间的区别。我们的目的，是，在新西兰，奥克兰这样有着多种族的多数人口的地区，提供这样的数据。
方法
在新西兰，奥克兰，所有的940，000个登记的居民中（年龄超过15岁），在2002—2003年的12个月中患病所有的中风病例，根据标准定义和神经影象及尸检（超过90%的患者）结果，将其分为，缺血性中风，原发性脑内出血（PICH），蛛网膜下腔出血，未确定的中风。缺血性中风被进一步分为5个亚型。种族由自我确认，分为新西兰（NZ）/欧洲，毛利人/太平洋，和亚洲/其他。关联率通过直接方法由WHO世界人口进行校正，不同种族之间的率的不同由率的比值来表示（RRs），使用新西兰（NZ）/欧洲组作为对照组。
发现
在新西兰（NZ）/欧洲组中，缺血性中风占73%，PICH占11%，蛛网膜下腔出血占6%，在毛利人/太平洋组（17%）和亚洲/其他组（22%）中，PICH患病率较高。与新西兰（NZ）/欧洲组相比，毛利人/太平洋组的PICH的年龄校正的RRs为2.7 (95% CI 1.8–4.0)，亚洲/其他组的PICH的年龄校正的RRs为2.3 (95% CI 1.4–3.7)，毛利人/太平洋组的缺血性中风的相应的RRs更高，1.7 [95% CI 1.4–2.0]，尤其是栓塞性中风，亚洲/其他组的该系数为1.3 [95% CI 1.0–1.7]。在发生中风的年龄方面，与新西兰（NZ）/欧洲组（75岁）相比，在毛利人/太平洋组和亚洲/其他组，发生中风的年龄比较早，分别为62和64岁，p<0·0001。对于不同的中风类型和亚型，在中风危险因素方面（诸如年龄，性别，高血压，心脏病，糖尿病，高胆固醇血症，吸烟状态，超重），也显示出种族的不同。
解释
与新西兰（NZ）/欧洲组相比，毛利人/太平洋组和亚洲/其他组有较高的缺血性中风和PICH的风险；而蛛网膜下腔出血的风险在各种族间相似（而不是较小）。不同中风类型由于种族的不同而出现的不同的发病率应该归于由于种族不同所造成的不同的患病危险因素。这个信息在多种族的社区进行中风预防和中风护理服务时应该加以考虑
Valery Feigin PhDa, , , Associate Prof, Kristie Carter MSca, b, Maree Hackett MAa, b, P Alan Barber PhDc, Harry McNaughton PhDd, Lorna Dyall PhDe, Mei-hua Chen MSca, ProfCraig Anderson PhDa, b and for the Auckland Regional Community Stroke Study Group
aClinical Trials Research Unit, Department of Medicine and School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, New Zealand
bThe George Institute for International Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia
cNeuroservices, Auckland City Hospital, and Department of Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
dMedical Research Institute of New Zealand, Wellington, New Zealand
eDepartment of Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
The Lancet Neurology, Volume 5, Issue 2, February 2006
Summary
Background
Limited population-based data exist on differences in the incidence of major pathological stroke types and ischaemic stroke subtypes across ethnic groups. We aimed to provide such data within the large multi-ethnic population of Auckland, New Zealand.
Methods
All first-ever cases of stroke (n=1423) in a population-based register in 940 000 residents (aged 15 years) in Auckland, New Zealand, for a 12-month period in 2002–2003, were classified into ischaemic stroke, primary intracerebral haemorrhage (PICH), subarachnoid haemorrhage, and undetermined stroke, according to standard definitions and results of neuroimaging/necropsy (in over 90% of cases). Ischaemic stroke was further classified into five subtypes. Ethnicity was self-identified and grouped as New Zealand (NZ)/European, Maori/Pacific, and Asian/other. Incidence rates were standardised to the WHO world population by the direct method, and differences in rates between ethnic groups expressed as rate ratios (RRs), with NZ/European as the reference group.
Findings
In NZ/European people, ischaemic stroke comprised 73%, PICH 11%, and subarachnoid haemorrhage 6%, but PICH was higher in Maori/Pacific people (17%) and in Asian/other people (22%). Compared with NZ/European people, age-adjusted RRs for PICH were 2·7 (95% CI 1·8–4·0) and 2·3 (95% CI 1·4–3·7) among Maori/Pacific and Asian/other people, respectively. The corresponding RR for ischaemic stroke was greater for Maori/Pacific people (1·7 [95% CI 1·4–2·0]), particularly embolic stroke, and for Asian/other people (1·3 [95% CI 1·0–1·7]). The onset of stroke in Maori/Pacific and Asian/other people began at significantly younger ages (62 years and 64 years, respectively) than in NZ/Europeans (75 years; p<0·0001). There were ethnic differences in the risk factor profiles (such as age, sex, hypertension, cardiac disease, diabetes, hypercholesterolaemia, smoking status, overweight) for the stroke types and subtypes.
Interpretation
Compared to NZ/Europeans, Maori/Pacific and Asian/other people are at higher risk of ischaemic stroke and PICH, whereas similar rates of subarachnoid haemorrhage were evident across ethnic groups. The ethnic disparities in the rates of stroke types could be due to substantial differences found in risk factor profiles between ethnic groups. This information should be considered when planning prevention and stroke-care services in multi-ethnic communities.
种族的不同与中风亚型的关联性：奥克兰社区中风研究，2002-2003
摘要
背景
基于有限的人口数量的数据显示（？）中风的主要病理类型和缺血性中风的亚型在不同的种族分组之间的区别。我们的目的，是，在新西兰，奥克兰这样有着多种族的多数人口的地区，提供这样的数据。
方法
在新西兰，奥克兰，所有的940，000个登记的居民中（年龄超过15岁），在2002—2003年的12个月中患病所有的中风病例，根据标准定义和神经影象及尸检（超过90%的患者）结果，将其分为，缺血性中风，原发性脑内出血（PICH），蛛网膜下腔出血，未确定的中风。缺血性中风被进一步分为5个亚型。种族由自我确认，分为新西兰（NZ）/欧洲，毛利人/太平洋，和亚洲/其他。关联率通过直接方法由WHO世界人口进行校正，不同种族之间的率的不同由率的比值来表示（RRs），使用新西兰（NZ）/欧洲组作为对照组。
发现
在新西兰（NZ）/欧洲组中，缺血性中风占73%，PICH占11%，蛛网膜下腔出血占6%，在毛利人/太平洋组（17%）和亚洲/其他组（22%）中，PICH患病率较高。与新西兰（NZ）/欧洲组相比，毛利人/太平洋组的PICH的年龄校正的RRs为2.7 (95% CI 1.8–4.0)，亚洲/其他组的PICH的年龄校正的RRs为2.3 (95% CI 1.4–3.7)，毛利人/太平洋组的缺血性中风的相应的RRs更高，1.7 [95% CI 1.4–2.0]，尤其是栓塞性中风，亚洲/其他组的该系数为1.3 [95% CI 1.0–1.7]。在发生中风的年龄方面，与新西兰（NZ）/欧洲组（75岁）相比，在毛利人/太平洋组和亚洲/其他组，发生中风的年龄比较早，分别为62和64岁，p<0·0001。对于不同的中风类型和亚型，在中风危险因素方面（诸如年龄，性别，高血压，心脏病，糖尿病，高胆固醇血症，吸烟状态，超重），也显示出种族的不同。
解释
与新西兰（NZ）/欧洲组相比，毛利人/太平洋组和亚洲/其他组有较高的缺血性中风和PICH的风险；而蛛网膜下腔出血的风险在各种族间相似（而不是较小）。不同中风类型由于种族的不同而出现的不同的发病率应该归于由于种族不同所造成的不同的患病危险因素。这个信息在多种族的社区进行中风预防和中风护理服务时应该加以考虑
作者: WHOEVER006 编译
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