目的:蛛网膜下腔出血(SAH)是脑卒中最严重的亚型,本研究是确定包头市动脉瘤性SAH的发病率。方法此研究是一项基于人群的、多中心、前瞻性的病例对照研究,从2009年5月8日至2011年5月8日,由内蒙古包头市中心医院神经内科和(或)神经外科的综合性医院、小型医院和部队医院等多中心(参加研究的中心详见附表)共同收集包头市城镇居民中动脉瘤性SAH病例(年龄≥15岁),并收集资料,包括患者的基线资料、临床特征、疾病管理、危险因素和预后等信息。并且到包头市唯一的火葬场登记不明原因突然死亡的资料,医生要在其后的4w到死亡者的家中用世界卫生组织(WHO)通用的口头验尸工具表收集资料,以确认是否有可能的SAH发生。用直接法计算年发病率,用中国和WHO人口对包头市人口进行标化。结果本研究共收集了226例确诊为SAH的患者,其中65%为女性,平均年龄59±13岁。SAH的年发病率为6.2/10万(95%CI 5.4~7.0),男性为4.3/10万(95%CI 3.3~5.2),女性为8.2/10万(95%CI6.9~9.6);与世界人口标化校正后,包头市年发病率为6.3/10万(95%CI 5.4~7.1),其中男性为4.5/10万(95%CI3.5~5.5),女性为8.1/10万(95%CI 6.7~9.4);女性与男性的相对危险度是1.89(95%CI 1.44~2.48)。50岁前后的女性,发病相对危险度分别为男性的1.48倍(95%CI 0.86~2.54)和2.01倍(95%CI 1.44~2.79)。对照组、治疗及预后的情况将在以后的SAH的危险因素分析中介绍。结论本研究显示内蒙古包头市SAH的发病率明显高于以前国内的报道,而女性发病率高于男性也与以往基于人群的研究结果迥然不同。%Objective Subarachnoid hemorrhage (SAH) is the most serious subtype of stroke.The purpose of this study was to determine the incidence of aneurysmal SAH in Baotou.Method This was a population-based, multi centre, prospective case-control study. Over a 2-year period from 8 May 2009 to 8 May 2011, all patients (age≥15years) with aneurysmal SAH were identified from multiple overlapping sources involving all major acute care hospitals with neurologyeurosurgery facilities, smaller hospitals and army hospital, and the sole crematorium in the city of Baotou, Inner Mongolia, China.Annual incidence rates were age adjusted to the Chinese and WHO world populations by the direct method to allow comparisons.Results A total of 226 cases of SAH were identified, 65%female with a mean age of 59 years (SD 13). The crude annual incidence rates (per 100,000) were overall 6.2 (95%CI 5.4-7.0) and 4.3 (95%CI 3.3-5.2) for males and 8.2 (95%CI 6.9-9.6) for females. The overall rate standardized to the world population was 6.3/10万(95%CI 5.4-7.1)and 4.5/10万 (95%CI 3.5-5.5) for males and 8.1/10万 (95%CI 6.7-9.4) for females. Standardized female:male rate ratio was 1.89 (95%CI 1.44-2.48). Age-adjusted crude rates for females versus males, before and after the age of 50 years, were 1.48 (95%CI 0.86-2.54), 2.01 (95%CI 1.44-2.79)
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