鄭建興2006-07-262018-07-122006-07-262018-07-122000http://ntur.lib.ntu.edu.tw//handle/246246/26077Purpose: Cerebrovascular disease (CVD) is still one of most important causes of death and physical/mental disabilities in Chinese populations. Is there geographic differences of stroke existed among different Chinese inhabitants? This study aimed to assess he patterns of CVD, and the distribution of risk factors in different types of CVD in Chinese patients living in Taipei and New York. Methods: Consecutive Chinese patients with acute stroke or transient ischemic attack from the National Taiwan University Hospital (NTUH) in Taipei and the New York University Downtown Hospital (NYUDTH) in New York were recruited into this study. Types of stroke (cerebral infarct, Cl; cerebral hemorrhage, CH; subarachnoid hemorrhage, SAH; and TIA) and subtypes of CI were diagnosed according to clinical and neuroimaging findings. CVD risk factors and conditions associated with carotid atherosclerosis were obtained from patient. An ultrasonographic assessment of extracranial carotid artery atherosclerosis and stenosis was carried out, The t-test in continuous variables and the Mantel-Haenszel x2 test in categorical risk factors are used to find the differences between CVD patients living in Taipei and New York. Results :During 1995-98, there were 3,117 and 427 patients, aged l8 years, with first-ever stroke recruited into NTUH and NYUDTH stroke registries respectively. For NTUH patients, 2057 (66%), 144 (5%), 718 (23%) and 197 (6%) were belonging to CI, TIA, CH and SAH in the order. For NYUDTH, 292 (68%), 40 (9%), 87 (20%) and 13 (3%) were belonging to CI, TIA, CM and SAM in the order. The average age of stroke was older in NYUDTH patients than NTUH patients (71 y vs 63 y). The frequencies of hypertension (74% vs 63%), DM (30% vs 26%), AF (18% vs 13%), were higher in NYUDTH patients than NTUH patients. The frequencies of severe extracranial ICA stenosis (>50%) were similar between NYDTH and NTUH patients with CI (both were 11%). The 30-day case-fatality of overall patients were 11.1% and 10.5% at NTUH and NYUDTI-I respectively. Conclusions :There were some difference of stroke types and their risk factors between Chinese populations in Taipei and New York. Further investigations are needed for clarification of the influence of environment or life style on CVD.本研究目的欲比較不同地域華人的腦中風型態及危險因子是否有差異。研究方法以台大醫院( NTUH ）及紐約大學下城醫院（NYUDTH ）的腦中風登錄比較兩地的異同。收錄1995-98 年急性腦中風年齡卹8 歲的病患，腦中風分為腦梗塞（CI ）、腦出血（CH ）、蜘珠網膜下出血（SAH ）及短暫缺血發作（TIA ) ，腦梗塞進一步分為大動脈粥狀硬化、小洞梗塞、心因性中風、其他特定原因及原因未明。 NYUDTH 的腦中風登錄，共843 位（438 位男性及405 位女性）病息，有499 位華人，153 位白種人種，88 位．黑種人種，99 位西語裔人種。腦中風的平約發生年齡為69.4土13.3 歲，華人及白種人種的平均年齡（71.5 歲及69.7 歲）高於黑種人種及西語裔人種（62.6 歲及64.9 歲）。華人的CH 較其他人種高，CI 對CH 之比華人為主6，白種人種為5.0 ，黑種人種為5.6 ，西語裔人種為6.0 。華人及黑種人種（76 ％及77 % ）具有高血壓比率高於白種人種及西語裔人種（63 ％及66 % ) ，糖尿病的比率以華人最高（33 % ) ，次為黑種人種、西語裔人種及白種人種（25 ％、25 ％、18 % ）。心臟疾病以白種人種最多（43 % ) ，華人則佔28 ％。 NTUH 的初發腦中風登錄，共3 , 117 位（男性57.6 % ，女性42.4 % ）。NTUH 的CH 及SAH 比率較高，而NYUDTH 的TIA 比率較高。NTUH 的初發腦中風平均年齡均明顯低於NYUDTH 。高血壓、糖尿病、心房顫動、高膽因醇在腦中風病患所佔比率以NYUDTH 較高，抽煙與飲酒習慣、高三酸甘油醋則在NTUH 較高，而缺血性心臟病及嚴重頸動脈狹窄則無顯著差異。30 日腦中風的疾病致死率兩醫院相差不大，對所有腦中風病患NTUH 為11.1 %, NYUDTH 為10.5 % ；對於Cl , NTUH 為5.4 %, NYUDTH 為4.8 %；對於CH, NTUH 為23.3 %, NYUDTH 為29.3％。 由以上結果，在紐約及台灣華人的腦中風型態與腦中風危險因子有明顯差異。是否環境因素會影響腦中風危險因子與腦中風的發生，需要更進一步研究。application/pdf970250 bytesapplication/pdfzh-TW國立臺灣大學醫學院神經科Cerebrovascular diseaseChineseStroke registryRacial difference腦血管疾病腦中風登錄種族差異journal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/26077/1/892314B002030.pdf