缺血性卒中的防治进展培训课件.pptVIP

缺血性卒中的防治进展 缺血性卒中的防治进展 WHO脑血管疾病二级预防推荐用药 如无明确禁忌证，所有有TIA史或推测因脑缺血或梗死而出现卒中的患者均应接受长期（甚至可能需要终生）抗血小板治疗。(Ia A) ——心 血 管 疾 病 预 防-心血管风险评估和管理袖珍指南 世界卫生组织2008 缺血性卒中的防治进展 谢 谢 * * * 20世纪50年代以后，传染病得到了有效的控制，发病率及死亡率大幅度下降，一些非传染性疾病如心血管病,卒中,恶性肿瘤在人类死亡原因序列中明显前移，成为三大主要死亡原因。根据 WHO卒中协作研究组对57个国家的统计资料，卒中列在前三位死亡的国家有40个。例如，卒中在美国是第三大死亡原因——仅次于冠心病和癌症。在日本卒中引起的死亡居于首位。首次卒中发作的第一年存活率为22%（男性）和 25% （女性）。每一次卒中复发都增加严重残疾和死亡的可能性。 全世界范围内卒中也是引起严重残疾的首要原因。由于卒中对老年人是重要的死亡或致残原因，在人口老龄化趋势日益加速的情况下，卒中的危害性也必然日益突出，因此，卒中的防治已成为卫生工作中的一项重要课题，越来越引起国内外医学界特别是神经科学界的重视。 1. WHO The World Heart Report 1999, Nikkei Medical 1999, Japan Welfare Ministry 1997 2.Williams GB, et al. Stroke 1999;30:2523–8. * * * 脑梗死是人类健康的巨大威胁，根据WHO2002年的数据，全球每年死亡人口中脑梗死（卒中）占10％，共550万人，是全世界第三位死亡原因。我国更加严重，每年因卒中死亡165万人，居世界首位。 Background and Purpose—To examine the incidence and trends of stroke and its major subtypes during the 1990s in 3 cities in China. Methods—Stroke cases registered between 1991 to 2000 were initially identified through the stroke surveillance networks established in Beijing, Shanghai, and Changsha, and then confirmed by neurologists. Results—The age-standardized incidence rates per 100 000 person years of overall first-ever stroke were 135.0 (95% CI, 126.5 to 144.6) in Beijing, 76.1 (70.6 to 82.6) in Shanghai, and 150.0 (141.3 to 160.0) in Changsha during the 1990s. Incidence of ischemic stroke (IS) was highest in Beijing, followed by Changsha and Shanghai; for intracerebral hemorrhage (ICH), the highest rate was found in Changsha, followed by Beijing and Shanghai. The same order as ICH was also observed for subarachnoid hemorrhage. The age-adjusted incidence of overall stroke and ICH for individuals 55 years of age in our populations was generally higher than that from Western populations. During the 1990s, ICH incidence decreased significantly at a rate of 12.0% per year in Beijing, 4.4% in Shanghai, and 7.7% in Changsha; in contrast, except for Changsha, IS incidence increased in Beijing (5.0% per year) and Shanghai (7