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山形県における急性期脳卒中の現状を調査し,全国と比較することで山形県の脳卒中の特徴につき検討した。平成10年1月1日~14年12月31日の5年間に山形県対脳卒中治療研究会参加施設に入院した急性期脳卒中全症例を前向きに登録し解析した。本登録の特徴は,(1)全例で急性期に必要な神経放射線学的検査を施行し,脳卒中専門医により診断・治療・評価が行われている,(2)急性期脳卒中が入院する県内のほとんどの施設が参加しているため,県内の脳卒中のほとんどを網羅している,ことが挙げられる。5年間で13,639例が登録され,その病型は脳梗塞58.4%,脳出血25.8%,くも膜下出血11.4%,一過性脳虚血発作4.4%であった。全国調査の結果と比較して出血性脳血管障害の占める割合が大きかった。また,発症後来院までに要する時間が全国と比較して長かった。
The purpose of this study was to clarify the incidence and features of acute cerebrovascular diseases in Yamagata Prefecture, by comparing with those in other prefectures reported in previous studies.
Consecutive 13,639 cases of acute stroke were prospectively registered to Yamagata Society in Treatment for Cerebral Stroke (YSTCS) between January 1, 1998 and December 31, 2002. Cerebral infarction (CI), intracerebral hemorrhage (CH), subarachnoid hemorrhage (SAH) and transient ischemic attack (TIA) were observed in 58.4%, 25.8%, 11.4% and 4.4% of the patients, respectively. The frequencies of CH and SAH(37.2%) in Yamagata Prefecture were higher than those reported in other studies(p<0.01). In addition, time from onset to admission in Yamagata Prefecture was longer than that reported in others(p<0.01).
This study was one of the largest stroke registration studies in Japan enrolling 13,639 patients. In addition, computed tomography (CT) and/or magnetic resonance image (MRI) was performed on admission in all patients. Diagnosis was made by a neurologist or a neurosurgeon based on CT and/or MRI findings. Our results might accurately reflect current status of stroke patients in Yamagata Prefecture.
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