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Brain and Nerve No to Shinkei Volume 44, Issue 8 （August 1992）

Brain and Nerve 脳と神経 44巻8号（1992年8月発行）

Japanese English

原著

北海道における運動ニューロン疾患の疫学的研究—その発病率，有病率および地域別分布の検討 Epidemiological Study of Motor Neuron Disease in Hokkaido Island : Its Incidence, Prevalence and Regional Distributions 奥村均 ¹ , 森若文雄 ¹ , 田代邦雄 ¹ , 濱田毅 ² , 松本昭久 ³ , 松本博之 ⁴ , 伊藤直樹 ⁵ , 真銅良吉 ⁶ , 高畑直彦 ⁷ , 島功二 ⁸ , 松浦亨 ⁸ , 柳原哲郎 ⁸ , 藤木直人 ⁸ , 安村修一 ⁸ , 千葉進 ⁸ , 矢崎一雄 ⁸ , 塩川哲男 ⁸ , 橋本和季 ⁸ Hitoshi Okumura ¹ , Fumio Moriwaka ¹ , Kunio Tashiro ¹ , Takeshi Hamada ² , Akihisa Matsumoto ³ , Hiroyuki Matsumoto ⁴ , Naoki Itoh ⁵ , Ryokichi Shindo ⁶ , Naohiko Takahata ⁷ , Kohji Shima ⁸ , Tohru Matsuura ⁸ , Tetsuro Yanagihara ⁸ , Naoto Fujiki ⁸ , Shu-ichi Yasumura ⁸ , Susumu Chiba ⁸ , Kazuo Yazaki ⁸ , Tetsuo Shiokawa ⁸ , Kazuki Hashimoto ⁸ ¹北海道大学医学部神経内科 ²北祐会神経内科病院 ³国療札幌南病院神経内科 ⁴札幌医科大学神経内科 ⁵中村記念病院神経内科 ⁶札幌市立病院神経内科 ⁷札幌医科大学神経精神科 ⁸ALS study group ¹Department of Neurology, Hokkaido University School of Medicine ²Hokuyukai Neurological Hospital ³Department of Neurology, National Sapporo Minami Hospital ⁴Department of Neurology, Sapporo Medical College ⁵Department of Neurology, Nakamura Memorial Hospital ⁶Department of Neurology, Sapporo City Hospital ⁷Department of Psychiatry, Sapporo Medical College キーワード： motor neuron disease , epidemiological study , incidence , prevalence Keyword: motor neuron disease , epidemiological study , incidence , prevalence pp.727-732

発行日 1992年8月1日 Published Date 1992/8/1

DOI https://doi.org/10.11477/mf.1406900370

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Abstract 文献概要
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　北海道における運動ニューロン疾患（MND）の疫学調査を道内で神経内科診療を行っている多施設との共同研究で行った。調査期間を1980年から1989年の10年間とし，この期間に発症した孤発性MND症例を，神経内科診療施設で診察・診断された症例，道内主要620施設へのアンケート調査，および特定疾患調査表を申請した症例から集計し389症例を確定した。389症例の平均発病年齢は58.2±10.3歳，男女比は1.6：1，臨床病型はALS 303例，PBP 52例およびSPMA 34例であった。10年間の年間平均発病率は人口10万人当たりO．69（95％信頼限界，95％CI 0.62-0.76），年齢性別補正発病率では男性例0.82／100.000（95％CIO．75—O．97），女性例0.53／100.000（95％CI 0.45-0.61）で，後半5年間の平均時点有病率は2.25であった。地域別発病率の検討ではSIR 300％以上を示す相対的集積地区がみられ，高SIR地区に限定された環境因子の解析が本症の発症要因の解明の糸口が得られると思われた。

The incidence, prevalence and regional distribu-tions of sporadic motor neuron disease (MND) from 1980 through 1989 were evaluated in collabora-tion with multiple neurological institutes in Hok-kaido island. Patients with sporadic MND were collected from three sources : 1) neurologist practicing in Hokkaido island, 2) sending inquiries to 620 major hospitals, 3) notification file of MND provided by Japanese Ministry of Welfare and Health.

Three hundred and eighty-nine patients with spo-radic MND were ascertained for this study. Of 389 patients, 238 patients were men and 151 patients were women, and the ratio of men to women was 1.6 : 1. The mean age of onset was 58.2±10.3 years old, 57.7±10.4 for men and 58.9±10.0 for women. Their clinical presentations were 303 patients with ALS, 52 patients were PBP and 34 patients were SPMA.

The crude incidence rate for both sexes combined for 1980 through 1989 was estimated as 0.69 per 100, 000 person-year. The age-and sex-adjusted inci-dence for men was 0.86 per 100,000 person-year (95% CI, 0.75 to 0.97) and that is higher than 0.53 per 100,000 person-year (95% CI, 0.45 to 0.61) for women. The average, crude prevalence rate from 1985 through 1989 was estimated as 2.25 per 100,000 person-year.

There are no overall trends of changing the pat-tern in incidence and prevalence of MND in Hok-kaido island, however the geographic distributionsof the incidence of MND according to towns and cities disclosed the presence of some relative clus-tering areas.

The further epidemiological study in Hokkaidoisland must be continued considering the characteristics of Hokkaido island such as many mineral mines and past epidemics of poliomyelitis.