八重山諸島におけるクモ膜下出血の疫学的検討  [in Japanese] Epidemiology of Subarachnoid Hemorrhage in the Yaeyama Islands, an Isolated Subtropical Region of Japan  [in Japanese]

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Author(s)

    • 泉原 昭文 Izumihara Akifumi
    • 独立行政法人国立病院機構関門医療センター救命救急センター部脳神経外科 Department of Neurosurgical Emergency, National Hospital Organization, Kanmon Medical Center

Abstract

温帯から亜寒帯に属する地域において,クモ膜下出血発症の周期性,群発性あるいは気象との関連性が指摘され,環境因子の影響が示唆される.本検討では亜熱帯に属する八重山諸島における13年間のクモ膜下出血患者94例を対象として,発症時活動状況を含む環境因子からの疫学的分析を行った.本邦の中では発症年齢(平均57.3歳)がやや低く,男女比約1:2で女性の比率がかなり高いが,年間発症率(年齢性別調整17.4)は平均的であった.季節別では秋に多く,月別では8月に多かった.曜日別では月曜に多く,時間別では18:00〜19:59に大きなピークを認め,6:00〜7:59に小さいピークを認めた.また0:00〜1:59と4:00〜5:59に少なかった.台風最接近日前後3日以内ではそれ以外の時に比べて約1.8倍多かった.生活・労働時発症が多かった.無・軽負荷例で周期性および台風接近との関連性がより明瞭であった.

Epidemiological studies of periodicity, clustering, and meteorological association in relation to the onset of subarachnoid hemorrhage (SAH) have already been reported for populations in the temperate and subarctic latitudes. The purpose of the present study was to analyze epidemiological, especially environmental data for patients with SAH in the Yaeyama Islands, an isolated subtropical region of Japan. A total of 94 patients (31 males and 63 females, mean age 57.3 years) were diagnosed as having SAH during a 13-year period from 1989 to 2002. The age- and sex-adjusted annual incidence rate of SAH was 17.4 per 100,000 person-years. In comparison with other Japanese studies, the present demographic data indicated a stronger predominance of females, a relative younger age at onset, and an average annual incidence rate. Periodic patterns of SAH onset showed a seasonal peak in fall, a monthly peak in August, a weekly peak on Monday, a daily large peak in the evening, a daily small peak in the morning, and a daily trough in the period from midnight to dawn. The incidence of SAH for the 3 days before and after the day when a typhoon went nearest within 300km from the Ishigaki Island was about 1.8 times as high as but those days. SAH occurred more frequently during daily living or labor activities. Periodicity in the onset of SAH and its association with the approach of typhoons were demonstrated more clearly in patients with no or light stress at onset.

Journal

  • Japanese Journal of Neurosurgery

    Japanese Journal of Neurosurgery 19(8), 605-615, 2010

    The Japanese Congress of Neurological Surgeons

References:  60

Codes

  • NII Article ID (NAID)
    110007686911
  • NII NACSIS-CAT ID (NCID)
    AN10380506
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    0917-950X
  • Data Source
    CJP  NII-ELS  J-STAGE 
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