Abstract: Objective  To analyze the temporal trends and population distribution characteristics of acute ischemic stroke (AIS) incidence in Tengzhou City, Shandong Province from 2013 to 2021. 
Methods  Data for this study were obtained from the Shandong provincial chronic disease surveillance information system. AIS case records from 2013 to 2021 were extracted from this system, while the corresponding household registration population data for the same period were obtained from the Tengzhou Public Security Bureau. Age- and gender-standardized incidence rates of AIS were calculated based on the seventh national population census of 2020. The differences in the distribution of crude and standardized incidence rates of AIS among populations with different characteristics were compared. The Cochran-Armitage trend test was used to analyze the temporal trends in crude and standardized incidence rates of AIS for the overall population, as well as for males and females, and urban and rural residents separately.
Results  From 2013 to 2021, the overall crude and standardized incidence rates of AIS in Tengzhou City increased from 170.94/100 000 and 212.37/100 000 to 379.21/100 000 and 361.41/100 000, respectively. The overall crude and standardized incidence rates of AIS showed two peaks in 2015 and 2018, with the crude incidence rates of 314.99/100 000 and 356.68/100 000, and the standardized incidence rates of 365.12/100 000 and 387.69/100 000, respectively. Compared with the year 2015, the overall crude incidence rate of AIS in 2021 increased by 20.39%, with an average annual increase of 3.05% (P<0.001). Except for 2017, when the difference in crude incidence rate between genders was not statistically significant, the crude and standardized incidence rates in males were higher than those in females in all other years (all P<0.001). In terms of crude incidence rate of AIS, the first peak occurred in 2015 among males in four age groups (<35, 45-54, 55-64, and≥65 years) and among females in two age groups (55-64 and≥65 years); the first peak occurred in 2016 among males in one age group (35-44 years) and among females in one age group (45-54 years). The second peak appeared in 2018 among males in two age groups (55-64 and≥65 years) and among females in one age group (≥65 years), and in 2017 among females in one age group (55-64 years). Both urban and rural areas experienced two peaks in crude incidence rate of AIS in 2015 and 2018. From 2015 to 2021, the crude incidence rate of AIS in rural areas increased by 24.95% (P＜0.001), whereas the increasing trend in urban areas was not statistically significant.
Conclusions  From 2013 to 2021, the increase in crude incidence rate of AIS in Tengzhou City slowed after 2015. The crude incidence rate is higher in males than in females, accompanied by a trend of younger onset, and the increase in rural areas is greater than in urban areas.

Key words: Acute ischemic stroke; Incidence rate; Epidemiological study

摘要： 目的 分析2013—2021年山东省滕州市急性缺血性卒中（acute ischemic stroke，AIS）发病率的时间变化趋势和人群分布特征。
方法 本研究数据来源于山东省慢性病监测信息系统，提取2013—2021年AIS病例监测数据，同期户籍人口数据来源于滕州市公安局。基于2020年第7次全国人口普查数据计算AIS年龄和性别标化发病率，比较AIS粗发病率和标化发病率在不同特征人群中的分布差异，采用Cochran-Armitage趋势检验分析AIS总体，以及男性和女性、城区和农村居民粗发病率和标化发病率的时间变化趋势。
结果 2013—2021年，滕州市总体AIS粗发病率和标化发病率分别从170.94/10万和212.37/10万上升至379.21/10万和361.41/10万。总体AIS粗发病率和标化发病率分别在2015年及2018年形成两个高峰，粗发病率分别为314.99/10万和356.68/10万，标化发病率分别为365.12/10万和387.69/10万。2021年总体AIS粗发病率较2015年升高了20.39%，年均增长3.05%（P＜0.001）。除2017年粗发病率在性别间的差异无统计学意义外，其余各年份男性的AIS粗发病率和标化发病率均高于女性（均P＜0.001）。在AIS粗发病率方面，男性4个年龄段（＜35岁、45～54岁、55～64岁和≥65岁）和女性2个年龄段（55～64岁和≥65岁）于2015年形成第一峰，男性1个年龄段（35～44岁）和女性1个年龄段（45～54岁）于2016年形成第一峰；男性2个年龄段（55～64岁和≥65岁）和女性1个年龄段（≥65岁）于2018年形成第二峰，女性1个年龄段（55～64岁）于2017年形成第二峰。城区和农村AIS粗发病率分别在2015年及2018年形成两个高峰，2021年较2015年农村AIS粗发病率升高了24.95%（P＜0.001），城区的变化无统计学意义。
结论 2013—2021年滕州市AIS粗发病率在2015年后上升速度减缓。男性粗发病率高于女性且有年轻化趋势，农村粗发病率升幅高于城区。

关键词: 急性缺血性卒中; 发病率; 流行病学研究