J Rheumatol:系统性硬化症患者缺血性卒中的风险升高

2019-06-25 xiangting MedSci原创

在美国退伍军人中,SSc与缺血性卒中的风险升高独立相关。

既往认为系统性硬化症(SSc)主要影响微血管系统,但SSc与大血管疾病的关系越来越密切。心血管(CV)和脑血管疾病占SSc死亡率的20-30%,但很少有研究表明SSc与卒中之间存在独立关联。这项研究评估了SSc是否为缺血性卒中的独立危险因素。

研究人员使用国家退伍军人事务(VA)管理数据库进行了一项回顾性队列研究,该数据库包含1999年至2014年的记录。获得了所有诊断为SSc患者的数据,并根据性别、种族、吸烟状态和VA地点将每个SSc患者与2名对照进行匹配。随访所有患者直至出现缺血性卒中、死亡或最后一次随诊。调整CV合并症(高血压糖尿病房颤、非脑血管动脉粥样硬化、高脂血症)、基线用药(阿司匹林、非甾体类抗炎药)和医保登记后,使用Cox比例风险回归模型估算缺血性卒中的风险。

在4545例SSc患者中(男性83%,平均年龄60.9岁),缺血性卒中的发病率为每1000人年15.3(对照组为12.2),未调整HR为1.28(95%CI 1.11-1.47)。调整基线CV风险因素、用药和医保登记后,调整后的HR为1.21(95%CI 1.05-1.40)。

在美国退伍军人中,SSc与缺血性卒中的风险升高独立相关。SSc患者可能受益于靶向卒中筛查预防性治疗。

原始出处:

David Ying. Increased Risk of Ischemic Stroke in Systemic Sclerosis: A National Cohort Study of US Veterans. J Rheumatol. 15 June 2019.

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    2019-06-25 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

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