Stroke:住院感染是急性缺血性卒中的触发因素

2016-05-16 MedSci MedSci原创

急性脑缺血性卒中的诱因,可能包括感染,目前正在被研究其是否是具有心血管疾病(CVD)危险背景患者的触发因素,来自美国的研究人员假设,感染增加了急性卒中的风险,特别是那些低心血管疾病风险的患者。住院卒中和感染在社区动脉粥样硬化的风险(ARIC)队列中进行了鉴定。病例交叉设计和条件逻辑回归用于比较卒中患者的住院感染(卒中前14,30,42,和90天)和卒中前相应的卒中前1年和2年的控制时期的住院感染。

急性脑缺血性卒中的诱因,可能包括感染,目前正在被研究其是否是具有心血管疾病(CVD)危险背景患者的触发因素,来自美国的研究人员假设,感染增加了急性卒中的风险,特别是那些低心血管疾病风险的患者。

住院卒中和感染在社区动脉粥样硬化的风险(ARIC)队列中进行了鉴定。病例交叉设计和条件逻辑回归用于比较卒中患者的住院感染(卒中前14,30,42,和90天)和卒中前相应的卒中前1年和2年的控制时期的住院感染。CVD风险背景在第1次随访和最接近卒中的一次随访中进行评估。

该研究共包括1008例缺血性卒中患者。与控制周期相比,住院感染在卒中前2周之内比较常见(14天比值比[OR]为7.7; 95%CI,2.1-27.3);随着卒中前暴露时间的增加,该联系的强度下降(30天OR,5.7[95%CI,2.3-14.3];42天OR,4.5[95%CI,2.0-10.2];90天OR,3.6[95%CI,2.1-6.5])。与具有较高CVD风险的患者相比,较低的CVD风险患者的卒中风险较高,这种相互作用在同一暴露时期达到统计学意义。

这些结果支持了住院感染是触发缺血性卒中因素的假说,这可能会解释一些隐源性卒中。加强感染控制可预防卒中。如果在感染前期进行CVD预防性治疗,可以预防卒中,但还需要进一步临床试验。

原始出处:

Cowan LT,Alonso A,Pankow JS,et al.Hospitalized Infection as a Trigger for Acute Ischemic Stroke,Stroke,2016.5.10

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