Stroke:早产成人的卒中风险

2021-06-17 MedSci原创 MedSci原创

在这个大型全国队列中,早产与成年期出血性和缺血性卒中的风险增加有关。早产幸存者需要早期预防性评估和长期临床随访,以降低他们终生的卒中风险

临床医生将面对越来越多的早产成年患者,因此,对于临床医生很有必要了解他们的长期后遗症。据报道,早产的成年幸存者患高血压和其他卒中危险因素的风险增加。然而,他们的卒中风险很少被评估,结果也不一致,可能是由于样本量小、随访不足或幸存者偏差所致。

近日,血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员在一个基于人群的大型队列中评估了早产是否与卒中相关。

研究人员对1973年至1994年期间在瑞典出生的所有2140866名存活至18岁的单胎婴儿进行了一项全国队列研究,他们被随访了到2015年首次卒中(最大年龄为43岁)。Cox回归用于评估与出生时胎龄相关的卒中风险,调整其他围产期和父母因素。Cosibling分析评估了共享家族(遗传或环境)因素的潜在混杂因素。

卒中风险

在2800万人次每年的随访中,4861人(0.2%)被诊断为卒中。在18至43岁期间,与足月产(39-41 周)相比,与早产(<37 周)相关的卒中调整风险比为1.26(95%CI为1.12-1.43;P<0.001),进一步分层对于早期早产(22-33 周)为1.42(1.11-1.81;P=0.005),对于晚期早产(34-36 周)为1.22(1.06-1.40;P=0.004)。研究人员其发现出血性卒中(早期早产:调整风险比为1.42 [95% CI为1.04-1.94];任何早产:1.15 [0.97-1.35])和缺血性卒中(早期早产:调整风险比为1.33 [ 95%CI为0.87–2.03];任何早产:1.31 [1.07–1.60])呈正相关。这些结果在男性和女性参与者中是相似的,只是部分可由家庭内早产和卒中的共同决定因素所解释。

由此可见,在这个大型全国队列中,早产与成年期出血性和缺血性卒中的风险增加有关。早产幸存者需要早期预防性评估和长期临床随访,以降低他们终生的卒中风险

原始出处:

Casey Crump.et al.Stroke Risks in Adult Survivors of Preterm Birth: National Cohort and Cosibling Study.stroke.2021.https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033797

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1281373, encodeId=535f12813e33b, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sat Jun 19 12:35:25 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026883, encodeId=6b22102688381, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046074, encodeId=ff8d10460e447, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974523, encodeId=50a89e4523ae, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210128/d719c5a457e640d88a16efd137890639/57d598105aeb4783b9073e2f13733562.jpg, createdBy=73dc5434031, createdName=ms3000000503829460, createdTime=Thu Jun 17 22:34:54 CST 2021, time=2021-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974498, encodeId=f2a39e4498d2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=45032553169, createdName=薛峰杰, createdTime=Thu Jun 17 21:51:25 CST 2021, time=2021-06-17, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1281373, encodeId=535f12813e33b, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sat Jun 19 12:35:25 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026883, encodeId=6b22102688381, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046074, encodeId=ff8d10460e447, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974523, encodeId=50a89e4523ae, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210128/d719c5a457e640d88a16efd137890639/57d598105aeb4783b9073e2f13733562.jpg, createdBy=73dc5434031, createdName=ms3000000503829460, createdTime=Thu Jun 17 22:34:54 CST 2021, time=2021-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974498, encodeId=f2a39e4498d2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=45032553169, createdName=薛峰杰, createdTime=Thu Jun 17 21:51:25 CST 2021, time=2021-06-17, status=1, ipAttribution=)]
    2021-06-18 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

  3. [GetPortalCommentsPageByObjectIdResponse(id=1281373, encodeId=535f12813e33b, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sat Jun 19 12:35:25 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026883, encodeId=6b22102688381, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046074, encodeId=ff8d10460e447, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974523, encodeId=50a89e4523ae, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210128/d719c5a457e640d88a16efd137890639/57d598105aeb4783b9073e2f13733562.jpg, createdBy=73dc5434031, createdName=ms3000000503829460, createdTime=Thu Jun 17 22:34:54 CST 2021, time=2021-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974498, encodeId=f2a39e4498d2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=45032553169, createdName=薛峰杰, createdTime=Thu Jun 17 21:51:25 CST 2021, time=2021-06-17, status=1, ipAttribution=)]
    2021-06-18 guging

    中风是俗称,应该称为缺血性卒中吧

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1281373, encodeId=535f12813e33b, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sat Jun 19 12:35:25 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026883, encodeId=6b22102688381, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046074, encodeId=ff8d10460e447, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974523, encodeId=50a89e4523ae, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210128/d719c5a457e640d88a16efd137890639/57d598105aeb4783b9073e2f13733562.jpg, createdBy=73dc5434031, createdName=ms3000000503829460, createdTime=Thu Jun 17 22:34:54 CST 2021, time=2021-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974498, encodeId=f2a39e4498d2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=45032553169, createdName=薛峰杰, createdTime=Thu Jun 17 21:51:25 CST 2021, time=2021-06-17, status=1, ipAttribution=)]
    2021-06-17 ms3000000503829460

    👍🏻

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1281373, encodeId=535f12813e33b, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Sat Jun 19 12:35:25 CST 2021, time=2021-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026883, encodeId=6b22102688381, content=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!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046074, encodeId=ff8d10460e447, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jun 18 00:35:25 CST 2021, time=2021-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974523, encodeId=50a89e4523ae, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210128/d719c5a457e640d88a16efd137890639/57d598105aeb4783b9073e2f13733562.jpg, createdBy=73dc5434031, createdName=ms3000000503829460, createdTime=Thu Jun 17 22:34:54 CST 2021, time=2021-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=974498, encodeId=f2a39e4498d2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=45032553169, createdName=薛峰杰, createdTime=Thu Jun 17 21:51:25 CST 2021, time=2021-06-17, status=1, ipAttribution=)]
    2021-06-17 薛峰杰

    学习了

    0

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