Neurology:年轻卒中幸存者的卒中后癫痫发作和痴呆风险

2022-07-01 Naomi MedSci原创

年轻卒中幸存者新发作的癫痫对随后发展为痴呆症的影响尚不清楚。近日,一项以人群为基础的卒中患者研究发现,年轻卒中幸存者的癫痫发作与发展为痴呆症的风险增加2.53倍相关。

年轻卒中幸存者新发作的癫痫对随后发展为痴呆症的影响尚不清楚。近日,一项发表在Neurology上的研究试图在一项以人群为基础的卒中患者研究中,评估新的癫痫发作与痴呆之间的关系。

2005-2014年的IBM Watson Health MarketScan®商业索赔和遭遇数据库作为本研究的数据源。使用国际疾病分类第九版,确定了2006年1月1日至2009年12月31日期间18-60岁的缺血性卒中患者(43.x1、434.x1和436)和出血性卒中患者(430、431、432.0、432.1和432.9),这些患者构成了基线研究队列。在基线水平,所有纳入的参与者都没有声称患有痴呆症、脑瘤、毒素暴露、创伤性脑损伤和神经感染性疾病,这些都已确定使用ICD-9代码。在指数卒中诊断之前,他们至少有1年的连续登记,在指数日期后的1年内,没有癫痫发作索赔。感兴趣事件的是癫痫发作:一个时间依赖变量。感兴趣的研究结果是痴呆症(ICD9:290.0,290.10-13,290.20-21,290.3,290.40-43,291.2,292.82,294.10-11,294.20-21,294.8,331.0,331.11,331.19,331.82),发生在2010年1月1日至2014年12月31日的随访期间。用Cox比例风险回归模型计算癫痫发作与痴呆发生独立关联的危险比(HR)和95%可信区间(CI)。

  • 在基准期结束时,共确定了23,680名卒中患者(IS:20,642,HS:3,038)。
  • 所有卒中、IS和HS的累积癫痫发生率分别为6.7%、6.4%和8.3%。
  • 所有卒中、IS和HS的累积痴呆症发病率分别为1.3%、1.4%和0.9%。
  • 经多因素调整后,有癫痫发作的青年卒中患者比无癫痫发作的青年卒中患者发生痴呆的风险更大(所有卒中调整后的HR:2.53,95%CI 1.84~3.48;IS:2.52,1.79~3.53;HS:2.80,1.05~7.43)。

结论:这些发现表明,年轻卒中幸存者的癫痫发作与发展为痴呆症的风险增加2.53倍相关。

文献来源:Lekoubou A, Ba DM, Nguyen C, et al. Poststroke Seizures and the Risk of Dementia Among Young Stroke Survivors [published online ahead of print, 2022 May 18]. Neurology. 2022;10.1212/WNL.0000000000200736. doi:10.1212/WNL.0000000000200736

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    2022-07-02 yinhl1978
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    2022-07-02 海阔天空Sin

    👍

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  6. [GetPortalCommentsPageByObjectIdResponse(id=2018374, encodeId=cff120183e41b, content=<a href='/topic/show?id=5cac36039a1' target=_blank style='color:#2F92EE;'>#卒中幸存者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36039, encryptionId=5cac36039a1, topicName=卒中幸存者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6393434, createdName=ailian1202, createdTime=Wed Feb 15 08:51:45 CST 2023, time=2023-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001849, encodeId=cffc200184903, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 02 05:51:45 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671481, encodeId=6ac216e14811f, content=<a href='/topic/show?id=9f4e360191a' target=_blank style='color:#2F92EE;'>#卒中后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36019, encryptionId=9f4e360191a, topicName=卒中后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ff7426824786, createdName=waiwai3039, createdTime=Wed Feb 22 14:51:45 CST 2023, time=2023-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1316850, encodeId=2558131685057, content=<a href='/topic/show?id=d3d0e121576' target=_blank style='color:#2F92EE;'>#痴呆风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71215, encryptionId=d3d0e121576, topicName=痴呆风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a98f453, createdName=pcw106, createdTime=Sat Jul 02 12:51:45 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230095, encodeId=ab8f1230095c0, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211030/727082c36c794e7a9cc18aad6a2886d1/d8e51d61f5f74b299541d33450410b09.jpg, createdBy=26f72982264, createdName=海阔天空Sin, createdTime=Sat Jul 02 10:27:54 CST 2022, time=2022-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1247130, encodeId=86c5124e1302f, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Fri Jul 01 00:51:45 CST 2022, time=2022-07-01, status=1, ipAttribution=)]
    2022-07-01 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

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