PLOS ONE:吸烟极大增加女性高血压患者致死性脑出血风险

2013-09-11 佚名 睿医资讯

蛛网膜下腔出血(SAH)是最具破坏性的脑血管事件之一,死亡病例的比例达40-50%。SAH的最常见原因为脑动脉瘤破裂。如早期发现动脉瘤,则可在其破裂前予以治疗。但一些脑动脉瘤永远不会破裂,医师难以判断哪些动脉瘤会破裂而哪些不会。因而,医生们不清楚哪些患者应予以治疗,而哪些患者可以不予治疗。 芬兰一项长期、基于人口数据的SAH研究于9月9日发表于PLOS ONE杂志,研

蛛网膜下腔出血(SAH)是最具破坏性的脑血管事件之一,死亡病例的比例达40-50%。SAH的最常见原因为脑动脉瘤破裂。如早期发现动脉瘤,则可在其破裂前予以治疗。但一些脑动脉瘤永远不会破裂,医师难以判断哪些动脉瘤会破裂而哪些不会。因而,医生们不清楚哪些患者应予以治疗,而哪些患者可以不予治疗。

芬兰一项长期、基于人口数据的SAH研究于9月9日发表于PLOS ONE杂志,研究数据显示,SAH的发生风险与特定危险因素组合密切相关。SAH的发病率为8-17/10万人•年,发病率取决于多重SAH危险因素,如抽烟、高血压和女性。【原文下载】

文章的主要作者之一Miikka Korja教授表示,心血管疾病发病率与危险因素如此相关超出了人们的预期,这一发现具有显著的临床意义。

如果收缩压较高的吸烟女性与从不吸烟且血压较低的男性相比,此类脑出血的比例增高20倍,那么此类女性患者诊断为未破裂的脑动脉瘤时应接受治疗。换言之,从不吸烟且血压较低的男性患者则可能不许治疗。

这是目前有关SAH危险因素的最大规模的研究,研究团队还确认了3个新兴的SAH危险因素:既往心肌梗死、母亲卒中史、男性胆固醇水平增高。研究结果修正了此前人们对SAH流行病学的理解,并指出SAH的危险因素与其他心血管疾病危险因素相似。

既往数据显示,生活方式危险因素对SAH幸存者的预期寿命有显著影响,现有数据又表明,相同的危险因素还对SAH自身风险有明显影响。因而,戒烟和降压治疗对于预防SAH和增加SAH患者预期寿命有重要意义。

原文下载

Miikka Korja1, Karri Silventoinen, Tiina Laatikainen, Pekka Jousilahti, Veikko Salomaa,Juha Hernesniemi, Jaakko Kaprio.Risk Factors and heir Combined Effects on the Incidence Rate of Subarachnoid Hemorrhage – A Population-Based Cohort Study.PLOS ONE 2013 September.


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    2013-11-03 仁医06
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    2013-09-13 andy2092