Stroke:感染与围产期卒中的风险!

2018-04-20 xing.T MedSci原创

由此可见,入院时感染增加了有或无妊娠高血压疾病妇女在分娩期间的卒中风险。这一结局受泌尿生殖道感染和脓毒症的驱使。感染可能是围产期卒中的一个未被认识到的危险因素。

分娩期间围产期卒中较为罕见,但母体发病率较高。感染被认为是一种可能的卒中触发因素。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员假设在入院时诊断感染的妇女在分娩期间有较高的卒中风险。

研究人员利用加利福尼亚(2007-2011)、佛罗里达州(2009-2011)和纽约(2009-2011)的国家住院管理数据库进行了一项病例对照研究。接受顺产或剖宫产并在入院时诊断为卒中的女性作为患者,并按年龄/入院年份和妊娠高血压疾病有无和严重程度随机匹配3个对照者。感兴趣的主要暴露是在入院时存在的任何类型的感染。次要暴露包括种族/民族、付款人状况、分娩方式和已知的血管危险因素,如慢性高血压糖尿病、吸烟、酗酒、高凝状态、凝血病和肾脏疾病。研究人员使用多变量条件Logistic回归估计感染和已知的血管危险因素与卒中风险之间相关性的比值比和95%可信区间。

该研究共有455例患者(平均年龄为29.8岁),其中妊娠高血压疾病患者195例(42.9%),并有1365例对照者。入院时任何类型的感染增加了卒中诊断的几率(调整后的比值比为1.74;95%可信区间为1.29-2.35)。泌尿生殖道感染(调整后的比值比为2.56;95%可信区间为1.25-5.24)和脓毒症(调整的比值比为10.4;95%可信区间为2.15 - 20)的风险较高。妊娠期高血压疾病的发生不会影响感染与分娩期间卒中之间的关系。

由此可见,入院时感染增加了有或无妊娠高血压疾病妇女在分娩期间的卒中风险。这一结局受泌尿生殖道感染和脓毒症的驱使。感染可能是围产期卒中的一个未被认识到的危险因素。

原始出处:

Eliza C. Miller,et al. Infections and Risk of Peripartum Stroke During Delivery Admissions.Stroke. 2018. https://doi.org/10.1161/STROKEAHA.118.020628

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  1. [GetPortalCommentsPageByObjectIdResponse(id=308566, encodeId=b64e30856660, content=这是一个比较少见的话题.学习到了很多知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Mon Apr 23 17:06:07 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026024, encodeId=ef031026024a7, 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=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Apr 21 00:06:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307688, encodeId=5bad30e68868, content=分娩期间围产期卒中较为罕见.但母体发病率较高.感染被认为是一种可能的卒中触发因素.近日.卒中领域权威杂志Stroke上发表了一篇研究文章.研究人员假设在入院时诊断为感染的妇女在分娩期间有较高的卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Apr 20 22:31:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307683, encodeId=2b2030e6833d, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Fri Apr 20 21:59:04 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307674, encodeId=d81430e674ec, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 20 21:32:02 CST 2018, time=2018-04-20, status=1, ipAttribution=)]
    2018-04-23 一天没事干

    这是一个比较少见的话题.学习到了很多知识

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=308566, encodeId=b64e30856660, content=这是一个比较少见的话题.学习到了很多知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Mon Apr 23 17:06:07 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026024, encodeId=ef031026024a7, 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=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Apr 21 00:06:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307688, encodeId=5bad30e68868, content=分娩期间围产期卒中较为罕见.但母体发病率较高.感染被认为是一种可能的卒中触发因素.近日.卒中领域权威杂志Stroke上发表了一篇研究文章.研究人员假设在入院时诊断为感染的妇女在分娩期间有较高的卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Apr 20 22:31:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307683, encodeId=2b2030e6833d, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Fri Apr 20 21:59:04 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307674, encodeId=d81430e674ec, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 20 21:32:02 CST 2018, time=2018-04-20, status=1, ipAttribution=)]
    2018-04-21 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=308566, encodeId=b64e30856660, content=这是一个比较少见的话题.学习到了很多知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Mon Apr 23 17:06:07 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026024, encodeId=ef031026024a7, 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=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Apr 21 00:06:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307688, encodeId=5bad30e68868, content=分娩期间围产期卒中较为罕见.但母体发病率较高.感染被认为是一种可能的卒中触发因素.近日.卒中领域权威杂志Stroke上发表了一篇研究文章.研究人员假设在入院时诊断为感染的妇女在分娩期间有较高的卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Apr 20 22:31:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307683, encodeId=2b2030e6833d, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Fri Apr 20 21:59:04 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307674, encodeId=d81430e674ec, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 20 21:32:02 CST 2018, time=2018-04-20, status=1, ipAttribution=)]
    2018-04-20 有备才能无患

    分娩期间围产期卒中较为罕见.但母体发病率较高.感染被认为是一种可能的卒中触发因素.近日.卒中领域权威杂志Stroke上发表了一篇研究文章.研究人员假设在入院时诊断为感染的妇女在分娩期间有较高的卒中风险.

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=308566, encodeId=b64e30856660, content=这是一个比较少见的话题.学习到了很多知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Mon Apr 23 17:06:07 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026024, encodeId=ef031026024a7, 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=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Apr 21 00:06:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307688, encodeId=5bad30e68868, content=分娩期间围产期卒中较为罕见.但母体发病率较高.感染被认为是一种可能的卒中触发因素.近日.卒中领域权威杂志Stroke上发表了一篇研究文章.研究人员假设在入院时诊断为感染的妇女在分娩期间有较高的卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Apr 20 22:31:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307683, encodeId=2b2030e6833d, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Fri Apr 20 21:59:04 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307674, encodeId=d81430e674ec, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 20 21:32:02 CST 2018, time=2018-04-20, status=1, ipAttribution=)]
    2018-04-20 王秀

    学习了.涨知识了!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=308566, encodeId=b64e30856660, content=这是一个比较少见的话题.学习到了很多知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Mon Apr 23 17:06:07 CST 2018, time=2018-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026024, encodeId=ef031026024a7, 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=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Sat Apr 21 00:06:00 CST 2018, time=2018-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307688, encodeId=5bad30e68868, content=分娩期间围产期卒中较为罕见.但母体发病率较高.感染被认为是一种可能的卒中触发因素.近日.卒中领域权威杂志Stroke上发表了一篇研究文章.研究人员假设在入院时诊断为感染的妇女在分娩期间有较高的卒中风险., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Apr 20 22:31:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307683, encodeId=2b2030e6833d, content=学习了.涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Fri Apr 20 21:59:04 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307674, encodeId=d81430e674ec, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Fri Apr 20 21:32:02 CST 2018, time=2018-04-20, status=1, ipAttribution=)]
    2018-04-20 天地飞扬

    了解一下.谢谢分享!

    0

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肺部真菌感染是由真菌感染引起的支气管-肺部疾病,包括原发性和继发性肺部真菌感染。肺真菌感染临床表现常无特异性,故容易误诊。以下就是一例误诊案例。 该患者为一个41岁男性。1个月前患者发现颈部、颌下及腋窝出现数个增大的淋巴结,其中颌下淋巴结有压痛。同时左胸部出现疼痛,按压时疼痛明显,但无放射痛,偶伴非刺激性咳嗽,无发热、头痛,无咳痰、咯血,口服头孢克洛治疗1周无效。在当地医院对下颌淋巴结穿

J Infect Dis:我国学者揭示人感染H7N9禽流感病毒排毒时间的独立危险因素:延迟抗病毒治疗和应用糖皮质激素

近日,中国肺炎研究网(CAP-China)最新研究揭示影响人感染H7N9禽流感病毒排毒时间的独立危险因素,2018年4月10日在线发表于美国感染病协会(IDSA)官方杂志《感染性疾病杂志》(J Infect Dis)。

Emerg Microbes Infect:中国上海金黄色葡萄球菌ST188的感染分析

金黄色葡萄球菌是人类和家畜物种感染的重要病原体,但对金黄色葡萄球菌在相同地理环境和同一时期内引起不同宿主物种感染的克隆分布的了解尚未清楚。2012年至2014年,通过鉴定中国上海的牛、小儿和成人患者金黄色葡萄球菌引起的感染,我们确定甲氧西林敏感的金黄色葡萄球菌(MSSA)ST188是引起多种宿主物种感染的主要谱系。全基因组测序和表型分析表明ST188可能来自家畜,而且从牲畜和人类中分离的ST188

结核病治疗可能会使一些患者感染

《纽约时报》报道,《临床感染性疾病》杂志上发表的研究数据显示,世界卫生组织的结核病药物利福平和异烟肼的剂量指南可能对艾滋病患者来说可能过低,这使得他们的传染性超过了必要的时间。研究人员关注了大约270名感染了艾滋病毒的结核病患者,这些患者血液中吸收或保留的药物数量更少。参与者接受标准TB剂量,但发现血液中的浓度很低,84%的患者异烟肼水平低于标准水平,78%的患者低于利福平标准。联合首席研究报告作