Stroke：含咖啡因药与出血性卒中危险增加相关

　　韩国一项研究表明，应用含有咖啡因的药物（CCM）与出血性卒中（HS）危险增加相关，包括蛛网膜下腔出血和脑出血。论文6月6日在线发表于《卒中》（Stroke）杂志。

　　该多中心病例对照研究共纳入940例年龄在30—84之间无卒中病史的非创伤性急性HS患者，以与之年龄和性别相匹配的940社区居民和住院者作为对照组。获取各组患者卒中首发时间及此时间之前的14天患者的药物应用信息。以首发卒中前或卒中的前3天应用CCM定义为CCM暴露。利用条件回归模型评估校正比值比（OR）和95%置信区间（CI）。

　　结果显示，对于所有HS患者，CCM应用与HS、蛛网膜下腔出血和脑出血危险的相关性校正OR值分别为2.23（95% CI1.41–3.69），2.24（95% CI 1.08–4.66）和2.49 （95% CI 1.29–4.80）。对每日咖啡摄入进行分层后，与每日不喝咖啡者相比，CCM应用的HS校正OR值为2.95 （95% CI 1.45–5.98）。

Caffeine-Containing Medicines Increase the Risk of Hemorrhagic Stroke
Background and Purpose
Research on the relationship between caffeine-containing medicines (CCMs) and the risk of hemorrhagic stroke (HS) is sparse. The aim of this study is to evaluate the association between CCMs and the risk of HS.
Methods
We performed a multicenter case–control study in South Korea, from 2002 to 2004. A total of 940 patients with nontraumatic acute HS, aged 30 to 84 years without a history of stroke, 940 community, and 940 hospital controls, age and sex matched to each case, were included. We obtained information on all medications taken in the 14 days before the date (index date) and time of stroke onset (zero-time) for case subjects or matched zero-time for control subjects. Exposure to CCMs was defined by use on the index date before zero-time or during the preceding 3 days. The adjusted odds ratios and their 95% confidence intervals (CIs) were estimated by conditional logistic regression.
Results
The adjusted odds ratio for the association between the use of CCM and risk for HS was 2.23 (95% CI, 1.41–3.69) for all HS, 2.24 (95% CI, 1.08–4.66) for subarachnoid hemorrhage, and 2.49 (95% CI, 1.29–4.80) for intracerebral hemorrhage. Stratified by daily coffee intake, adjusted odds ratio of CCMs for HS was 2.95 (95% CI, 1.45–5.98) for those who did not drink coffee on a daily basis.
Conclusions
These results suggest that use of CCMs is associated with increased risk of HS, both subarachnoid hemorrhage and intracerebral hemorrhage.