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BMJ：应激相关疾病与心血管疾病风险

2019-04-11 xing.T 网络

应激相关疾病心血管疾病风险
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由此可见，应激相关疾病与多种类型的心血管疾病密切相关，与家族背景、身体/精神疾病史和精神病合并症无关。

近日，顶级杂志BMJ上发表了一篇研究文章，研究人员旨在评估应激相关疾病与随后的心血管疾病风险之间的关联。

该研究是基于人群的、以兄弟为对照的队列研究。参与者为1987年至2013年期间瑞典国家患者登记中心136637名应激相关疾病患者，包括创伤后应激障碍（PTSD）、急性应激反应、适应障碍和其他应激反应；171314名这些患者的未受影响的兄弟；以及一般人群中有1366370名未配对的人士。该研究的主要结果指标是心血管疾病事件的初步诊断-任何或特定亚型（缺血性心脏病、脑血管疾病、栓子/血栓形成、高血压疾病、心力衰竭、心律失常/传导障碍和致命性心血管疾病）-以及心血管疾病的16项个体诊断。在控制多个混杂因素后，通过Cox模型得到心血管疾病的风险比率。

在长达27年的随访期间，暴露患者、未受影响的兄弟姐妹和未配对的未暴露个体的任何心血管疾病的粗发病率分别为每1000人每年10.5人、10.4人和6.9人。在基于兄弟姐妹的比较中，任何心血管疾病的风险比为1.64（95％置信区间为1.45至1.84），在任何应激相关疾病诊断后的第一年内观察到的最高亚型特异性风险比为心力衰竭（6.95,1.88至25.68）。超过一年，风险比率降低（总体为1.29,1.24至1.34），从心律失常的1.12（1.04至1.21）到动脉血栓形成/栓子的2.02（1.45至2.82）。应激相关疾病与早发性心血管疾病（（年龄<50）风险比率1.40（1.32至1.49））更密切，相比于晚发疾病（（1.24（1.18至1.30），年龄≥50岁; P=0.002）。除致命性心血管疾病外，这些相关性并未因精神病合并症而改变。在人群匹配队列的分析得出了类似的结果（在随访的第一年中任何心血管疾病的风险比为1.71（1.59至1.83），之后为1.36（1.33至1.39））。

由此可见，应激相关疾病与多种类型的心血管疾病密切相关，与家族背景、身体/精神疾病史和精神病合并症无关。

原始出处：

Huan Song.et al.Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study.BMJ.2019;https://doi.org/10.1136/bmj.l1255

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    2020-02-27 gaoxiaoe

    #BMJ#

    0

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    2019-04-12 ms1260584454294838

    #应激#

    0

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    2019-04-12 花花1368

    #疾病风险#

    0

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    2019-04-12 andy2090

    #血管疾病#

    0

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    2019-04-11 haige

    应激是疾病产生的原因之一，不可等闭忽视之。

    0