患有炎症性肠道疾病的患者中风的长期风险:基于人口的,兄弟姐妹控制的队列研究,1969-2019年
Jiangwei Sun1, Jonas Halfvarson2, Peter Appelros2
1From the Department of Medical Epidemiology and Biostatistics (J.S., D.B., F.E., B.R., J.F.L.), Karolinska Institutet, Stockholm; Department of Gastroenterology (J.H.), and University Health Care Research Center (P.A.), Faculty of Medicine and Health, Örebro University, Sweden; Department of Gastroenterology and Hepatology (F.E.), Clarunis University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland; Clinical Epidemiology Division (O.O.), Department of Medicine Solna, Karolinska Institutet, Stockholm; Sachs' Children and Youth Hospital (O.O.), Stockholm South General Hospital; Department of Clinical Science and Education Södersjukhuset (O.O.), Karolinska Institutet, Stockholm; Department of Pediatrics (J.F.L.), Örebro University Hospital, Sweden; and Division of Digestive and Liver Disease (J.F.L.), Department of Medicine, Columbia University Medical Center, New York, NY. jiangwei.sun@ki.se.
患有炎症性肠病 (IBD) 的患者在所有亚型中都有更高的中风长期风险,特别是缺血性中风. 这种增加的风险在诊断后至少持续25年,强调需要持续监测.
科学领域:
- 胃肠病学 胃肠病学
- 神经学 神经学
- 流行病学 流行病学
背景情况:
- 炎症性肠病 (IBD) 与血栓栓塞事件的增加有关.
- 在IBD患者的长期中风风险需要进一步调查.
研究的目的:
- 为了确定活检确认的IBD是否会增加中风的长期风险.
- 分析不同IBD亚型中风风险,并将其与匹配的对照和兄弟姐妹进行比较.
主要方法:
- 瑞典的一项队列研究 (1969-2019) 包括85,006名IBD患者和匹配的对照/兄弟姐妹.
- 通过国家患者登记册确定了中风结果 (整体,缺血,出血).
- 灵活的参数生存模型估计了调整后的危险比率 (aHR).
主要成果:
- 与参考患者相比,IBD患者的整体中风风险增加了13% (aHR 1.13).
- 风险增加,主要来自缺血性中风,持续了25年.
- 在克罗恩病,性结肠炎和IBD-未分类中观察到增加的缺血性中风风险.
结论:
- 患有IBD的患者面临着明显增加的中风的长期风险,特别是缺血性事件.
- 这种风险在IBD亚型中一致,并持续数十年.
- 对脑血管事件的临床警对于长期IBD管理至关重要.
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