缺血性中风亚型与中风严重程度之间的关联:社区动脉样硬化风险研究
Michelle C Johansen1, Jinyu Chen2, Andrea L C Schneider2
1From the Johns Hopkins University School of Medicine (M.C.J.); Johns Hopkins University School of Public Health (J. Chen, J. Coresh), Baltimore, MD; University of Pennsylvania (A.L.C.S.), Philadelphia; University of North Carolina (J. Carlson), Chapel Hill; Virginia Commonwealth University (T.H.), School of Medicine, Richmond; University of Minnesota (K.L., S.P.), Minneapolis; National Institutes of Neurological Disorders and Stroke Intramural Program (R.F.G.), NIH, Bethesda, MD; and Stanley Steyer School of Health Professions (S.K.), Tel Aviv University, Israel. mjohans3@jhmi.edu.
与血栓性中风相比,栓塞性中风与更严重的后果和更高的死亡率有关. 即使考虑到其他健康状况,这种关联仍然存在,并且因性别而异.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
- 心血管研究研究心血管研究
背景情况:
- 脑卒中残疾因缺血性脑卒中亚型而异.
- 栓塞性中风可能比血栓性中风更严重.
- 伴随性疾病和最初中风严重程度对结局的影响尚不清楚.
研究的目的:
- 为了比较栓塞性和血栓性中风亚型之间的中风严重程度和死亡风险.
- 调查中风亚型的差异是否可以通过并发症或初始严重程度来解释.
- 为了检查种族和性别是否会改变中风亚型和结果之间的关联.
主要方法:
- 在社区的动脉样硬化风险分析 (ARIC) 研究的参与者与缺血性中风.
- 使用多项逻辑回归来评估中风亚型和入院NIH中风量表 (NIHSS) 严重程度.
- 应用考克斯的比例危险模型来评估全因死亡率,并对种族和性别进行相互作用分析.
主要成果:
- 与血栓性中风患者相比,栓塞性中风患者患更严重中风的风险更高 (NIHSS>5).
- 在对心房进行调整后,这种关联仍然显著,尽管减弱了.
- 脑卒中严重程度与亚型的关联因性别而异,栓塞性脑卒中增加了死亡风险 (HR 1.66).
结论:
- 与血栓性中风相比,栓塞性中风与更大的初始严重程度和增加的死亡风险有关.
- 这些差异在调整患者层面的混因素后仍然存在.
- 性别是中风亚型和严重程度之间的关系的重要修饰因素.
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