关于高山氏动脉炎中风和过渡性缺血性发作的最新情况:系统性审查和元分析
Xuepeng Jin1, Yutong Yang1, Xue Wang2
1Department of Rheumatology & Allergy, Xuanwu Hospital Capital Medical University, No. 45, Changchun Street, Xicheng District, China.
Joint bone spine
|July 25, 2025
概括
塔卡亚苏动脉炎 (TA) 患者患中风和暂时性缺血性发作 (TIA) 的风险很高,全球影响10.7%. 吸烟是这些患者中风/TIA的唯一可改变的风险因素.
科学领域:
- 血管神经学 血管神经学
- 类风湿病学 类风湿病学
- 流行病学 流行病学
背景情况:
- 塔卡亚苏动脉炎 (TA) 是一种罕见的大血管血管炎,具有显著的脑血管并发症.
- 之前对TA患者中风和过时性缺血性发作 (TIA) 患病率的估计缺乏全面的全球更新.
- 识别可修改的风险因素对于预防TA的神经事件至关重要.
研究的目的:
- 系统地审查和分析塔卡亚苏动脉炎患者中风和TIA的全球患病率.
- 评估不同小组中风/TIA患病率的变化.
- 在TA中识别与中风/TIA相关的显著可修改的风险因素.
主要方法:
- 在2025年1月之前对8个数据库进行系统的文献搜索,遵循PRISMA和MOOSE指南.
- 随机效应模型元分析,从34项观察性队列研究 (5112名患者) 中汇集流行率估计.
- 亚组分析和风险因素评估,使用I2统计和出版偏差通过漏斗图表和埃格尔测试来评估异质性.
主要成果:
- 在TA患者中,中风/TIA的综合患病率为10.7% (95% CI:8.4%-13.6%),具有相当大的异质性 (I2=90.4%).
- 在男性 (20%) 和欧洲人口 (13%) 中观察到更高的患病率. 缺血性中风占主导地位 (7%).
- 吸烟成为唯一显著可修改的风险因素 (RR=1.64,95% CI:1.13-2.38);中风占TA相关死亡的21.2%.
结论:
- 塔卡亚苏动脉炎患者经历了大量的中风/TIA负担,与人口和方法相关的显著异质性.
- 男性和欧洲血统的人患中风/TIA的患病率更高.
- 戒烟是减少TA患者中风/TIA风险的主要可修改干预措施.
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