Urbanek Christian, Palm Frederick, Grau Armin J
Department of Neurology, Städtisches Klinikum Ludwigshafen, 67073 Ludwigshafen, Germany.
Infect Disord Drug Targets. 2010 Apr;10(2):122-31. doi: 10.2174/187152610790963474.
There is increasing evidence that acute bacterial and viral infection represent trigger factors that temporarily elevate the risk of ischemic stroke. During and after influenza epidemics vascular death rates and hospitalizations for stroke are increased. Influenza vaccination is an effective measure to reduce hospitalization and mortality in the elderly and work incapacity in adults of working age. Results of several observational studies support the hypothesis that influenza vaccination is associated with reduced odds of stroke. As randomized studies are lacking, a causal role of influenza vaccination in stroke prevention is not proven, however. According to current guidelines in many countries, that recommend the vaccination in all patients with chronic vascular disease, all patients with a history of stroke or TIA should receive an influenza vaccination annually. Furthermore, patients with diabetes mellitus or with a combination of risk factors that increase stroke risk should obtain the vaccination. In addition, there is evidence from observational data that the neuraminidase inhibitor oseltamivir reduces the risk of stroke within 6 months after influenza infection.
越来越多的证据表明，急性细菌和病毒感染是暂时增加缺血性中风风险的触发因素。在流感流行期间及之后，中风的血管死亡率和住院率会上升。流感疫苗接种是降低老年人住院率和死亡率以及工作年龄成年人工作能力丧失的有效措施。多项观察性研究的结果支持了流感疫苗接种与中风几率降低相关的假设。然而，由于缺乏随机研究，流感疫苗接种在预防中风中的因果作用尚未得到证实。根据许多国家的现行指南，建议所有患有慢性血管疾病的患者接种疫苗，所有有中风或短暂性脑缺血发作病史的患者应每年接种流感疫苗。此外，患有糖尿病或有增加中风风险的危险因素组合的患者也应接种疫苗。此外，观察数据表明，神经氨酸酶抑制剂奥司他韦可降低流感感染后6个月内中风的风险。
