Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
Stroke. 2013 Aug;44(8):2327-9. doi: 10.1161/STROKEAHA.113.001562. Epub 2013 May 21.
There is a temporal relationship between cannabis use and stroke in case series and population-based studies.
Consecutive stroke patients, aged 18 to 55 years, who had urine screens for cannabis were compared with a cohort of control patients admitted to hospital without cardiovascular or neurological diagnoses.
One hundred sixty of 218 (73%) ischemic stroke/transient ischemic attack patients had urine drug screens (100 men; mean [SD] age, 44.8 [8.7] years). Twenty-five (15.6%) patients had positive cannabis drug screens. These patients were more likely to be men (84% versus 59%; χ2: P=0.016) and tobacco smokers (88% versus 28%; χ2: P<0.001). Control urine samples were obtained from 160 patients matched for age, sex, and ethnicity. Thirteen (8.1%) control participants tested positive for cannabis. In a logistic regression analysis adjusted for age, sex, and ethnicity, cannabis use was associated with increased risk of ischemic stroke/transient ischemic attack (odds ratio, 2.30; 95% confidence interval, 1.08-5.08). However after adjusting for tobacco use, an association independent of tobacco could not be confirmed (odds ratio, 1.59; 95% confidence interval, 0.71-3.70).
This study provides evidence of an association between a cannabis lifestyle that includes tobacco and ischemic stroke. Further research is required to clarify whether there is an association between cannabis and stroke independent of tobacco.
http://www.anzctr.org.au. Unique identifier: ACTRN12610000198022.
在病例系列和基于人群的研究中，大麻使用与中风之间存在时间关系。
连续入组年龄在 18 至 55 岁之间的中风患者，这些患者的尿液进行了大麻筛查，并与一组没有心血管或神经诊断的住院对照患者进行了比较。
218 例缺血性中风/短暂性脑缺血发作患者中有 160 例（73%）进行了尿液药物筛查（100 例男性；平均[标准差]年龄 44.8[8.7]岁）。25 例（15.6%）患者的大麻药物筛查呈阳性。这些患者更可能是男性（84%比 59%；χ2：P=0.016）和吸烟者（88%比 28%；χ2：P<0.001）。对照组尿液样本来自 160 例年龄、性别和种族相匹配的患者。13 例（8.1%）对照组患者大麻检测呈阳性。在调整年龄、性别和种族的 logistic 回归分析中，大麻使用与缺血性中风/短暂性脑缺血发作的风险增加相关（比值比，2.30；95%置信区间，1.08-5.08）。然而，在调整吸烟因素后，不能确认与吸烟无关的独立关联（比值比，1.59；95%置信区间，0.71-3.70）。
本研究提供了大麻生活方式（包括吸烟）与缺血性中风之间存在关联的证据。需要进一步研究以明确大麻与中风之间是否存在与吸烟无关的关联。
