Department of Chest Medicine, Taipei Veterans General Hospital , Taipei , Taiwan.
Ann Med. 2014 Mar;46(2):84-9. doi: 10.3109/07853890.2013.870018. Epub 2014 Jan 27.
Epidemiological studies have shown a strong association between systemic inflammatory diseases, particularly allergic diseases, and cardiovascular diseases. However, the relationship between atopic dermatitis (AD) and ischemic stroke remains unclear.
The study identified 20,323 AD patients and 20,323 comorbidity-matched subjects between 2005 and 2008. The two cohorts were followed until 31 December 2009. Ischemic stroke and other cardiovascular events were determined.
During the follow-up period, 301 (1.48%) patients in the AD cohort and 228 (1.12%) matched subjects experienced ischemic stroke. After multivariate adjustment, patients with AD had a 1.33-fold (95% confidence interval (CI), 1.12-1.59; P = 0.001) increased incidence of ischemic stroke. Adjusted hazard ratios for the risk of ischemic stroke in patients with mild, moderate, and severe AD were 1.20 (95% CI, 1.00-1.45; P = 0.052), 1.64 (95% CI, 1.23-2.19; P = 0.001), and 1.71 (95% CI, 1.15-2.56; P = 0.008), respectively. The log-rank test showed a higher cumulative incidence of ischemic stroke in the severe AD group than in the moderate and mild AD groups during the follow-up period (P < 0.001).
AD may be an independent risk factor for ischemic stroke, and risk of ischemic stroke increases with AD severity.
流行病学研究表明，系统性炎症性疾病，尤其是过敏性疾病，与心血管疾病之间存在密切关联。然而，特应性皮炎（AD）与缺血性卒中之间的关系尚不清楚。
该研究在 2005 年至 2008 年间确定了 20323 例 AD 患者和 20323 例伴有共病的匹配患者。对这两个队列进行了随访，直至 2009 年 12 月 31 日。确定了缺血性卒中和其他心血管事件的发生情况。
在随访期间，AD 队列中有 301 例（1.48%）患者和 228 例（1.12%）匹配患者发生了缺血性卒中。经多变量调整后，AD 患者发生缺血性卒中的风险增加了 1.33 倍（95%置信区间[CI]，1.12-1.59；P = 0.001）。轻度、中度和重度 AD 患者发生缺血性卒中的风险调整后 hazard 比分别为 1.20（95%CI，1.00-1.45；P = 0.052）、1.64（95%CI，1.23-2.19；P = 0.001）和 1.71（95%CI，1.15-2.56；P = 0.008）。对数秩检验显示，在随访期间，重度 AD 组的缺血性卒中累积发生率高于中度和轻度 AD 组（P < 0.001）。
AD 可能是缺血性卒中的一个独立危险因素，且缺血性卒中的风险随着 AD 的严重程度增加而升高。
