颈内动脉夹层患者一级亲属中的中风情况。

Stroke in first-degree relatives of patients with cervical artery dissection.

作者信息

Kloss M, Grond-Ginsbach C, Pezzini A, Metso T M, Metso A J, Debette S, Leys D, Dallongeville J, Caso V, Thijs V, Bersano A, Touzé E, Bonati L H, Tatlisumak T, Arnold M-L, Lyrer P A, Engelter S T

机构信息

Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.

Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.

出版信息

Eur J Neurol. 2014 Aug;21(8):1102-1107. doi: 10.1111/ene.12437. Epub 2014 Apr 2.

Abstract

BACKGROUND AND PURPOSE

Patients with ischaemic stroke (IS) caused by a spontaneous cervical artery dissection (CeAD) worry about an increased risk for stroke in their families. The occurrence of stroke in relatives of patients with CeAD and in those with ischaemic stroke attributable to other (non-CeAD) causes were compared.

METHODS

The frequency of stroke in first-degree relatives (family history of stroke, FHS) was studied in IS patients (CeAD patients and age- and sex-matched non-CeAD patients) from the Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) database. FHS ≤ 50 and FHS > 50 were defined as having relatives who suffered stroke at the age of ≤50 or >50 years. FHS ≤ 50 and FHS > 50 were studied in CeAD and non-CeAD IS patients and related to age, sex, number of siblings, hypertension, hypercholesterolemia, smoking and body mass index (BMI).

RESULTS

In all, 1225 patients were analyzed. FHS ≤ 50 was less frequent in CeAD patients (15/598 = 2.5%) than in non-CeAD IS patients (38/627 = 6.1%) (P = 0.003; odds ratio 0.40, 95% confidence interval 0.22-0.73), also after adjustment for age, sex and number of siblings (P = 0.005; odds ratio 0.42, 95% confidence interval 0.23-0.77). The frequency of FHS > 50 was similar in both study groups. Vascular risk factors did not differ between patients with positive or negative FHS ≤ 50. However, patients with FHS > 50 were more likely to have hypertension and higher BMI.

CONCLUSION

Relatives of CeAD patients had fewer strokes at a young age than relatives of non-CeAD IS stroke patients.

摘要

背景与目的

自发性颈动脉夹层(CeAD)所致缺血性卒中(IS)患者担心其家族中卒中风险增加。比较了CeAD患者亲属以及其他(非CeAD)原因所致缺血性卒中患者亲属中卒中的发生率。

方法

在颈动脉夹层与缺血性卒中患者(CADISP)数据库的IS患者(CeAD患者以及年龄和性别匹配的非CeAD患者)中研究一级亲属中卒中的发生频率(卒中家族史,FHS)。FHS≤50和FHS>50分别定义为有亲属在50岁及以下或50岁以上发生卒中。在CeAD和非CeAD的IS患者中研究FHS≤50和FHS>50,并与年龄、性别、兄弟姐妹数量、高血压、高胆固醇血症、吸烟和体重指数(BMI)相关联。

结果

总共分析了1225例患者。CeAD患者中FHS≤50的发生率(15/598 = 2.5%)低于非CeAD的IS患者(38/627 = 6.1%)(P = 0.003;优势比0.40,95%置信区间0.22 - 0.73),在对年龄、性别和兄弟姐妹数量进行校正后也是如此(P = 0.005;优势比0.42,95%置信区间0.23 - 0.77)。两个研究组中FHS>50的发生率相似。FHS≤50呈阳性或阴性的患者之间血管危险因素无差异。然而,FHS>50的患者更可能患有高血压且BMI更高。

结论

CeAD患者的亲属在年轻时发生卒中的情况比非CeAD的IS卒中患者的亲属少。

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