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尘肺病患者缺血性中风风险增加。

Increased risk of ischemic stroke in patients with pneumoconiosis.

作者信息

Cheng Yuan-Yang, Hsu Kuo-Hsuan, Chen Yi-Huei, Lin Ching-Heng

机构信息

Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taiwan.

Department of Chest Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

出版信息

J Clin Neurosci. 2015 Feb;22(2):363-7. doi: 10.1016/j.jocn.2014.08.013. Epub 2014 Dec 8.

Abstract

Although past studies have confirmed that chronic dust exposure is a risk factor for cardiovascular disease, the relationship between it and cerebrovascular disease is still unclear. We aimed to determine whether pneumoconiosis is related to increased incidence of ischemic stroke in the following 5 to 11 years. We selected 1238 patients with pneumoconiosis from Taiwan's National Health Insurance database as our study cohort. After matching for age, sex and the date of ambulatory care visit, another 4952 patients without pneumoconiosis were selected as the comparison cohort. Each patient was individually followed up until the end of 2010 to track the incidence of stroke, and Cox proportional hazard regression analysis was performed to compute the relative hazard ratio of stroke. Our results showed 19.6% of pneumoconiosis patients and 15.8% of non-pneumoconiosis patients developed stroke. After statistically adjusting for age, sex, and medical comorbidities, the hazard of developing stroke was 1.36 times greater for those with pneumoconiosis compared to those without. Even in those with pneumoconiosis excluding chronic obstructive pulmonary disease, the hazard of developing stroke was still 1.31 times greater than those without pneumoconiosis. Our study revealed that pneumoconiosis patients are at a higher risk of ischemic stroke, and primary prevention of stroke is particularly important in this group of patients.

摘要

尽管过去的研究已经证实,长期接触粉尘是心血管疾病的一个危险因素,但其与脑血管疾病之间的关系仍不明确。我们旨在确定尘肺病是否与接下来5至11年缺血性中风发病率的增加有关。我们从台湾国民健康保险数据库中选取了1238例尘肺病患者作为我们的研究队列。在匹配年龄、性别和门诊就诊日期后,另外选取4952例无尘肺病的患者作为对照队列。对每位患者进行单独随访直至2010年底,以追踪中风的发病率,并进行Cox比例风险回归分析以计算中风的相对风险比。我们的结果显示,19.6%的尘肺病患者和15.8%的非尘肺病患者发生了中风。在对年龄、性别和合并症进行统计学调整后,尘肺病患者发生中风的风险是无尘肺病患者的1.36倍。即使在排除慢性阻塞性肺疾病的尘肺病患者中,发生中风的风险仍然比无尘肺病患者高1.31倍。我们的研究表明,尘肺病患者发生缺血性中风的风险更高,对这组患者进行中风的一级预防尤为重要。

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