创伤后应激障碍患者的中风风险：全国性纵向研究。
Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study.
机构信息
Mu-Hong Chen, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei; Tai-Long Pan, PhD, School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, and Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, and Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan; Cheng-Ta Li, MD, PhD, Wei-Chen Lin, MD, Ying-Sheue Chen, MD, Ying-Chiao Lee, MD, Shih-Jen Tsai, MD, Ju-Wei Hsu, MD, Kai-Lin Huang, MD, Chia-Fen Tsai, MD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei; Wen-Han Chang, MSc, Department of Psychiatry, Taipei Veterans General Hospital, Taipei; Tzeng-Ji Chen, MD, PhD, Department of Family Medicine, Taipei Veterans General Hospital, Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei; Tung-Ping Su, MD, Ya-Mei Bai, MD, PhD, Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
出版信息
Br J Psychiatry. 2015 Apr;206(4):302-7. doi: 10.1192/bjp.bp.113.143610. Epub 2015 Feb 19.
BACKGROUND
Previous evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown.
AIMS
To investigate the temporal association between PTSD and the development of stroke.
METHOD
Identified from the Taiwan National Health Insurance Research Database, 5217 individuals aged ≥18 years, with PTSD but with no history of stroke, and 20 868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke.
RESULTS
Individuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44-4.67) and ischaemic stroke (HR = 3.47, 95% CI 2.23-5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% CI 2.13-4.28; ischaemic stroke HR = 2.89, 95% CI 1.79-4.66) after excluding the first year of observation.
CONCLUSIONS
Individuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms.
背景
先前的证据表明，创伤后应激障碍（PTSD）与高血压、血脂异常和糖尿病之间存在正相关关系，这些都是中风的危险因素，但 PTSD 在中风后续发展中的作用尚不清楚。
目的
探讨 PTSD 与中风发展之间的时间关联。
方法
从台湾全民健康保险研究数据库中确定，2002 年至 2009 年间共纳入 5217 名年龄≥18 岁、有 PTSD 但无中风史的个体和 20868 名年龄和性别匹配的对照者，并随访至 2011 年底，以确定中风的发生情况。
结果
在调整了人口统计学数据和合并症后，PTSD 个体发生任何中风（风险比（HR）3.37，95%置信区间 2.44-4.67）和缺血性中风（HR = 3.47，95%置信区间 2.23-5.39）的风险增加。敏感性测试显示，在排除观察的第一年之后，结果一致（任何中风 HR = 3.02，95%置信区间 2.13-4.28；缺血性中风 HR = 2.89，95%置信区间 1.79-4.66）。
结论
PTSD 个体发生任何中风和缺血性中风的风险增加。需要进一步的研究来探讨潜在的机制。
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