Shigematsu Kazuo, Watanabe Yoshiyuki, Nakano Hiromi
Department of Neurology, the National Hospital Organization, Minami Kyoto Hospital, 11 Nakaashihara, Joyo, Kyoto, 610-0113, Japan.
Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
BMC Neurol. 2015 Mar 25;15:44. doi: 10.1186/s12883-015-0297-1.
Although hyperlipidemia is known as a risk factor of stroke, its effects on the outcome are unknown. The aim of the study is to clarify the influences of hyperlipidemia on the stroke early outcome by estimating odds ratio (OR) for sequelae requiring care and hazard ratio (HR) for death.
A total of 12617 stroke patients registered in the Kyoto Stroke Registry with information on a hyperlipidemia history. We compared patients who had hyperlipidemia history and patients who hadn't. The OR for remaining sequelae requiring certain care on 30 day after stroke was calculated using a logistic regression in stroke as a whole and in each stroke subtype; cerebral infarction (CI), cerebral hemorrhage (CH) and subarachnoid hemorrhage (SAH). The HR for death within 30 day after stroke was estimated by the Cox regression.
The OR (95% confidence interval) for remaining sequelae 30 days after stroke was 0.66 (0.60-0.73, p < 0.001) in patients with hyperlipidemia history compared with patients without hyperlipidemia history. After stratified by stroke subtypes, it was 0.75 (0.67-0.85, p < 0.001) in CI, 0.59 (0.45-0.77, p < 0.001) in CH and 0.77 (0.43-1.38, p = 0.767) in SAH. The HR (95% confidence interval) for death was 0.39 (0.31-0.48, p < 0.001) in patients with hyperlipidemia history comparing patients without hyperlipidemia history. After stratified by stroke subtypes, it was 0.45 (0.32-0.63, p < 0.001) in CI, 0.64 (0.44-0.93, p = 0.018) in CH and 0.76 (0.47-1.23, p = 0.264) in SAH. Each value was adjusted for age and sex.
This study suggests that the outcome is favorable for patients with hyperlipidemia history in terms of both remaining sequelae and HR for death. A factor which increases the incidence of the disease could influence on the severity of the disease in a favorable way.
尽管高脂血症被认为是中风的一个危险因素,但其对中风结局的影响尚不清楚。本研究的目的是通过估计需要护理的后遗症的比值比(OR)和死亡的风险比(HR)来阐明高脂血症对中风早期结局的影响。
共有12617例中风患者登记在京都中风登记处,并有高脂血症病史信息。我们比较了有高脂血症病史的患者和没有高脂血症病史的患者。使用逻辑回归计算中风后30天需要特定护理的剩余后遗症的OR,整体中风以及每种中风亚型(脑梗死(CI)、脑出血(CH)和蛛网膜下腔出血(SAH))分别计算。通过Cox回归估计中风后30天内的死亡HR。
有高脂血症病史的患者与无高脂血症病史的患者相比,中风后30天剩余后遗症的OR(95%置信区间)为0.66(0.60 - 0.73,p < 0.001)。按中风亚型分层后,CI为0.75(0.67 - 0.85,p < 0.001),CH为0.59(0.45 - 0.77,p < 0.001),SAH为0.77(0.43 - 1.38,p = 0.767)。有高脂血症病史的患者与无高脂血症病史的患者相比,死亡的HR(95%置信区间)为0.39(0.31 - 0.48,p < 0.001)。按中风亚型分层后,CI为0.45(0.32 - 0.63,p < 0.001),CH为0.64(0.44 - 0.93,p = 0.018),SAH为0.76(0.47 - 1.23,p = 0.264)。每个值均根据年龄和性别进行了调整。
本研究表明,就剩余后遗症和死亡HR而言,有高脂血症病史的患者结局较好。一种增加疾病发病率的因素可能以一种有利的方式影响疾病的严重程度。