Wiseman Stewart J, Ralston Stuart H, Wardlaw Joanna M
From the Centre for Clinical Brain Sciences, University of Edinburgh (S.J.W., J.M.W.), Centre for Genomic and Experimental Medicine (S.H.R.), University of Edinburgh, Edinburgh, United Kingdom.
Stroke. 2016 Apr;47(4):943-50. doi: 10.1161/STROKEAHA.115.012052. Epub 2016 Feb 25.
Some rheumatic diseases are associated with stroke. Less is known about associations with stroke subtypes or stroke risk by age. We quantified the association between stroke, its subtypes, and rheumatic diseases and identified when stroke risk is greatest.
Searches of EMBASE (from 1980) and MEDLINE (from inception) to end 2014 and manual search of reference lists for studies of stroke and stroke subtypes in rheumatic diseases as well as studies measuring cerebrovascular disease from magnetic resonance imaging.
Prior published meta-analyses and new pooled analyses of any stroke in rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, gout, and psoriasis show an excess risk of stroke over the general population with odds ratio (OR) ranging from 1.51 (95% confidence interval: 1.39-1.62) to 2.13 (1.53-2.98). New meta-analyses of stroke subtypes in rheumatoid arthritis [ischemic: OR, 1.64 (1.32-2.05); hemorrhagic: OR, 1.68 (1.11-2.53)] and systemic lupus erythematosus [ischemic: OR, 2.11 (1.66-2.67); hemorrhagic: OR, 1.82 (1.07-3.09)] show an excess risk of stroke over the general population. Stroke risk across rheumatic diseases is highest in those aged <50 years [OR, 1.79 (1.46-2.20)] and reduces relatively with ageing [>65 years: OR, 1.14 (0.94-1.38); difference P<0.007]. Inflammatory arthropathies conveyed higher stroke risk than noninflammatory diseases (OR, 1.3, 1.2-1.3). It was not possible to adjust ORs for risk factors or treatments.
Risk of any stroke is higher in most rheumatic diseases than in the general population, particularly <50 years. Rheumatoid arthritis and systemic lupus erythematosus increase ischemic and hemorrhagic stroke risk by 60% to 100% relative to the general population.
某些风湿性疾病与中风相关。关于中风亚型或中风风险与年龄之间的关联，人们了解较少。我们对中风及其亚型与风湿性疾病之间的关联进行了量化，并确定了中风风险最高的时间。
检索EMBASE（自1980年起）和MEDLINE（自起始起）至2014年底，并人工检索参考文献列表，以查找有关风湿性疾病中中风及中风亚型的研究，以及通过磁共振成像测量脑血管疾病的研究。
先前发表的荟萃分析以及对类风湿关节炎、系统性红斑狼疮、强直性脊柱炎、痛风和银屑病中任何中风的新汇总分析显示，与一般人群相比，中风风险增加，优势比（OR）范围为1.51（95%置信区间：1.39 - 1.62）至2.13（1.53 - 2.98）。对类风湿关节炎[缺血性：OR，1.64（1.32 - 2.05）；出血性：OR，1.68（1.11 - 2.53）]和系统性红斑狼疮[缺血性：OR，2.11（1.66 - 2.67）；出血性：OR，1.82（1.07 - 3.09）]中风亚型的新荟萃分析显示，与一般人群相比，中风风险增加。风湿性疾病患者中，年龄<50岁者中风风险最高[OR，1.79（1.46 - 2.20）]，且随年龄增长风险相对降低[>65岁：OR，1.14（0.94 - 1.38）；差异P<0.007]。炎性关节病比非炎性疾病的中风风险更高（OR，1.3，1.2 - 1.3）。无法针对风险因素或治疗方法对OR进行调整。
大多数风湿性疾病患者发生任何中风的风险高于一般人群，尤其是年龄<50岁者。类风湿关节炎和系统性红斑狼疮使缺血性和出血性中风风险相对于一般人群增加60%至100%。
