Zhang Yanting, Luo Ganfeng, Huang Yuanwei, Yu Qiuyan, Wang Li, Li Ke
Department of Public Health, Shantou University Medical College, Shantou, Guangdong, China.
National Center of STD/AIDS Control and Prevention, China CDC, Changping District, Beijing, China.
J Stroke Cerebrovasc Dis. 2017 Aug;26(8):1807-1816. doi: 10.1016/j.jstrokecerebrovasdis.2017.04.013. Epub 2017 May 10.
Accumulating evidence indicates that herpes zoster (HZ) may increase the risk of stroke/transient ischemic attack (TIA) or myocardial infarction (MI), but the results are inconsistent. We aim to explore the relationship between HZ and risk of stroke/TIA or MI and between herpes zoster ophthalmicus (HZO) and stroke.
We estimated the relative risk (RR) and 95% confidence intervals (CIs) with the meta-analysis. Cochran's Q test and Higgins I statistic were used to check for heterogeneity.
HZ infection was significantly associated with increased risk of stroke/TIA (RR = 1.30, 95% CI: 1.17-1.46) or MI (RR = 1.18, 95% CI: 1.07-1.30). The risk of stroke after HZO was 1.91 (95% CI 1.32-2.76), higher than that after HZ. Subgroup analyses revealed increased risk of ischemic stroke after HZ infection but not hemorrhagic stroke. The risk of stroke was increased more at 1 month after HZ infection than at 1-3 months, with a gradual reduced risk with time. The risk of stroke after HZ infection was greater with age less than 40 years than 40-59 years and more than 60 years. Risk of stroke with HZ infection was greater without treatment than with treatment and was greater in Asia than Europe and America but did not differ by sex.
Our study indicated that HZ infection was associated with increased risk of stroke/TIA or MI, and HZO infection was the most marked risk factor for stroke. Further studies are needed to explore whether zoster vaccination could reduce the risk of stoke/TIA or MI.
越来越多的证据表明，带状疱疹（HZ）可能会增加中风/短暂性脑缺血发作（TIA）或心肌梗死（MI）的风险，但结果并不一致。我们旨在探讨HZ与中风/TIA或MI风险之间的关系，以及眼部带状疱疹（HZO）与中风之间的关系。
我们通过荟萃分析估计相对风险（RR）和95%置信区间（CI）。使用 Cochr an Q检验和Higgins I统计量检查异质性。
HZ感染与中风/TIA风险增加（RR = 1.30，95% CI：1.17 - 1.46）或MI风险增加（RR = 1.18，95% CI：1.07 - 1.30）显著相关。HZO后中风的风险为1.91（95% CI 1.32 - 2.76），高于HZ后。亚组分析显示，HZ感染后缺血性中风风险增加，但出血性中风风险未增加。HZ感染后1个月时中风风险增加幅度大于1 - 3个月时，且风险随时间逐渐降低。HZ感染后年龄小于40岁者中风风险大于40 - 59岁者及大于60岁者。未治疗的HZ感染患者中风风险大于接受治疗者，亚洲患者的中风风险大于欧美患者，但性别间无差异。
我们的研究表明，HZ感染与中风/TIA或MI风险增加有关，且HZO感染是中风最显著的危险因素。需要进一步研究以探讨带状疱疹疫苗接种是否可降低中风/TIA或MI的风险。
