Rim Tyler Hyungtaek, Han Jinu, Choi Yoon Seong, Lee Taekjune, Kim Sung Soo
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Acta Ophthalmol. 2017 Nov;95(7):e656-e661. doi: 10.1111/aos.13488. Epub 2017 Aug 3.
This study sought to determine whether isolated third, fourth and sixth cranial nerve palsies (NPs) are associated with increased short- and long-term risk of a subsequent stroke.
This was a nationwide retrospective propensity score-matched cohort study. A cohort of patients with NP (n = 466) and a randomly selected, propensity-matched control cohort (n = 2281) were extracted from the Korean national insurance claim database. Subjects were tracked for 5 years total, subdivided into periods of 0-1 years, 1-3 years and 3-5 years. We assessed the risk of stroke using hazard ratios (HRs) and confidence intervals (CIs) after adjustments using Cox regression at different time intervals.
The median follow-up was 3.1 years. Stroke developed in 18.9% of the NP cohort and 7.5% of the control cohort. Stroke risk after NP was highest in the first year [14.7 per 100 person-year at 0-1 years (HR = 6.6), 3.1 per 100 person-year at 1-3 years (HR = 1.6) and 4.3 per 100 person-year at 3-5 years (HR = 2.8)]. Each type of NP was also associated with stroke risk: within 0-1 years, stroke risk was increased in third (HR = 7.6), fourth (HR = 6.0) and sixth (HR = 5. 84) NPs. In the 3- to 5-year period, risk was increased in sixth (HR = 4.7) and fourth (HR = 3.3) NPs, but not third (HR = 0.6) NPs.
Patients in the NP cohort were more likely to have a stroke than those in the matched control cohort; the increased risk was both time- and cranial nerve-dependent.
本研究旨在确定孤立性动眼神经、滑车神经和展神经麻痹（NPs）是否与后续中风的短期和长期风险增加相关。
这是一项全国性的回顾性倾向评分匹配队列研究。从韩国国民保险索赔数据库中提取了一组NP患者（n = 466）和一个随机选择的、倾向匹配的对照队列（n = 2281）。对受试者进行了总共5年的跟踪，分为0至1年、1至3年和3至5年三个时间段。我们在不同时间间隔使用Cox回归进行调整后，使用风险比（HRs）和置信区间（CIs）评估中风风险。
中位随访时间为3.1年。NP队列中有18.9%发生中风，对照队列中有7.5%发生中风。NP后中风风险在第一年最高[0至1年为每100人年14.7例（HR = 6.6），1至3年为每100人年3.1例（HR = 1.6），3至5年为每100人年4.3例（HR = 2.8）]。每种类型的NP也与中风风险相关：在0至1年内，动眼神经（HR = 7.6）、滑车神经（HR = 6.0）和展神经（HR = 5.84）麻痹患者的中风风险增加。在3至5年期间，展神经（HR = 4.7）和滑车神经（HR = 3.3）麻痹患者的风险增加，但动眼神经（HR = 0.6）麻痹患者的风险未增加。
NP队列中的患者比匹配的对照队列中的患者更易发生中风；风险增加与时间和脑神经均相关。
