Chou Ping-Song, Chang Wei-Pin, Chou Yii-Her
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Intern Med J. 2018 Apr;48(4):445-450. doi: 10.1111/imj.13622.
Epidemiological studies have reported an association between urolithiasis and cardiovascular disease. However, studies examining the risks of ischaemic and haemorrhagic stroke in patients with urolithiasis are limited.
By using a nationwide population database, we conducted a matched cohort study to investigate the association between urolithiasis and longitudinal risks of ischaemic and haemorrhagic stroke.
The urolithiasis and non-urolithiasis cohorts included 12 979 and 64 895 patients respectively. Of these, 728 (5.6%) and 2802 (4.3%) patients in the urolithiasis and non-urolithiasis cohorts, respectively, had a stroke during the 5-year follow-up period. The hazard ratio (HR) for stroke was 1.19 times higher (95% confidence interval [CI] = 1.10-1.29; P < 0.001) in the urolithiasis cohort than in the non-urolithiasis cohort after adjustment for potential confounders. The risk of both ischaemic (adjusted HR = 1.16; 95% CI = 1.05-1.29) and haemorrhagic stroke (adjusted HR = 1.30; 95% CI = 1.03-1.64) remained significant in the urolithiasis cohort. Furthermore, the risk of stroke was significant in both men (adjusted HR = 1.16; 95% CI = 1.05-1.28) and women (adjusted HR = 1.26; 95% CI = 1.10-1.45). Middle-aged (40-59 years; adjusted HR = 1.26; 95% CI = 1.10-1.45) and older (≥60 years; adjusted HR = 1.14; 95% CI = 1.03-1.27) patients had a particularly high risk of stroke.
The present study detected an increased risk of both ischaemic and haemorrhagic stroke in patients with urolithiasis, particularly in those older than 40 years.
流行病学研究报告了尿路结石与心血管疾病之间的关联。然而，关于尿路结石患者缺血性和出血性中风风险的研究有限。
通过使用全国人口数据库，我们进行了一项匹配队列研究，以调查尿路结石与缺血性和出血性中风纵向风险之间的关联。
尿路结石队列和非尿路结石队列分别包括12979例和64895例患者。其中，尿路结石队列和非尿路结石队列分别有728例（5.6%）和2802例（4.3%）患者在5年随访期内发生中风。在调整潜在混杂因素后，尿路结石队列中风的风险比（HR）比非尿路结石队列高1.19倍（95%置信区间[CI]=1.10-1.29；P<0.001）。尿路结石队列中缺血性中风（调整后HR=1.16；95%CI=1.05-1.29）和出血性中风（调整后HR=1.30；95%CI=1.03-1.64）的风险仍然显著。此外，男性（调整后HR=1.16；95%CI=1.05-1.28）和女性（调整后HR=1.26；95%CI=1.10-1.45）中风的风险均显著。中年（40-59岁；调整后HR=1.26；95%CI=1.10-1.45）和老年（≥60岁；调整后HR=1.14；95%CI=1.03-1.27）患者中风风险特别高。
本研究发现尿路结石患者缺血性和出血性中风的风险增加，尤其是40岁以上的患者。
