登革热患者发生中风的风险：一项基于人群的队列研究。
Risk of stroke in patients with dengue fever: a population-based cohort study.
机构信息
Department of Radiology (Li), E-Da Hospital; Department of Radiology (Huang), Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan; Management Office for Health Data (Su) and Department of Nuclear Medicine and PET Center (Kao), China Medical University Hospital; College of Medicine (Su) and Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine (Kao), China Medical University; Department of Bioinformatics and Medical Engineering (Kao), Asia University, Taichung, Taiwan.
Department of Radiology (Li), E-Da Hospital; Department of Radiology (Huang), Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan; Management Office for Health Data (Su) and Department of Nuclear Medicine and PET Center (Kao), China Medical University Hospital; College of Medicine (Su) and Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine (Kao), China Medical University; Department of Bioinformatics and Medical Engineering (Kao), Asia University, Taichung, Taiwan
出版信息
CMAJ. 2018 Mar 12;190(10):E285-E290. doi: 10.1503/cmaj.170994.
BACKGROUND
Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue.
METHODS
Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan-Meier curves and Cox proportional hazards regression.
RESULTS
The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01-1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48-4.18).
INTERPRETATION
Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic.
背景
中风是登革热的一种严重神经并发症，仅在少数病例报告中有所描述。登革热患者中风的发病率和危险因素仍不清楚。我们进行了一项基于人群的回顾性队列研究，以调查登革热患者中风的风险。
方法
利用来自台湾全民健康保险研究数据库的数据，我们共纳入了 2000 年至 2012 年间新诊断为登革热的 13787 名患者。对照组由未患登革热的患者组成，按照人口统计学特征和中风相关合并症进行 1:1 匹配。我们使用 Kaplan-Meier 曲线和 Cox 比例风险回归计算了两个队列中中风的累积发生率和风险比（HR）。
结果
登革热组中风的总发病率为 5.33/1000 人年，对照组为 3.72/1000 人年，调整后的 HR 为 1.16（95%置信区间[CI]1.01-1.32）。登革热患者中风的风险在诊断后前 2 个月最高（25.53/1000 人年，调整后的 HR 2.49，95%CI 1.48-4.18）。
解释
登革热与诊断后几个月中风风险增加有关。登革热对中风的影响可能是急性的而不是慢性的。
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