Zheng Shengbang, Yao Baodong
Department of Chronic Disease Prevention and Control, Minhang District Center for Disease Control and Prevention, Shanghai, China.
Department of Chronic Disease Prevention and Control, Minhang District Center for Disease Control and Prevention, Shanghai, China.
J Clin Neurosci. 2019 Feb;60:24-30. doi: 10.1016/j.jocn.2018.10.026. Epub 2018 Oct 16.
Risk factors for first-ever stroke have been studied extensively, while those for recurrent stroke are not accurately understood. To provide the adequate secondary prevention for the patients, it is necessary to reveal the risk factors that dominate recurrent stroke. Multiple databases were adopted to search for the relevant studies and full-text articles involving in the risk factors for stroke recurrence were reviewed. Meta-analyses were performed with Review Manager 5.0 to estimate the impact of risk factors included, and forest plots, quality analysis and bias analysis for the articles included were also conducted. Finally 11 studies which eventually satisfied the eligibility criteria were included in this study, and patients with initial stroke and recurrent stroke were 14,455 and 1545, respectively. The meta-analyses showed that hypertension (OR = 1.67, 95%CI [1.45, 1.92], P < 0.00001), diabetes mellitus (OR = 1.50, 95%CI [1.30, 1.72], P < 0.00001), atrial fibrillation (OR = 1.88, 95%CI [1.56, 2.25], P < 0.00001) and coronary heart disease (OR = 1.77, 95%CI [1.31, 2.39], P = 0.0002) played a certain role in the process of stroke recurrence, while the influences of dyslipidemia (OR = 0.92, 95%CI [0.67, 1.27], P = 0.62) and smoking (OR = 0.96, 95%CI [0.80, 1.15], P = 0.62) were not significant. Hypertension, diabetes mellitus, atrial fibrillation and coronary heart disease of patients with stroke have statistical associations with recurrent stroke, and secondary prevention and treatment should be provided to curb the recurrence.
首次中风的危险因素已得到广泛研究，而复发中风的危险因素尚未得到准确认识。为了给患者提供充分的二级预防，有必要揭示主导复发中风的危险因素。采用多个数据库搜索相关研究，并对涉及中风复发危险因素的全文文章进行了综述。使用Review Manager 5.0进行荟萃分析，以估计纳入的危险因素的影响，并对纳入的文章进行森林图、质量分析和偏倚分析。最终，本研究纳入了11项最终符合纳入标准的研究，初始中风患者和复发中风患者分别为14455例和1545例。荟萃分析表明，高血压（OR = 1.67，95%CI [1.45, 1.92]，P < 0.00001）、糖尿病（OR = 1.50，95%CI [1.30, 1.72]，P < 0.00001）、心房颤动（OR = 1.88，95%CI [1.56, 2.25]，P < 0.00001）和冠心病（OR = 1.77，95%CI [1.31, 2.39]，P = 0.0002）在中风复发过程中起一定作用，而血脂异常（OR = 0.92，95%CI [0.67, 1.27]，P = 0.62）和吸烟（OR = 0.96，95%CI [0.80, 1.15]，P = 0.62）的影响不显著。中风患者的高血压、糖尿病、心房颤动和冠心病与复发中风有统计学关联，应提供二级预防和治疗以抑制复发。
