Chen Chun-Chao, Chou Kuan-Ting, Liu Ju-Chi, Chiu Chun-Chih, Yang Tsung-Yeh, Lin Cheng-Hsin, Fang Yu-Ann, Jian William, Lei Meng-Huan, Yeh Hsien-Tang, Hsu Min-Huei, Hao Wen-Rui
Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
Taipei Heart Institute, Taipei Medical University, Taipei 110, Taiwan.
Vaccines (Basel). 2022 Aug 8;10(8):1278. doi: 10.3390/vaccines10081278.
The risk of stroke in patients with gout is high. The effect of vaccines in lowering the stroke risk in patients with gout remains unclear. We retrospectively analyzed 23,949 patients with gout (age ≥ 55 years) from the National Health Insurance Research Database over a 12-year period. The patients were divided into vaccinated (n = 11,649) and unvaccinated groups (n = 12,300). Overall, the vaccinated group had significantly lower risks of all stroke, hemorrhagic stroke, and ischemic stroke than the unvaccinated group (adjusted hazard ratio [aHR], 0.59 and 95% confidence interval [CI], 0.55-0.63; aHR, 0.60 and 95% CI, 0.49-0.73; and aHR, 0.60 and 95% CI, 0.55-0.65, respectively). The association appeared to be dose-dependent for both hemorrhagic and ischemic stroke (hemorrhagic stroke: aHR, 0.81 and 95% CI, 0.61-1.08; aHR, 0.80 and 95% CI, 0.62-1.02; and aHR, 0.37 and 95% CI, 0.28-0.48; ischemic stroke: aHR, 0.83 and 95% CI, 0.74-0.94; aHR, 0.73 and 95% CI, 0.65-0.81; and aHR, 0.42 and 95% CI, 0.38-0.47 for patients vaccinated 1, 2 or 3, and ≥4 times, respectively, during the follow-up period). Patients with a history of atrial fibrillation did not have a lower risk of hemorrhagic stroke even after receiving four vaccinations (aHR, 0.59; 95% CI, 0.25-1.38). Influenza vaccination was associated with a lower risk of all stroke in people with gout, and the association appeared to be dose-dependent.
痛风患者发生中风的风险很高。疫苗对降低痛风患者中风风险的效果仍不明确。我们对国家健康保险研究数据库中12年间23949例年龄≥55岁的痛风患者进行了回顾性分析。这些患者被分为接种疫苗组（n = 11649）和未接种疫苗组（n = 12300）。总体而言，接种疫苗组发生所有中风、出血性中风和缺血性中风的风险均显著低于未接种疫苗组（校正风险比[aHR]分别为0.59，95%置信区间[CI]为0.55 - 0.63；aHR为0.60，95%CI为0.49 - 0.73；aHR为0.60，95%CI为0.55 - 0.65）。出血性中风和缺血性中风的这种关联似乎都呈剂量依赖性（出血性中风：随访期间接种1次、2次或3次以及≥4次的患者，aHR分别为0.81，95%CI为0.61 - 1.08；aHR为0.80，95%CI为0.62 - 1.02；aHR为0.37，95%CI为0.28 - 0.48；缺血性中风：aHR分别为0.83，95%CI为0.74 - 0.94；aHR为0.73，95%CI为0.65 - 0.81；aHR为0.42，95%CI为0.38 - 0.47）。有房颤病史的患者即使接种4次疫苗后出血性中风风险也未降低（aHR为0.59；95%CI为0.25 - 1.38）。流感疫苗接种与痛风患者所有中风风险降低相关，且这种关联似乎呈剂量依赖性。
