Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung.
School of Medicine, National Yang Ming Chiao Tung University, Taipei.
Int J Stroke. 2023 Apr;18(4):408-415. doi: 10.1177/17474930221125556. Epub 2022 Oct 15.
Research investigating differences in the overall stroke risk between individuals with and without immune thrombocytopenia (ITP) is lacking.
This real-world study used the National Health Insurance Research Database (NHIRD). Risk of stroke was compared between 13,085 individuals with ITP enrolled between 1 January 2000 and 31 December 2015 and a control cohort of 52,340 individuals without ITP (1:4 ratio propensity score-matched by age, sex, index year, relevant comorbidities, and medications). Sub-distribution hazards models were used to estimate adjusted sub-distribution hazard ratio (SHR) and 95% confidence intervals (CIs), with the non-ITP group as the control group.
Of the 65,425 participants, 13,085 had ITP, 63.3% were women, and the mean age was 52.59 years. The risk of both ischemic and hemorrhagic stroke was 1.14 times (adjusted SHR 1.14, 95% CI, 1.07-1.22) and 1.93 times (adjusted SHR 1.93, 95% CI, 1.70-2.20) higher in the ITP group than in controls. Patients with ITP in the 20- to 29-year subgroup had a higher risk of new-onset stroke (adjusted SHR, 4.06 (95% CI, 2.72-6.07), value for interaction <0.01) than those aged 20-29 years without ITP. Individuals with severe ITP with splenectomy had a 1.79 times higher overall stroke risk than those without.
ITP is associated with increased risk of both ischemic and hemorrhagic stroke.
缺乏研究个体免疫性血小板减少症（ITP）患者与无 ITP 患者整体中风风险差异的研究。
本真实世界研究使用了全民健康保险研究数据库（NHIRD）。2000 年 1 月 1 日至 2015 年 12 月 31 日期间，共纳入 13085 例 ITP 患者，并与无 ITP 的 52340 例患者（1:4 比例，按年龄、性别、指数年、相关合并症和药物匹配）进行对照。使用亚分布风险模型估计调整后的亚分布风险比（SHR）和 95%置信区间（CI），以非 ITP 组为对照组。
在 65425 名参与者中，有 13085 例患有 ITP，63.3%为女性，平均年龄为 52.59 岁。ITP 组缺血性和出血性中风的风险分别为 1.14 倍（调整后的 SHR 1.14，95%CI，1.07-1.22）和 1.93 倍（调整后的 SHR 1.93，95%CI，1.70-2.20）。在 20-29 岁亚组中，ITP 患者发生新发中风的风险更高（调整后的 SHR，4.06（95%CI，2.72-6.07），交互 值<0.01）。与无 ITP 的 20-29 岁年龄组相比，伴有脾切除术的重症 ITP 患者整体中风风险增加 1.79 倍。
ITP 与缺血性和出血性中风风险增加相关。
