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大麻滥用对年轻人中风发生的影响:一项系统评价和荟萃分析。

Impact of cannabis abuse on the occurrence of stroke in young people: a systematic review and meta-analysis.

作者信息

Liu Dongxue, Yang Liu, Liu Peiqi, Wang Yujiao, Gao Lan

机构信息

The First Hospital of Jilin University, Changchun, China.

Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Neurol. 2024 Oct 22;15:1426023. doi: 10.3389/fneur.2024.1426023. eCollection 2024.

Abstract

BACKGROUND

The occurrence of stroke in young people has risen significantly. This can easily lead to physical disabilities, swallowing difficulties, and cognitive impairment, among other issues, having a profound impact on families and society. Risk factors for stroke in young people differ from those for traditional stroke, with cannabis abuse emerging as a significant high-risk factor. However, the extent of the impact of cannabis abuse on the occurrence of stroke and the rate of disability in young people remains unclear. To clarify this issue and provide evidence supporting the primary prevention of stroke in young people, this systematic review and meta-analysis summarizes the latest findings from previous studies.

METHODS

A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science databases was conducted until April 2023. The review included observational studies comparing stroke risk estimates between cannabis abusers and non-users.

RESULTS

This review included six observational studies focusing on cannabis abuse, involving 119,284,152 participants. A significant association was found between cannabis abuse and an increased risk of stroke [OR = 1.14, 95% CI (1.08, 1.20)]. However, there was substantial heterogeneity among the studies (  = 89%,  < 0.001). After adjusting for confounders such as smoking and alcohol abuse, we found a stronger association between cannabis abuse and stroke in young adults [OR = 1.21, 95% CI (1.12, 1.29)]. Subgroup analyses revealed no significant difference in stroke risk between ischemic and hemorrhagic strokes ( = 0.43).

CONCLUSION

The results of our systematic review and meta-analysis showed that cannabis abuse has a more significant effect on the occurrence of stroke in young people; however, it was not possible to distinguish whether cannabis abuse is more likely to cause ischemic or hemorrhagic stroke. Further research is needed to explore the impact of different drug types, dosages, and behaviors on stroke risk.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, Identifier CRD42023443261.

摘要

背景

年轻人中风的发生率显著上升。这很容易导致身体残疾、吞咽困难和认知障碍等问题,对家庭和社会产生深远影响。年轻人中风的风险因素与传统中风不同,大麻滥用已成为一个重要的高风险因素。然而,大麻滥用对年轻人中风发生率和残疾率的影响程度仍不清楚。为了阐明这一问题并提供支持年轻人中风一级预防的证据,本系统评价和荟萃分析总结了以往研究的最新发现。

方法

对PubMed、EMBASE、Cochrane图书馆和Web of Science数据库进行系统检索,直至2023年4月。该评价纳入了比较大麻滥用者和非使用者中风风险估计值的观察性研究。

结果

本评价纳入了6项关注大麻滥用的观察性研究,涉及119284152名参与者。发现大麻滥用与中风风险增加之间存在显著关联[比值比(OR)=1.14,95%置信区间(CI)(1.08,1.20)]。然而,研究之间存在很大的异质性(I²=89%,P<0.001)。在调整吸烟和酗酒等混杂因素后,我们发现大麻滥用与年轻成年人中风之间的关联更强[OR=1.21,95%CI(1.12,1.29)]。亚组分析显示,缺血性中风和出血性中风的中风风险无显著差异(P=0.43)。

结论

我们的系统评价和荟萃分析结果表明,大麻滥用对年轻人中风的发生有更显著的影响;然而,无法区分大麻滥用更易导致缺血性中风还是出血性中风。需要进一步研究以探讨不同药物类型、剂量和行为对中风风险的影响。

系统评价注册

https://www.crd.york.ac.uk/prospero/,标识符CRD42023443261。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dae6/11536518/d94c6e07eb90/fneur-15-1426023-g001.jpg

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