Ann Rheum Dis：严重感染和心血管疾病治疗不足可导致卒中！

2017-05-09 tianxuexin MedSci原创

近年来在一般人群中，卒中发生率有所增加（紧随严重事件和住院治疗后）。该研究调查了严重不良事件对风湿性关节炎（RA）患者中风风险的影响，同时危险因素和治疗方法纳入了研究范围。

近年来在一般人群中，卒中发生率有所增加（紧随严重事件和住院治疗后）。该研究调查了严重不良事件对风湿性关节炎（RA）患者中风风险的影响，同时危险因素和治疗方法纳入了研究范围。

采用德国生物制剂寄存器RABBIT（类风湿关节炎：生物治疗观察）数据，采用多态和Cox比例风险模型研究了12354例RA患者的不良事件发生率（IRs）和中风危险因素。此外，在嵌套的病例对照研究中，所有患有卒中患者中具有相同的基线风险特征和使用共享的虚弱模型进行分析的比例分配为1：2。

随访期间共收集166例卒中患者报告。总体IR为3.2 / 1000患者每年（PY）（95％CI为2.7-3.7）。其中严重不良事件发生后IR较高（IR：9.0（7.3-11.0）），尤其在事件发生后30天内（IR：94.9（72.6-121.9））。调整后的Cox模型显示，每5年（HR：1.4（1.3-1.5）），高脂蛋白血症（HR：1.6（1.0-2.5））和吸烟（HR：1.9（1.3-2.6））的HR风险增加。HR风险随着身体功能的改善而下降（HR：0.9（0.8-0.96））。在病例对照研究中，163例患者与326例对照。结果显示，中风的主要危险因素是未治疗的心血管疾病（HR：3.3（1.5至7.2））和严重感染（HR：4.4（1.6至12.5））或其他严重不良事件（HR：2.6（1.4至4.8））。

该研究结论表明，不良事件,特别是严重感染，心血管疾病治疗不足是卒中风险的独立驱动因素。医生应该认识到，经历过严重事件的患者的卒中风险会增加。

原始出处：

Y Meissner, et al. Serious adverse events and the risk of stroke in patients with rheumatoid arthritis: results from the German RABBIT cohort. Annals of the Rheumatic Diseases Published Online First: 08 May 2017. doi: 10.1136/annrheumdis-2017-211209

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2017-10-31 qindq

#疾病治疗#

72 0
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2018-04-18 cmj8wellington

#Dis#

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2017-05-19 惠映实验室

学习了，以后临床要多加关注

136 0
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2017-05-13 lou.minghong

学习了

91 0
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2017-05-11 andy2090

#血管疾病#

103 0
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2017-05-11 智智灵药

#严重感染#

56 0
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2017-05-10 cqykthl

严重事件的患者猝中风险增加原因

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