PRECEDING INFECTION AS AN IMPORTANT RISK FACTOR FOR ISCHEMIC BRAIN INFARCTION IN YOUNG AND MIDDLE-AGED PATIENTS
PRECEDING INFECTION AS AN IMPORTANT RISK FACTOR FOR ISCHEMIC BRAIN INFARCTION IN YOUNG AND MIDDLE-AGED PATIENTS
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DOI：
10.1136/bmj.296.6630.1156
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发表时间：
1988-04-23
影响因子：
105.7
通讯作者：
HUTTUNEN, JK
中科院分区：
文献类型：
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作者：
SYRJANEN, J;VALTONEN, VV;HUTTUNEN, JK
在一项病例对照研究中，对先前感染作为缺血性中风危险因素的作用进行了调查，该研究对 54 名 50 岁以下脑梗塞连续患者和 54 名来自性别和年龄匹配的社区随机选择的对照进行了研究。收集了有关既往疾病、吸烟、饮酒和吸毒的信息。分析血样的标准生化变量，并测定血清胆固醇、高密度脂蛋白胆固醇、甘油三酯和空腹血糖浓度。测定了针对各种细菌（包括葡萄球菌、链球菌、耶尔森氏菌、沙门氏菌）和多种病毒的抗菌抗体的滴度。脑梗塞前一个月患者中发现发热感染的频率明显高于检查前一个月的对照者（19 名患者 vs 3 名对照者；估计相对风险为 9.0（95% 置信区间 2.2 至 80.0））。最常见的发热感染是呼吸道感染（80%）。根据培养、血清学和临床数据，脑梗塞之前的感染大多是细菌来源的。在配对配对的条件逻辑回归分析中，当对甘油三酯浓度、高血压、吸烟和先前酒精中毒进行测试时，先前发热感染的影响仍然显着（估计相对风险 14.5（95% 置信区间 1.9 至 112.3））。尽管无法从这些数据中推断出因果关系，并且合理的潜在机制仍未确定，但之前的发热感染可能在中青年患者脑梗塞的发展中发挥重要作用。
The role of preceding infection as a risk facto for ischaemic stroke was investigated in a case-control study of 54 consecutive patients under 50 years of age with brain infarction and 54 randomly selected controls from the community matched for sex and age. Information about previous illnesses, smoking, consumption of alcohol, and use of drugs was taken. A blood sample was analysed for standard biochemical variables and serum cholesterol, high density lipoprotein cholesterol, triglyceride, and fasting blood glucose concentrations determined. Titres of antimicrobial antibodies against various bacteria, including Staphylococcus, Streptococcus, Yersinia, and Salmonella and several viruses wer determined. Febrile infection was found in patients during the month before the brain infarction significantly more often than in controls one month before their examination (19 patients v three controls; estimated relative risk 9.0 (95% confidence interval 2.2 to 80.0)). The most common preceding febrile infection was respiratory infection (80%). Infections preceding brain infarction were mostly of bacterial origin based on cultural, serological, and clinical data. In conditional logistic regression analysis for matched pairs the effect of preceding febrile infection remained significant (estimated relative risk 14.5 (95% confidence interval 1.9 to 112.3)) when tested with triglyceride concentration, hypertension, smoking, and preceding intoxication with alcohol. Although causality cannot be inferred from these data and plausible underlying mechanisms remain undetermined, preceding febrile infection may play an important part in the development of brain infarction in young and middle aged patients.