Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts.
Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts.
复制标题
lacunar笔触真的不同吗？对lacunar和非lacunar梗塞之间危险因素概况差异的系统回顾。
DOI：
10.1161/01.str.0000157949.34986.30
复制
发表时间：
2005-04
期刊：
影响因子：
8.3
通讯作者：
Sudlow, C
中科院分区：
文献类型：
--
作者：
Jackson, C;Sudlow, C
腔隙性梗塞和非腔隙性梗塞之间危险因素的差异可能支持腔隙性梗塞潜在的独特动脉病理过程。我们对比较腔隙性梗塞与非腔隙性梗塞患者危险因素的研究进行了系统回顾。对于每个风险因素，我们计算了腔隙性梗塞与非腔隙性梗塞的研究特定和汇总相对风险 (RR)。 28 项研究中共有 16 项在其缺血性中风亚型定义中纳入了危险因素。与非腔隙性梗塞患者相比，高血压和糖尿病在腔隙性梗塞患者中更为常见。然而，仅限于使用无危险因素缺血亚型定义的研究的分析发现，与非腔隙性梗死相比，高血压合并腔隙性梗死的情况仅略有增加（RR，1.11；95% CI，1.04至1.19），而糖尿病则没有差异（RR，0.95；95% CI，0.83至1.09）。心房颤动和颈动脉狭窄与非腔隙性梗塞的相关性高于腔隙性梗死，但当仅考虑使用无危险因素分类的研究时，相关性较小。除此之外，没有证据表明风险因素概况存在差异。应使用无危险因素的缺血性卒中亚型分类方法来比较腔隙性和非腔隙性亚型之间的危险因素概况。
Differences in risk factors between lacunar and nonlacunar infarcts might support a distinct arterial pathological process underlying lacunar infarction. We did a systematic review of studies comparing risk factors in patients with lacunar versus nonlacunar infarction. For each risk factor, we calculated study-specific and pooled relative risks (RRs) for lacunar versus nonlacunar infarction. A total of 16 of 28 studies included risk factors in their ischemic stroke subtype definitions. Hypertension and diabetes appeared commoner among patients with lacunar versus nonlacunar infarction. However, analyses confined to studies using risk factor-free ischemic subtype definitions found only a marginal excess of hypertension with lacunar versus nonlacunar infarction (RR, 1.11; 95% CI, 1.04 to 1.19) and no difference for diabetes (RR, 0.95; 95% CI, 0.83 to 1.09). Atrial fibrillation and carotid stenosis were associated more with nonlacunar than lacunar infarction but less so when only studies using risk factor-free classifications were considered. Otherwise, there was no evidence of differences in risk factor profiles. Risk factor-free ischemic stroke subtype classification methods should be used for comparing risk factor profiles between lacunar and nonlacunar subtypes.