The Role of Infection in Childhood Stroke

感染在儿童中风中的作用

• 批准号: 7626381
• 负责人: HEATHER J FULLERTON
• 金额: $ 17.15万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-06-08 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7626381
• 关键词: Acute; Adult; Affect; Age; Anti-Inflammatory Agents; Anti-inflammatory; Bacteremia; Blood Vessels; California; Caring; Case-Control Studies; Chickenpox; Child; Child Care; Childhood; Childhood stroke; Chronic; Clinical Research; Data; Disease; Electronics; Encephalitis; Enrollment; Environmental Risk Factor; Epidemiology; Etiology; Fever; Functional disorder; Goals; Hand; Health Maintenance Organizations; Herpes zoster disease; Herpesvirus Type 3; HiB Meningitis; Hospitals; Immune response; Individual; Infection; Infection prevention; Inflammation Mediators; Interview; Ischemic Stroke; Lead; Life; Light; Measures; Medical; Medical Records; Meningitis; Methodology; Methods; Minority; Outpatients; Pathogenesis; Population; Population Programs; Populations at Risk; Predisposition; Prevention strategy; Psyche structure; Random Allocation; Recording of previous events; Recurrence; Research; Risk; Risk Factors; Role; Sepsis; Sickle Cell Anemia; Streptococcus pneumoniae; Stroke; Stroke prevention; Structure; Telephone Interviews; Time; Training; Vaccination; Viral; Virus Diseases; base; career; congenital heart disorder; design; disability; genetic risk factor; improved; influenza virus vaccine; influenzavirus; population based; programs; public health relevance; respiratory; young adult

DESCRIPTION (provided by applicant): Stroke is an increasingly recognized cause of childhood disability, occurring in as many as 13 per 100,000 children per year. Despite improved recognition, our understanding of the pathophysiology of this disease remains limited. A better understanding could improve our care of these children, and also shed light on non-atherosclerotic mechanisms of stroke applicable to both children and adults. Infection may be an important risk factor for childhood stroke, either due to systemic effects of inflammatory mediators causing a relatively pro-thrombotic state, or by direct or indirect effects on blood vessels through a variety of mechanisms. The overall goal of this project is explore the role of infection in childhood stroke, and thereby improve our understanding of the mechanisms underlying this disease. The Specific Aims of the study are: 1) to determine whether infections (recent febrile infection, severe acute infections such as meningitis and remote chicken pox) are risk factors for first childhood stroke; 2) to determine whether a history of infection prior to a first stroke predicts stroke recurrence, and 3) to determine whether vaccinations against varicella-zoster virus, influenza virus and bacterial etiologies of meningitis are protective against childhood stroke. We propose a case-control study within the well-defined population of approximately 1 million children enrolled in Kaiser Permanente Medical Care Program (KPMCP), a health maintenance organization including 16 hospitals and 36 out-patient facilities in Northern California. We will include as cases all children with stroke over a 17 year time period (1993 to 2009); controls will be randomly selected from the KPMCP population and matched for age. Exposure history will be measured through review of electronic and traditional medical records, and by telephone interview of subjects or their surrogates. Public Health Relevance: This study will improve our understanding of why children have strokes, an important cause of life-long physical and mental disability that tends to occur in the very youngest of children, those in the first year of life. Understanding why strokes occur in children is the first step towards designing effective methods of preventing stroke.

描述（由申请人提供）：中风是导致儿童残疾的一个日益被认可的原因，每年每 100,000 名儿童中就有多达 13 名中风。尽管认识有所提高，但我们对该疾病病理生理学的了解仍然有限。更好的理解可以改善我们对这些儿童的护理，并揭示适用于儿童和成人的中风的非动脉粥样硬化机制。感染可能是儿童卒中的一个重要危险因素，这要么是由于炎症介质的全身作用导致相对促血栓形成的状态，要么是通过多种机制对血管产生直接或间接影响。该项目的总体目标是探索感染在儿童中风中的作用，从而提高我们对该疾病潜在机制的理解。该研究的具体目的是：1）确定感染（近期发热感染、脑膜炎和远期水痘等严重急性感染）是否是儿童首次中风的危险因素； 2) 确定首次中风之前的感染史是否可以预测中风复发，以及 3) 确定针对水痘带状疱疹病毒、流感病毒和脑膜炎细菌病因的疫苗接种是否可以预防儿童中风。我们建议在 Kaiser Permanente 医疗护理计划 (KPMCP) 注册的大约 100 万儿童的明确人群中进行病例对照研究，该计划是一个健康维护组织，在北加州拥有 16 家医院和 36 个门诊设施。我们将纳入 17 年期间（1993 年至 2009 年）内所有中风儿童的病例；对照将从 KPMCP 人群中随机选择并进行年龄匹配。将通过审查电子和传统医疗记录以及对受试者或其代理人进行电话采访来测量暴露史。公共健康相关性：这项研究将提高我们对儿童中风原因的理解，中风是导致终身身体和精神残疾的重要原因，往往发生在最小的儿童（即一岁的儿童）中。了解儿童中风的原因是设计有效预防中风方法的第一步。