Recent bacterial and viral infection is a risk factor for cerebrovascular ischemia - Clinical and biochemical studies
Recent bacterial and viral infection is a risk factor for cerebrovascular ischemia - Clinical and biochemical studies
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DOI：
10.1212/wnl.50.1.196
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发表时间：
1998-01-01
期刊：
影响因子：
9.9
通讯作者：
Hacke, W
中科院分区：
文献类型：
--
作者：
Grau, AJ;Buggle, F;Hacke, W
我们进行了一项病例对照研究，以调查近期感染作为中风危险因素的作用，并确定感染与中风之间的发病机制。我们连续检查了 166 名患有急性脑血管缺血的患者和 166 名因非血管和非炎症性神经系统疾病住院的患者。对照受试者与患者的性别、年龄和入院季节进行单独匹配。我们评估了最近感染和未感染的中风患者亚组（n = 21）的特殊生化参数，这些患者在人口统计学和临床参数方面相似。在单变量（比值比 [OR] 3.1；95% 置信区间 (CI)，1.57 至 6.1）和年龄调整多元 Logistic 回归分析（OR 2.9；95% CI，1.31 至 6.4）中，前一周内的感染是脑血管缺血的危险因素。近期感染的OR与年龄呈负相关。细菌和病毒感染都会导致风险增加。感染会增加心源性栓塞的风险，并且往往会增加动脉栓塞的风险。既往感染和未感染的中风患者在因子 VII 和因子 VIII 活性、纤维蛋白单体、纤维蛋白 D-二聚体、血管性血友病因子、C4b 结合蛋白、蛋白 S、抗心磷脂抗体、白细胞介素 1 受体拮抗剂、可溶性肿瘤坏死因子 α 受体、白细胞介素 6、白细胞介素 8 和 新蝶呤。总之，近期感染是急性脑血管缺血的独立危险因素。它的作用似乎在年轻群体中更为重要。感染与中风之间的发病机制仍不清楚。
We performed a case-control study to investigate the role of recent infection as stroke risk factor and to identify pathogenetic pathways linking infection and stroke. We examined 166 consecutive patients with acute cerebrovascular ischemia and 166 patients hospitalized for nonvascular and noninflammatory neurologic diseases. Control subjects were individually matched to patients for sex, age, and season of admission. We assessed special biochemical parameters in subgroups of stroke patients with and without recent infection (n = 21) who were similar with respect to demographic and clinical parameters. Infection within the preceding week was a risk factor for cerebrovascular ischemia in univariate (odds ratio [OR] 3.1; 95% confidence interval (CI), 1.57 to 6.1) and age-adjusted multiple logistic regression analysis (OR 2.9; 95% CI, 1.31 to 6.4). The OR of recent infection and age were inversely related. Both bacterial and viral infection contributed to increased risk. Infection elevated the risk for cardioembolism and tended to increase the risk for arterioarterial embolism. Stroke patients with and without preceding infection were not different with respect to factor VII and factor VIII activity, fibrin monomer, fibrin D-dimer, von Willebrand factor, C4b-binding protein, protein S, anticardiolipin antibodies, interleukin-1 receptor antagonist, soluble tumor necrosis factor-alpha receptor, interleukin-6, interleukin-8, and neopterin. In conclusion, recent infection is an independent risk factor for acute cerebrovascular ischemia. Its role appears to be more important in younger age groups. The pathogenetic linkage between infection and stroke is still insufficiently understood.