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Neurology:高血压能够预测儿童癌症幸存者的复发性卒中?

2015-09-25 崔倩 译 MedSci原创

该研究的目的是评估儿童癌症幸存者中已经有过第一次卒中的患者,继发性卒中的危险因素。该儿童癌症幸存者研究是一项回顾性队列研究,对招募的14358名幸存者进行纵向随访(<21岁时被确诊;确诊于1970至1986年;癌症诊断后幸存≥5年),研究人员自1994年以来进行了前瞻性随访。研究人员调查了443名第一次卒中后确诊为复发性卒中的幸存者,评估了其癌症诊断≥5年后卒中复发率。在329名受访者中(74%的

该研究的目的是评估儿童癌症幸存者中已经有过一次卒中的患者的继发性卒中的危险因素。

该儿童癌症幸存者研究是一项回顾性队列研究,对招募的14358名幸存者进行纵向随访(<21岁时被确诊;确诊于1970至1986年;癌症诊断后幸存≥5年),研究人员自1994年以来进行了前瞻性随访。研究人员调查了443名第一次卒中后确诊为复发性卒中的幸存者,评估了其癌症诊断≥5年后卒中的复发率。

在329名受访者中(74%的反应率),271名在平均年龄为19岁(0-53)时发生第一次卒中,70例在平均年龄为32岁(1-56)时发生第二次卒中。在一个多变量Cox比例风险模型中,复发性卒中的独立预测因子包括颅放射治疗(CRT)剂量≥50Gy (VS 没有进行颅放射治疗,危险比[HR]4.4;95%可信区间为1.4-13.7),高血压( HR 1.9;95%Cl 1.0-3.5),第一次卒中时年龄较大(HR 6.4;95%Cl为1.8-23;年龄≥40岁 VS 0-17岁)。

总体而言,晚期复发性卒中的10年累积发生率为21%(95%Cl为16%-27%),对于那些CRT≥50Gy治疗的患者,10年累积发生率为33%(95%CI为21%-44%)。

儿童癌症幸存者,特别是那些只用使用大剂量头颅放射治疗的患者,在第一次卒中后的几十年复发性卒中的风险很高。虽然这些卒中大多是在青年时期发生,但是高血压(一个导致动脉粥样硬化的危险因素)能够在这些人群中独立预测复发性卒中。

原始出处:

Heather J. Fullerton, Kayla Stratton, Sabine Mueller,et al.Recurrent stroke in childhood cancer survivors,Neurology,2015.9.22

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    2015-09-30 yinhl1978
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