Stroke：大麻应用或与缺血性卒中风险升高相关

　　新西兰一项研究表明，大麻应用与缺血性卒中风险升高具有相关性，但烟草应用亦显著涉及上述相关性。论文于5月21日在线发表于《卒中》（Stroke）。

　　既往病例序列和基于人群研究显示大麻应用与卒中具有一过相关性。此项研究纳入了接受大麻尿检的序贯性卒中患者（18～55岁），并与无心血管或神经学诊断的对照住院患者进行比较。

　　结果显示，共有160例缺血性卒中/短暂性脑缺血发作患者（73%）接受药物尿检（男性100例，平均年龄44.8岁）。25例（15.6%）患者为大麻尿检阳性；此类患者更有可能为男性（P=0.016）和吸烟者（P<0.001）。从160例年龄、性别和种族相匹配的患者中采集对照尿样，其中13例（8.1%）对照者为大麻尿检阳性。对年龄、性别和种族进行校正之后，大麻应用与缺血性卒中/短暂性脑缺血发作风险升高具有相关性[比值比（OR ）2.30]。然而，对烟草应用进行校正之后，未能确认独立于烟草应用的相关性（OR 1.59）。

Cannabis, Ischemic Stroke, and Transient Ischemic Attack: A Case-Control Study.
BACKGROUND AND PURPOSE
There is a temporal relationship between cannabis use and stroke in case series and population-based studies.
METHODS
Consecutive stroke patients, aged 18 to 55 years, who had urine screens for cannabis were compared with a cohort of control patients admitted to hospital without cardiovascular or neurological diagnoses.
RESULTS
One hundred sixty of 218 (73%) ischemic stroke/transient ischemic attack patients had urine drug screens (100 men; mean [SD] age, 44.8 [8.7] years). Twenty-five (15.6%) patients had positive cannabis drug screens. These patients were more likely to be men (84% versus 59%; χ2: P=0.016) and tobacco smokers (88% versus 28%; χ2: P<0.001). Control urine samples were obtained from 160 patients matched for age, sex, and ethnicity. Thirteen (8.1%) control participants tested positive for cannabis. In a logistic regression analysis adjusted for age, sex, and ethnicity, cannabis use was associated with increased risk of ischemic stroke/transient ischemic attack (odds ratio, 2.30; 95% confidence interval, 1.08-5.08). However after adjusting for tobacco use, an association independent of tobacco could not be confirmed (odds ratio, 1.59; 95% confidence interval, 0.71-3.70).
CONCLUSIONS
This study provides evidence of an association between a cannabis lifestyle that includes tobacco and ischemic stroke. Further research is required to clarify whether there is an association between cannabis and stroke independent of tobacco.Clinical Trial Registration-URL: http://www.anzctr.org.au. Unique identifier: ACTRN12610000198022.