全身性硬皮症與年輕型中風的風險研究

Elevated risk of young stroke in patients with systemic sclerosis: a population-based study

研究目標：全身性硬皮症已知與缺血性中風的發生相關，本篇研究旨為探討全身性硬皮症患者是否為發生年輕型（年齡小於50歲）缺血性中風的危險因子。研究方法：本研究使用台灣全民健保資料庫，設定對象為2004年到2016年被診斷為硬皮症的患者，同時間自全人口中抽取一百萬位沒有硬皮症診斷的個案作為對照組。在校正年紀、性別、傳統中風危險因子及相關藥物後，使用Cox比例風險模型來統計分析全身性硬皮症患者相對於對照組發生缺血性中風的危險率。研究結果：至2007到2016年間，共收入1,507位全身性硬皮症患者，平均追蹤時間為5.3年。在全身性硬皮症患者及其對照組中，分別有31次（2.1%）及14,803次（1.48%）與缺血性中風相關的住院事件發生。在經過多因子校正及年齡分層分析後發現，全身性硬皮症患者相較於對照組，產生小於50歲的年輕型缺血性中風的危險比率是2.79（HR 2.79, 95%信賴區間1.38–5.63）。結論：全身性硬皮症為發生年輕型缺血性中風的獨立危險因子。針對此族群患者，早期控制及監測相關危險因子，應有助於避免中風事件。

Objective: Systemic sclerosis (SSc) has been linked to incident ischemic stroke. Our study was designed to verify SSc as a risk factor for young stroke in patients aged < 50 years old. Methods: We used a nationwide population database from Taiwan to investigate patients with SSc and 1,000,000 matched comparisons between 2004 and 2016. Cox proportional hazards regression models were used to calculate the hazard ratio (HR) of ischemic stroke for systemic sclerosis after adjusting for age, sex, traditional risk factors, and related medications. Results: In total, 1,507 patients with SSc were identified. The mean follow-up time was 5.3 years. Among the patients with SSc and the comparisons, 31 (2.1%) and 14,803 (1.48%) ischemic stroke-related hospitalizations occurred, respectively. The adjusted HR for ischemic stroke among young patients with SSc was 2.79 (95% CI 1.38–5.63) compared with the comparisons.Conclusions: SSc is an independent risk factor for young ischemic stroke. Prevention strategies and monitoring are required to prevent devastating clinical events.