PDF(Pubmed)
Abstract：
This review focuses on emerging risk factors for stroke, including air pollution and climate change, gut microbiota, high altitude, and systemic infection. Up to 14% of all stroke-associated mortality is attributed to air pollution and is more pronounced in developing countries. Fine particulate matter and other air pollutants contribute to an increased stroke risk, and this risk appears to increase with higher levels and duration of exposure. Short term air pollution exposure has also been reported to increase the stroke risk. The gut microbiota is a complex ecosystem of bacteria and other microorganisms that reside in the digestive system and affect multiple body systems. Disruptions in the gut microbiota may contribute to stroke development, possibly by promoting inflammation and atherosclerosis. High altitudes have been associated with erythrocytosis and cerebrovascular sinus thrombosis, but several studies have reported an increased risk of thrombosis and ischemic stroke at high altitudes, typically above 3000 m. Systemic infection, particularly infections caused by viruses and bacteria, can also increase the risk of stroke. The risk seems to be greatest in the days to weeks following the infection, and the pathophysiology is complex. All these emerging risk factors are modifiable, and interventions to address them could potentially reduce stroke incidence.
摘要：
这篇综述集中在新出现的卒中危险因素，包括空气污染和气候变化，肠道菌群，高海拔,和全身性感染。所有中风相关死亡率的14％归因于空气污染，在发展中国家更为明显。细颗粒物和其他空气污染物导致中风风险增加，这种风险似乎随着暴露水平和持续时间的增加而增加。据报道，短期接触空气污染也会增加中风的风险。肠道微生物群是细菌和其他微生物的复杂生态系统，它们存在于消化系统中并影响多个身体系统。肠道微生物群的破坏可能有助于中风的发展，可能通过促进炎症和动脉粥样硬化。高海拔与红细胞增多症和脑血管窦血栓形成有关，但是一些研究报道了高海拔地区血栓形成和缺血性中风的风险增加，通常超过3000米。全身性感染，特别是由病毒和细菌引起的感染，也会增加中风的风险。在感染后的几天到几周内，风险似乎最大，病理生理学是复杂的。所有这些新出现的风险因素都是可以改变的，和解决这些问题的干预措施可能会降低卒中发生率。
