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Abstract：
Smoking is a well-established risk factor for stroke, yet its impact on stroke prognosis remains complex and multifaceted. This systematic review aims to elucidate the relationship between smoking and various stroke outcomes, including response to treatment and long-term recovery. We conducted a comprehensive analysis of four fundamental studies that examined the prognosis of stroke in smokers, focusing on clinical outcomes post-endovascular treatment, response to antiplatelet therapy, incidence of post-stroke delirium, and the effectiveness of thrombolysis treatment. The studies varied in design, including observational, retrospective, and post hoc trial analyses. The review reveals that smoking may paradoxically predict better clinical outcomes in specific treatment scenarios, such as post-endovascular treatment and when using clopidogrel. However, smokers also demonstrated higher rates of ischemic stroke and post-stroke delirium. Notably, the smoker\'s paradox in thrombolysis treatment was not supported. These findings highlight the need for personalized treatment approaches based on smoking status. Smoking has a complex and significant impact on stroke prognosis. While some benefits in specific treatment contexts were observed, the overall evidence strongly advises against smoking due to its adverse health consequences. This review underscores the importance of personalized stroke management in smokers and the integration of smoking cessation programs in post-stroke care. Future research should focus on larger, longitudinal studies to explore these associations further.
摘要：
吸烟是中风的一个公认的危险因素，但其对卒中预后的影响仍然是复杂和多方面的.本系统综述旨在阐明吸烟与各种卒中结局之间的关系。包括对治疗的反应和长期康复。我们对四项基础研究进行了全面分析，这些研究检查了吸烟者中风的预后，专注于血管内治疗后的临床结果，抗血小板治疗的反应，卒中后谵妄的发生率,以及溶栓治疗的有效性。这些研究的设计各不相同，包括观察，回顾性,和事后试验分析。该综述显示，吸烟可能矛盾地预测特定治疗方案中更好的临床结果。如血管内治疗和使用氯吡格雷时。然而,吸烟者的缺血性卒中和卒中后谵妄发生率也较高.值得注意的是,溶栓治疗中的吸烟者悖论未得到支持.这些发现强调了基于吸烟状况的个性化治疗方法的必要性。吸烟对脑卒中预后有复杂而显著的影响。虽然在特定治疗环境中观察到一些益处，总体证据强烈建议不要吸烟，因为它对健康不利。这篇综述强调了对吸烟者进行个性化卒中管理以及将戒烟计划整合到卒中后护理中的重要性。未来的研究应该集中在更大的，纵向研究进一步探讨这些关联。
