Abstract：
Stroke is a common worldwide cause of death and disability, resulting from an obstruction or reduction in blood flow to the brain. Research has demonstrated that systemic infection such as herpes zoster (HZ) / ophthalmicus herpes zoster (HZO) can potentially trigger stroke. This study includes an updated systematic review and meta-analysis of the epidemiologic data on the connection between HZ/HZO infection and the risk of stroke. A meticulous search of different database yielded 905 studies. Furthermore, an additional 14 studies from a previous meta-analysis were incorporated. Eligible studies underwent rigorous screening, resulting in 18 papers. Statistical analyses, including random/fixed effects models and subgroup analyses, were conducted to assess pooled relative risk (RR) and heterogeneity. The meta-analysis consisted of 5,505,885 participants and found a statistically significant association between HZ infection and the risk of stroke (pooled RR = 1.22, 95% confidence interval [CI] 1.12-1.34). The HZO infection showed a significantly higher overall pooled RR of 1.71 (95% CI 1.06-2.75), indicating a strong connection with the risk of stroke. Subgroup analysis revealed that the odds ratio might play a significant role in causing heterogeneity. Time since infection emerged as a crucial factor, with heightened stroke risk in the initial year post-HZ/HZO exposure, followed by a decline after the first year. Asian/Non-Asian studies demonstrated varied results in HZ/HZO patients. Meta-analysis reveals a significant HZ/HZO-stroke link. Subgroups highlight varied risks and warrant extended Asian/non-Asian patient investigation.
摘要：
脑卒中是全球常见的死亡和残疾原因，由于大脑的血流阻塞或减少。研究表明，全身性感染如带状疱疹（HZ）/眼带状疱疹（HZO）可能会引发中风。这项研究包括对HZ/HZO感染与卒中风险之间联系的流行病学数据的最新系统评价和荟萃分析。对不同数据库的细致搜索产生了905项研究。此外，纳入了先前荟萃分析的另外14项研究.符合条件的研究经过严格的筛选，产生了18篇论文。统计分析，包括随机/固定效应模型和亚组分析，进行评估合并相对风险(RR)和异质性。荟萃分析包括5,505,885名参与者，发现HZ感染与卒中风险之间存在统计学上的显着关联（合并RR=1.22，95％置信区间[CI]1.12-1.34）。HZO感染显示出显著较高的总体合并RR，为1.71(95%CI1.06-2.75)，表明与中风风险有很强的联系。亚组分析显示，比值比可能在造成异质性中起重要作用。感染后的时间成为关键因素，在HZ/HZO暴露后的最初一年中风风险增加，第一年后下降。亚洲/非亚洲研究显示HZ/HZO患者的不同结果。荟萃分析揭示了HZ/HZO-卒中的显著联系。亚组强调不同的风险，并需要扩大亚洲/非亚洲患者的调查。
