■出血性中风(HS)是一种突发性疾病,死亡率和致残率很高,探索HS的触发因素至关重要。在这项研究中,我们分析了HS的个体诱因,为HS的预防和干预提供依据.
■对五个数据库进行了系统搜索,直到2022年12月。使用病例交叉研究或自我对照病例系列设计进行的与HS相关的个体触发因素的研究包括在每个触发因素的描述性总结和综合证据中。
■筛选后共纳入39项研究,并探讨了32个触发因素类别的关联。HS的潜在触发因素如下:抗血小板(奇数比(OR),1.10;95%置信区间(CI),1.00-1.21)和抗凝剂(OR,5.43;95%CI,2.04-14.46)药物,情绪稳定剂/抗精神病药(或,1.33;95%CI,1.07-1.65),感染(或,2.15;95%CI,1.73-2.67),疫苗接种(相对风险,1.11;95%CI,1.02-1.21),体力消耗(或,2.08;95%CI,1.58-2.74),可乐消费(或,5.45;95%CI,2.76-10.76),性活动(或,7.49;95%CI,2.23-25.22),吹鼻子(或范围,2.40-56.40),排便(或,16.94;95%CI,3.40-84.37),和愤怒(或,3.59;95%CI,1.56-8.26)。没有观察到与非法药物使用(OR,2.05;95%CI,0.52-8.06)或吸烟(OR,0.81;95%CI,0.52-1.24)和HS。
■单个触发器,包括几种药物,感染,疫苗接种,和行为,可能引发HS发作。对行为触发因素的直接控制措施可以在预防HS方面发挥关键作用。高危人群在用药过程中应接受个性化治疗和监测措施,以平衡急性HS和基础疾病的风险。
Hemorrhagic stroke (HS) is a sudden-onset disease with high mortality and disability rates, and it is crucial to explore the triggers of HS. In this study, we analyzed individual triggers for HS to provide a basis for HS prevention and intervention.
A systematic search of five databases was conducted until December 2022. Studies on HS-related individual triggers conducted using a
case-crossover study or self-controlled
case series design were included in the descriptive summary and comprehensive evidence synthesis of each trigger.
A total of 39 studies were included after the screening, and 32 trigger factor categories were explored for associations. Potential trigger factors for HS were as follows: Antiplatelet (odd ratio (OR), 1.10; 95% confidence interval (CI), 1.00-1.21) and anticoagulant (OR, 5.43; 95% CI, 2.04-14.46) medications, mood stabilizers/antipsychotics (OR, 1.33; 95% CI, 1.07-1.65), infections (OR, 2.15; 95% CI, 1.73-2.67), vaccinations (relative risk, 1.11; 95% CI, 1.02-1.21), physical exertion (OR, 2.08; 95% CI, 1.58-2.74), cola consumption (OR, 5.45; 95% CI, 2.76-10.76), sexual activity (OR, 7.49; 95% CI, 2.23-25.22), nose blowing (OR range, 2.40-56.40), defecation (OR, 16.94; 95% CI, 3.40-84.37), and anger (OR, 3.59; 95% CI, 1.56-8.26). No associations were observed with illicit drug use (OR, 2.05; 95% CI, 0.52-8.06) or cigarette smoking (OR, 0.81; 95% CI, 0.52-1.24) and HS.
Individual triggers, including several medications, infections, vaccinations, and behaviors, may trigger HS onset. Direct control measures for behavioral triggers can play a crucial role in preventing HS. High-risk populations should receive personalized therapies and monitoring measures during the medication treatment to balance the risk of acute HS and the basic diseases.