% 0期刊文章% Jiangwei太阳%一个彼得Appelros乔纳斯Halfvarson % %一个大卫·伯格曼%法希姆Ebrahimi % Bjorn Roelstraete %一个乔纳斯·f·Ludvigsson Ola克拉% % T在炎症性肠病的患者的长期风险中风% B以人群为基础的Sibling-Controlled队列研究,1969 - 2019年% D R 10.1212 / WNL 2023%。0000000000207480 % J首页神经病学% P e653-e664 % V 101% N 6% X背景和目标炎症性肠病(IBD)患者血栓栓塞事件的风险增加,但证据长期中风的风险仍然稀缺。我们旨在探索一个活检确诊IBD患者是否增加长期患中风的风险。方法这个群体包括所有活检确诊IBD患者在瑞典在1969年和2019年之间,5匹配参考个人/病人被随机选择从一般人群和IBD-free完整的兄弟姐妹。主要结果是事件总体中风;次要结果缺血性中风和出血性中风。中风被确认来自瑞典国家利用初级和二级诊断病人登记。调整风险比率(明显)中风被灵活的参数生存模型估计。结果共有85006名患者炎症性肠病(包括克罗恩病(CD, n = 25257),溃疡性结肠炎(UC, n = 47354),和IBD-unclassified [IBD-U n = 12395]), 406987匹配参考个人,101082 IBD-free完整的兄弟姐妹被包括在分析中。我们观察了3720事件中风患者的炎症性肠病(发病率(IR) 32.6每10000人年)和15599年参考个人(IR 27.7;aHR 1.13, 95%可信区间1.08 - -1.17)。 The elevated aHR remained increased even 25 years after diagnosis, corresponding to 1 additional stroke case per 93 patients with IBD until then. The excess aHR was mainly driven by ischemic stroke (aHR 1.14; 1.09–1.18) rather than hemorrhagic stroke (aHR 1.06; 0.97–1.15). The risk of ischemic stroke was significantly increased across IBD subtypes (CD [IR 23.3 vs 19.2; aHR 1.19; 1.10–1.29], UC [IR 25.7 vs 22.6; aHR 1.09; 1.04–1.16], and IBD-U [IR 30.5 vs 22.8; aHR 1.22; 1.08–1.37]). Similar results were found when patients with IBD were compared with their siblings.Discussion Patients with IBD were at an increased risk of stroke, especially of ischemic events, irrespective of the IBD subtype. The excess risk persisted even 25 years after diagnosis. These findings highlight the need for clinical vigilance about the long-term excess risk of cerebrovascular events in patients with IBD.aHR=adjusted HR; CD=Crohn disease; COPD=chronic obstructive pulmonary disease; CVD=cardiovascular disease; E=extent; ESPRESSO=Epidemiology Strengthened by histoPathology Reports in Sweden; GI=gastrointestinal; HR=hazard ratio; IBD=inflammatory bowel disease; IBD-U=IBD-unclassified; ICD=International Classification of Diseases; IR=incidence rate; L=location; NPR=National Patient Register; PPV=positive predictive value; UC=ulcerative colitis %U //www.ez-admanager.com/content/neurology/101/6/e653.full.pdf