| 뇌졸중 선행인자에 관한 연구 :
위험인자의 변동, 선행된 감염, 추위에의 노출, 정신적 스트레스의 역할 |
| 정선주, 김종성 이창화* |
| 울산대학교 의과대학 아산재단 서울중앙병원 신경과, 정신과* |
| Precipitants of Stroke : Roles of Risk Factor Changes,
Preceding Infection, Exposure to Coldness,
and Psychologic Stress |
| Sun Ju Chung, M.D., Jong Sung Kim, M.D., Chang Hwa Lee, M.D.* |
| Department of Neurology, Asan Medical Center, College of Medicine University of Ulsan
Department of Psychiatry, Asan Medical Center, College of Medicine University of Ulsan* |
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| Abstract |
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Background : Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described insufficiently as predisposing risk factors for cerebral infarction. Therefore, we attempted to examine the roles of recent infection, psychologic stress, and the changes of risk factors as potential precipitants in each stroke subtypes. We also tested the temporal relationship between preceding exposure to coldness and stroke onset. Methods : In this case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale. Results : The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of the other risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01). Conclusion : Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be com
Key Words : Stroke, Precipitants, Infection, Coldness, Stress |
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