缺血性卒中的肥胖悖论

Obesity paradox of ischemic stroke

肥胖是公认的卒中危险因素。但是,许多研究显示,与体重正常和不足的患者相比,肥胖或超重的缺血性卒中患者死亡风险更低,功能转归更佳,提示在缺血性卒中患者中存在肥胖悖论。与之相反,在接受再灌注治疗(包括静脉溶栓和血管内治疗)的患者中并未观察到肥胖悖论。因此,缺血性卒中是否存在肥胖悖论仍存在争议,需要进一步的高质量证据来澄清体重与缺血性卒中转归的相关性。

Obesity is a recognized risk factor for stroke.However,many studies have shown that compared with normal weight and underweight patients,obese or overweight patients with ischemic stroke have lower risk of death and better functional outcome,suggesting that there is an obesity paradox in patients with ischemic stroke.In contrast,the obesity paradox was not observed in patients receiving reperfusion therapy,including intravenous thrombolysis and endovascular therapy.Therefore,whether there is obesity paradox in ischemic stroke is still controversial.Further high-quality evidence is needed to clarify the correlation between body weight and the outcome of ischemic stroke.