Stroke:内在凝血途径、头痛史与缺血性卒中风险

2019-07-09 xing.T MedSci原创

由此可见,头痛和高内在凝血蛋白水平可能在生物学上相互作用,并增加缺血性中风的风险。

偏头痛患者的高凝状态可能在偏头痛和缺血性卒中之间相关性中发挥病理生理学作用。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,该研究旨在更深入地了解头痛、缺血性卒中和内源性凝血途径的潜在关联。

研究人员纳入了RATIO研究(动脉血栓形成与口服避孕药相关风险研究)的受试者,这是一项基于荷兰人群的病例对照研究,包括了缺血性卒中患者和健康对照的年轻女性(年龄<50岁)。研究人员根据头痛史的调查问卷定义了头痛组。通过用C1酯酶抑制剂(FXIIa-C1-INH、FXIa-C1-INH、Kallikrein-C1-INH)或抗胰蛋白酶抑制剂(FXIa-AT-INH)测定来测量活化蛋白复合物,以确定抗原水平(FXII、FXI、前激肽释放酶、HK [高分子量激肽原])和蛋白质活化来衡量内在凝血蛋白。研究人员计算了调整后的比值比,并进行了相互作用分析,评估了与高水平内源性凝血和头痛病史相关的卒中风险增加情况。

研究人员纳入了113例缺血性卒中病例和598例健康对照者。总共有134例(19%)患者有头痛史,其中38例为病例,96例为对照。头痛和高内在凝血蛋白水平(除了FXII抗原水平和两种FXIa抑制剂之外)的组合与缺血性卒中风险的增加相关,高于基于其个体效应的预期(仅FXI抗原水平调整后的比值比为1.7 ,95%CI为1.0-2.9;仅头痛调整后的比值比为2.0,95%CI为1.1-3.7;组合的比值比为5.2,95%CI为2.3-11.6)。

由此可见,头痛和高内在凝血蛋白水平可能在生物学上相互作用,并增加缺血性中风的风险。 

原始出处:

Hendrikus J.A. van Os.et al.Intrinsic Coagulation Pathway, History of Headache, and Risk of Ischemic Stroke.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023124

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    2019-07-09 125a5206m32暂无昵称

    非常好

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1893186, encodeId=5afa189318607, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Sep 03 16:32:00 CST 2019, time=2019-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806332, encodeId=fc35180633216, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Tue Nov 12 22:32:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281314, encodeId=88a112813145e, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Thu Jul 11 09:32:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369371, encodeId=bd493693e19e, content=非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ff42581216, createdName=125a5206m32暂无昵称, createdTime=Tue Jul 09 22:18:04 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026402, encodeId=27ee1026402b3, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jul 09 21:32:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045876, encodeId=4bd510458e6d4, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Jul 09 21:32:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369367, encodeId=6f8e36936e2d, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 09 21:13:08 CST 2019, time=2019-07-09, status=1, ipAttribution=)]
    2019-07-09 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1893186, encodeId=5afa189318607, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Sep 03 16:32:00 CST 2019, time=2019-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806332, encodeId=fc35180633216, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Tue Nov 12 22:32:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281314, encodeId=88a112813145e, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Thu Jul 11 09:32:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369371, encodeId=bd493693e19e, content=非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ff42581216, createdName=125a5206m32暂无昵称, createdTime=Tue Jul 09 22:18:04 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026402, encodeId=27ee1026402b3, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jul 09 21:32:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045876, encodeId=4bd510458e6d4, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Jul 09 21:32:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369367, encodeId=6f8e36936e2d, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 09 21:13:08 CST 2019, time=2019-07-09, status=1, ipAttribution=)]
    2019-07-09 guging

    中风是俗称,应该称为缺血性卒中吧

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1893186, encodeId=5afa189318607, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, encryptionId=c738e93521f, topicName=缺血性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=66ec123, createdName=guihongzh, createdTime=Tue Sep 03 16:32:00 CST 2019, time=2019-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806332, encodeId=fc35180633216, content=<a href='/topic/show?id=b649e9358fa' target=_blank style='color:#2F92EE;'>#缺血性卒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79358, encryptionId=b649e9358fa, topicName=缺血性卒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=636e2500187, createdName=12498da4m32(暂无昵称), createdTime=Tue Nov 12 22:32:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281314, encodeId=88a112813145e, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Thu Jul 11 09:32:00 CST 2019, time=2019-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369371, encodeId=bd493693e19e, content=非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ff42581216, createdName=125a5206m32暂无昵称, createdTime=Tue Jul 09 22:18:04 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026402, encodeId=27ee1026402b3, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Jul 09 21:32:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045876, encodeId=4bd510458e6d4, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Jul 09 21:32:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369367, encodeId=6f8e36936e2d, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Tue Jul 09 21:13:08 CST 2019, time=2019-07-09, status=1, ipAttribution=)]
    2019-07-09 qingfengqishi5

    学习了,学习了

    0