JACC：颈动脉支架后的缺血性脑损伤增加脑血管风险

2015-02-20 赵洲 MedSci原创

在颈动脉支架（CAS）手术过后，通过扩散加权成像（DWI）技术可以经常发现脑损伤，但二者临床联系仍旧不明确。来自瑞士、荷兰和英国等国的科研人员开展研究，以调查CAS或动脉内膜切除术（CEA）后的围术期缺血性DWI损伤是否和经常发生的脑血管疾病风险上升有关。 在国际颈动脉支架研究（ICSS）的核磁共振成像（MRI）的分支研究中，231名患有颈动脉狭窄的病人随机进行了CAS(124人）和CE

在颈动脉支架（CAS）手术过后，通过扩散加权成像（DWI）技术可以经常发现脑损伤，但二者临床联系仍旧不明确。来自瑞士、荷兰和英国等国的科研人员开展研究，以调查CAS或动脉内膜切除术（CEA）后的围术期缺血性DWI损伤是否和经常发生的脑血管疾病风险上升有关。

在国际颈动脉支架研究（ICSS）的核磁共振成像（MRI）的分支研究中，231名患有颈动脉狭窄的病人随机进行了CAS(124人）和CEA(107人)。在术前1-7天和术后1-3天，进行MRI检测。主要结果是发生卒中或者短暂缺血性损伤。在术后有新的DWI损伤（DWI+）和没有新的损伤（DWI﹣）之间，对CAS和CEA两组主要结果出现的时间分别进行比较。跟踪随访的中值时间是4.1年（四分差：3.0-5.2）。在CAS组中，DWI+病人中发生卒中或短暂缺血性损伤高于DWI﹣病人。DWI+62名病人中12人发病，DWI﹣62名病人中6人发病，5年发病率分别是22.8%（标准偏差SE 7.1%）和8.8%（SE 3.8%）。DWI+和DWI﹣病人中分别有8人和2人在术后6个月内发病。在CEA组中，DWI+和DWI﹣病人患脑血管疾病并无差别。

在CAS术后利用DWI成像发现的缺血性脑损伤似乎成为了脑血管疾病风险增加的标志。有围术期DWI损伤的病人或许可以在CAS术后进行的更有的、持续很久的抗血小板治疗中获益。

原始出处：

Henrik Gensicke et al.Journal of the American College of Cardiology.JACC.Volume 65, Issue 6, 17 February 2015, Pages 521–529

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2015-04-15 guihongzh

#缺血性#

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2015-09-07 liuyg0228

#颈动脉支架#

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2015-03-07 ms5353107019656438

#血管风险#

18 0
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GetPortalCommentsPageByObjectIdResponse(id=1325001, encodeId=fd6d13250014e, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396902, encodeId=f0af13969026d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=)]
2016-01-17 ms7524819409032184

#缺血性脑#

24 0
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843386, encodeId=df3218433860b, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Tue Aug 04 23:09:00 CST 2015, time=2015-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16870, encodeId=9117168e030, content=不错的文章，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:17:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325001, encodeId=fd6d13250014e, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396902, encodeId=f0af13969026d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=)]
2015-11-08 hbwxf

#JACC#

25 0
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843386, encodeId=df3218433860b, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Tue Aug 04 23:09:00 CST 2015, time=2015-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16870, encodeId=9117168e030, content=不错的文章，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:17:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325001, encodeId=fd6d13250014e, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396902, encodeId=f0af13969026d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=)]
2015-08-04 mhzhuang@stu.e

#颈动脉#

23 0
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843386, encodeId=df3218433860b, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Tue Aug 04 23:09:00 CST 2015, time=2015-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16870, encodeId=9117168e030, content=不错的文章，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:17:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), 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createdName=智者为医08, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=)]
2015-02-24 orthoW

不错的文章，学习了

148 0
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createdName=liuyg0228, createdTime=Mon Sep 07 07:09:00 CST 2015, time=2015-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082359, encodeId=6e342082359bb, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Mar 07 12:09:00 CST 2015, time=2015-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806993, encodeId=716f18069930d, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Jan 17 10:09:00 CST 2016, time=2016-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853323, encodeId=861218533237b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Nov 08 12:09:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843386, encodeId=df3218433860b, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Tue Aug 04 23:09:00 CST 2015, time=2015-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16870, encodeId=9117168e030, content=不错的文章，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:17:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325001, encodeId=fd6d13250014e, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396902, encodeId=f0af13969026d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=)]
2015-02-22 12498568m50暂无昵称

#ACC#

24 0
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createdName=liuyg0228, createdTime=Mon Sep 07 07:09:00 CST 2015, time=2015-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082359, encodeId=6e342082359bb, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Mar 07 12:09:00 CST 2015, time=2015-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1806993, encodeId=716f18069930d, content=<a href='/topic/show?id=245de9378aa' target=_blank style='color:#2F92EE;'>#缺血性脑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79378, encryptionId=245de9378aa, topicName=缺血性脑)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Sun Jan 17 10:09:00 CST 2016, time=2016-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1853323, encodeId=861218533237b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sun Nov 08 12:09:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1843386, encodeId=df3218433860b, content=<a href='/topic/show?id=dab8100523bb' target=_blank style='color:#2F92EE;'>#颈动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100523, encryptionId=dab8100523bb, topicName=颈动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=416347, createdName=mhzhuang@stu.e, createdTime=Tue Aug 04 23:09:00 CST 2015, time=2015-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16870, encodeId=9117168e030, content=不错的文章，学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=148, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f2fb1607679, createdName=orthoW, createdTime=Tue Feb 24 11:17:00 CST 2015, time=2015-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325001, encodeId=fd6d13250014e, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1396902, encodeId=f0af13969026d, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Sun Feb 22 13:09:00 CST 2015, time=2015-02-22, status=1, ipAttribution=)]
2015-02-22 智者为医08

#损伤#

21 0

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