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Lancet：围手术期隐匿性脑卒中与不良预后风险

2019-08-16 MedSci MedSci原创

隐匿性脑卒中认知衰退谵妄
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研究发现，非心脏手术患者发生围手术期隐匿性脑卒中导致认知衰退及不良预后风险增加

在非手术环境下，隐匿性卒中比显性卒中更为常见，并与认知功能下降有关。尽管在非心脏手术后，只有不到1%的成年人发生明显的脑卒中，但我们对围手术期隐匿性脑卒中知之甚少。近日研究人员考察了围手术期隐匿性脑卒中(即在无临床中风症状的非心脏手患者，术后MRI上发现急性脑梗死)与术后1年认知功能减退之间的关系。

NeuroVISION研究在9个国家开展，65岁以上，择期接受非心脏手术患者参与研究，术后接受MRI。研究的主要终点为隐匿性脑卒中与认知衰退，定义为随访1年期间蒙特利尔认知评估得分下降2分及以上。

1114名参与者，78人（7%）出现隐匿性脑卒中。随访1年，69名隐匿性脑卒中患者中29人(42%)出现认知衰退，未出现隐匿性脑卒中932名患者中，274人出现认知衰退（29%，OR=1.98）。隐匿性脑卒中与术后谵妄（HR=2.24，绝对风险增加6%）以及随访1年间脑卒中或短暂性脑缺血发作（HR=4.13，绝对风险增加3%）风险相关。

研究发现，非心脏手术患者发生围手术期隐匿性脑卒中导致认知衰退及不良预后风险增加。

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    2020-05-10 ms3117646317107274

    #手术期#

    0

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    2020-03-09 howi

    #Lancet#

    0

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    2019-09-20 天下~杰

    学习了

    0

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    2019-10-27 1179102698_36768926

    #隐匿性#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2053872, encodeId=391d20538e2b9, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun May 10 12:08:00 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830211, encodeId=b0991830211fa, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Mar 09 13:08:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=372985, encodeId=ed143e2985c2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/GRviaeTeMXqv6SQWAOSSc6p32e6h3H4sZ3iasG4FP6lhJ1h2RqgCKc4AFKy8SjEekXvmT6rDibLvouuw2hSrBhugQ/132, createdBy=caaa2380558, createdName=天下~杰, createdTime=Fri Sep 20 23:29:47 CST 2019, time=2019-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1936105, encodeId=fd8e1936105e7, content=<a href='/topic/show?id=1908984822d' target=_blank style='color:#2F92EE;'>#隐匿性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98482, encryptionId=1908984822d, topicName=隐匿性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b71f2500114, createdName=1179102698_36768926, createdTime=Sun Oct 27 03:08:00 CST 2019, time=2019-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336392, encodeId=d4d3133639269, content=<a href='/topic/show?id=071820530c5' target=_blank style='color:#2F92EE;'>#不良预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20530, encryptionId=071820530c5, topicName=不良预后)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c97a2500111, createdName=thinkibmz_44722594, createdTime=Sun Aug 18 10:08:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618467, encodeId=32b2161846e4f, content=<a href='/topic/show?id=5dbc98480ef' target=_blank style='color:#2F92EE;'>#隐匿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98480, encryptionId=5dbc98480ef, topicName=隐匿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1caf19894563, createdName=41514493@qq.com, createdTime=Sun Aug 18 10:08:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026433, encodeId=a16c1026433cf, 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=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Aug 16 22:08:00 CST 2019, time=2019-08-16, status=1, ipAttribution=)]
    2019-08-18 thinkibmz_44722594

    #不良预后#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2053872, encodeId=391d20538e2b9, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun May 10 12:08:00 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830211, encodeId=b0991830211fa, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Mar 09 13:08:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=372985, encodeId=ed143e2985c2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/GRviaeTeMXqv6SQWAOSSc6p32e6h3H4sZ3iasG4FP6lhJ1h2RqgCKc4AFKy8SjEekXvmT6rDibLvouuw2hSrBhugQ/132, createdBy=caaa2380558, createdName=天下~杰, createdTime=Fri Sep 20 23:29:47 CST 2019, time=2019-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1936105, encodeId=fd8e1936105e7, content=<a href='/topic/show?id=1908984822d' target=_blank style='color:#2F92EE;'>#隐匿性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98482, encryptionId=1908984822d, topicName=隐匿性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b71f2500114, createdName=1179102698_36768926, createdTime=Sun Oct 27 03:08:00 CST 2019, time=2019-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336392, encodeId=d4d3133639269, content=<a href='/topic/show?id=071820530c5' target=_blank style='color:#2F92EE;'>#不良预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20530, encryptionId=071820530c5, topicName=不良预后)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c97a2500111, createdName=thinkibmz_44722594, createdTime=Sun Aug 18 10:08:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618467, encodeId=32b2161846e4f, content=<a href='/topic/show?id=5dbc98480ef' target=_blank style='color:#2F92EE;'>#隐匿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98480, encryptionId=5dbc98480ef, topicName=隐匿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1caf19894563, createdName=41514493@qq.com, createdTime=Sun Aug 18 10:08:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026433, encodeId=a16c1026433cf, 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=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Aug 16 22:08:00 CST 2019, time=2019-08-16, status=1, ipAttribution=)]
    2019-08-18 41514493@qq.com

    #隐匿#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2053872, encodeId=391d20538e2b9, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun May 10 12:08:00 CST 2020, time=2020-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830211, encodeId=b0991830211fa, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Mar 09 13:08:00 CST 2020, time=2020-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=372985, encodeId=ed143e2985c2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/GRviaeTeMXqv6SQWAOSSc6p32e6h3H4sZ3iasG4FP6lhJ1h2RqgCKc4AFKy8SjEekXvmT6rDibLvouuw2hSrBhugQ/132, createdBy=caaa2380558, createdName=天下~杰, createdTime=Fri Sep 20 23:29:47 CST 2019, time=2019-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1936105, encodeId=fd8e1936105e7, content=<a href='/topic/show?id=1908984822d' target=_blank style='color:#2F92EE;'>#隐匿性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98482, encryptionId=1908984822d, topicName=隐匿性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b71f2500114, createdName=1179102698_36768926, createdTime=Sun Oct 27 03:08:00 CST 2019, time=2019-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336392, encodeId=d4d3133639269, content=<a href='/topic/show?id=071820530c5' target=_blank style='color:#2F92EE;'>#不良预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20530, encryptionId=071820530c5, topicName=不良预后)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c97a2500111, createdName=thinkibmz_44722594, createdTime=Sun Aug 18 10:08:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618467, encodeId=32b2161846e4f, content=<a href='/topic/show?id=5dbc98480ef' target=_blank style='color:#2F92EE;'>#隐匿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98480, encryptionId=5dbc98480ef, topicName=隐匿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1caf19894563, createdName=41514493@qq.com, createdTime=Sun Aug 18 10:08:00 CST 2019, time=2019-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026433, encodeId=a16c1026433cf, 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=35, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Aug 16 22:08:00 CST 2019, time=2019-08-16, status=1, ipAttribution=)]
    2019-08-16 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