Stroke:症状性颈动脉疾病与微血栓形成有关

2017-01-13 xing.T MedSci原创

脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。基于这些结果,积极的抗凝和抗血小板治疗症状性颈动脉闭塞可能值得进一步调查研究。

症状性颈动脉疾病与发病率和死亡率显著相关。颈动脉闭塞患者脑缺血的病理生理机制仍然没有明确。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员旨在评估症状性颈动脉疾病与微血栓形成之间的相关性。

研究人员进行了一项前瞻性观察性队列研究,以颈动脉狭窄或闭塞超过50%的缺血性卒中或短暂性脑缺血发作7天以内的住院患者作为研究对象。经颅多普勒检测有症状颈动脉同侧的大脑中动脉内的血栓,研究人员描述了微栓子信号(MES)的患病率,归纳了梗死类型,并且报告了90天的临床结局。

在47例患者中,颈动脉闭塞患者有19例,颈动脉狭窄患者有28例,这些患者均完成了经颅多普勒检查,并纳入了最终分析。38%的患者有MES,研究者发现MES在颈动脉闭塞患者(7/19、37%)和颈动脉狭窄患者(11/28,39%;P=0.87)之间没有差异。这些患者梗死的影像学证据(n=39)显示,38%的患者为分水岭模式的梗死,41%的患者为非分水岭模式的梗死,而21%的患者两者都有。40%分水岭模式梗死的患者存在MES,9例患者发生了复发性脑缺血事件(19%;短暂性脑缺血发作患者有6例,缺血性脑卒中患者有3例),在那些有MES和无MES的患者之间复发率无明显差异。

由此可见,脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。基于这些结果,积极的抗凝和抗血小板治疗症状性颈动脉闭塞可能值得进一步调查研究。  

原始出处:


Ava L. Liberman, et al. Symptomatic Carotid Occlusion Is Frequently Associated With Microembolization. Stroke. 2017. 

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    2017-01-15 杨柳青青

    学习了…………分享

    0

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  4. 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GetPortalCommentsPageByObjectIdResponse(id=1464272, encodeId=7ef114642e280, content=<a href='/topic/show?id=bb8050e7336' target=_blank style='color:#2F92EE;'>#微血栓#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50773, encryptionId=bb8050e7336, topicName=微血栓)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20216649846, createdName=闆锋旦, createdTime=Sun Jan 15 02:18:00 CST 2017, time=2017-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170349, encodeId=63491e03496d, content=不错学习并分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200816/e4675a86ea694f12b82202b320dc2654/12f6b900498349e994ce8f516a584d6a.jpg, createdBy=09431951290, createdName=大爰, createdTime=Sat Jan 14 20:17:10 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170213, encodeId=e3021e0213f7, content=很好的文章,值得读, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Jan 14 07:46:42 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170203, encodeId=e53c1e020348, content=继续学习!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sat Jan 14 07:05:14 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170132, encodeId=89861e0132d9, content=好饿逆袭好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Fri Jan 13 18:19:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170108, encodeId=7ab81e0108ce, content=很好,值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-14 大爰

    不错学习并分享!

    0

  5. 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-14 1e10c84am36(暂无匿称)

    很好的文章,值得读

    0

  6. 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-14 深海的鱼

    继续学习!!

    0

  7. 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20:17:10 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170213, encodeId=e3021e0213f7, content=很好的文章,值得读, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sat Jan 14 07:46:42 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170203, encodeId=e53c1e020348, content=继续学习!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sat Jan 14 07:05:14 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170132, encodeId=89861e0132d9, content=好饿逆袭好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Fri Jan 13 18:19:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170108, encodeId=7ab81e0108ce, content=很好,值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-13 thlabcde

    好饿逆袭好东西学习了!

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sat Jan 14 07:05:14 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170132, encodeId=89861e0132d9, content=好饿逆袭好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Fri Jan 13 18:19:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170108, encodeId=7ab81e0108ce, content=很好,值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-13 不着调的小师兄

    很好,值得推荐

    0

  9. 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createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRkia1DP5MpwEgtXo1XhXA11xD6MWKxunAZFXKSNic0fWHUQx83oNHPlRMxxIctM83QKeCLkJpMibibiaC/0, createdBy=7e581734408, createdName=深海的鱼, createdTime=Sat Jan 14 07:05:14 CST 2017, time=2017-01-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170132, encodeId=89861e0132d9, content=好饿逆袭好东西学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Fri Jan 13 18:19:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170108, encodeId=7ab81e0108ce, content=很好,值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-13 不着调的小师兄

    给力

    0

  10. 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:44:11 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170107, encodeId=8d141e01072a, content=给力, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20170203/IMG58944A1F6F77F5112.jpg, createdBy=29891665859, createdName=不着调的小师兄, createdTime=Fri Jan 13 15:43:55 CST 2017, time=2017-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=170102, encodeId=25dc1e010239, content=脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Jan 13 14:42:00 CST 2017, time=2017-01-13, status=1, ipAttribution=)]
    2017-01-13 ylzr123

    脑栓塞形成在颈动脉闭塞和狭窄导致缺血的病理生理过程中起着重要的作用,甚至在分水岭梗死的患者中也起着重要作用。

    0