Ann Neurol:中风后右背前岛叶皮质损伤可导致心肌损伤

2017-10-30 zhangfan MedSci原创

研究人员通过功能神经影像学的最新证据,证实背侧岛叶皮质在心脏和自主神经功能的副交感神经控制中发挥着突出的作用,该脑区的急性血管损伤可能导致自主神经平衡失调,交感神经功能上调,从而导致心肌损伤

心肌肌钙蛋白水平升高与急性心肌损伤相关,同时在急性缺血性脑卒中(AIS)后,肌钙蛋白水平升高也十分常见,导致患者不良预后。最近的研究表明,大部分的AIS患者,心肌损伤不是由冠状动脉缺血引起的,相反中风病灶部位是造成心肌损伤的主要因素。

299名磁共振成像证实前循环内急性缺血性卒中以及肌钙蛋白T(hs-cTnT)超敏患者参与研究,其中228人在中风急性发病期进行了二次肌钙蛋白测量。hs-cTnT绝对值≥14ng/l患者资料以及其随时间的变化规律纳入连续变量模型研究和多元回归分析。

研究发现,右半球前岛叶皮质,特别是背区的中风病灶与hs-cTnT的相对时间变化显著相关(p<0.01);相反,入院时的基线hs-cTnT水平与前循环内任何部位的病变均无关。

研究人员通过功能神经影像学的最新证据,证实背侧岛叶皮质在心脏和自主神经功能的副交感神经控制中发挥着突出的作用,该脑区的急性血管损伤可能导致自主神经平衡失调,交感神经功能上调,从而导致心肌损伤。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2000152, encodeId=9a502000152f3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Apr 16 15:22:00 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=258624, encodeId=39fb25862498, content=谢谢分享谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Nov 04 13:38:14 CST 2017, time=2017-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310049, encodeId=a13c1310049cb, content=<a href='/topic/show?id=ddd95126e4e' target=_blank style='color:#2F92EE;'>#心肌损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51267, encryptionId=ddd95126e4e, topicName=心肌损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4723380, createdName=yangcx0915, createdTime=Wed Nov 01 04:22:00 CST 2017, time=2017-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397365, encodeId=14b4139e365c3, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Wed Nov 01 04:22:00 CST 2017, time=2017-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257481, encodeId=2dac25e481f0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Oct 31 10:46:16 CST 2017, time=2017-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257248, encodeId=451d25e248e1, content=新观点.但没有具体病理生理和解剖的分析噢, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b6d2184980, createdName=1207fadam17(暂无昵称), createdTime=Mon Oct 30 17:08:28 CST 2017, time=2017-10-30, status=1, ipAttribution=)]
    2018-04-16 yinhl1978
  2. [GetPortalCommentsPageByObjectIdResponse(id=2000152, encodeId=9a502000152f3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Apr 16 15:22:00 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=258624, encodeId=39fb25862498, content=谢谢分享谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Nov 04 13:38:14 CST 2017, time=2017-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310049, encodeId=a13c1310049cb, content=<a href='/topic/show?id=ddd95126e4e' target=_blank style='color:#2F92EE;'>#心肌损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51267, encryptionId=ddd95126e4e, topicName=心肌损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4723380, createdName=yangcx0915, createdTime=Wed Nov 01 04:22:00 CST 2017, time=2017-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397365, encodeId=14b4139e365c3, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Wed Nov 01 04:22:00 CST 2017, time=2017-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257481, encodeId=2dac25e481f0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Oct 31 10:46:16 CST 2017, time=2017-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257248, encodeId=451d25e248e1, content=新观点.但没有具体病理生理和解剖的分析噢, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b6d2184980, createdName=1207fadam17(暂无昵称), createdTime=Mon Oct 30 17:08:28 CST 2017, time=2017-10-30, status=1, ipAttribution=)]
    2017-11-04 虈亣靌

    谢谢分享谢谢分享

    0

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    2017-10-31 虈亣靌

    是很好的学习材料.不错.以后会多学习.

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2000152, encodeId=9a502000152f3, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Apr 16 15:22:00 CST 2018, time=2018-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=258624, encodeId=39fb25862498, content=谢谢分享谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Sat Nov 04 13:38:14 CST 2017, time=2017-11-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310049, encodeId=a13c1310049cb, content=<a href='/topic/show?id=ddd95126e4e' target=_blank style='color:#2F92EE;'>#心肌损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51267, encryptionId=ddd95126e4e, topicName=心肌损伤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4723380, createdName=yangcx0915, createdTime=Wed Nov 01 04:22:00 CST 2017, time=2017-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397365, encodeId=14b4139e365c3, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Wed Nov 01 04:22:00 CST 2017, time=2017-11-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257481, encodeId=2dac25e481f0, content=是很好的学习材料.不错.以后会多学习., beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zMoyicyo6ia9f4IuLQAwZoxD6Hx4ibd5CMcOCYhStY6oDibbKK6O2X8iaicldO5ib8j1iapOIobIKCGiczU2A/0, createdBy=56251941490, createdName=虈亣靌, createdTime=Tue Oct 31 10:46:16 CST 2017, time=2017-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=257248, encodeId=451d25e248e1, content=新观点.但没有具体病理生理和解剖的分析噢, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b6d2184980, createdName=1207fadam17(暂无昵称), createdTime=Mon Oct 30 17:08:28 CST 2017, time=2017-10-30, status=1, ipAttribution=)]
    2017-10-30 1207fadam17(暂无昵称)

    新观点.但没有具体病理生理和解剖的分析噢

    0

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