小児期の動脈性缺血性脳卒中後の臨床的および放射線学的再発
Vijeya Ganesan1, Mara Prengler, Angela Wade
1Neurosciences Unit, Institute of Child Health, University College London, London, United Kingdom. v.ganesan@ich.ucl.ac.uk
Circulation
|November 1, 2006
まとめ
臨床的および放射線学的再発は,小児期の動脈性缺血性脳卒中 (AIS) の後に一般的です. モヤモヤ病と遺伝性血栓形成症は,臨床再発のリスクを高め,以前の診断と白血球症は,放射線学的再発に関連しています.
科学分野:
- 小児神経学について
- 神経科学は神経科学である.
- 血管神経学 血管神経学
背景:
- 小児性動脈性缺血性脳卒中 (AIS) の再発率とリスク要因は,二次予防戦略の開発において極めて重要です.
- 再発パターンの理解は,小児性脳卒中の臨床管理と研究方向性を伝える.
研究 の 目的:
- 第一次動脈性缺血性脳卒中 (AIS) を受けた子どもにおける臨床的および放射線学的再発に関連する発生率とリスク要因を調査する.
- 再発を予測する特定の患者の特徴と状態を特定し,標的型二次予防を支援します.
主な方法:
- 1978年から2000年の間に初めてAISと診断された小児患者の遡及的および将来の識別.
- コックスおよびロジスティック回帰モデルを用いた臨床再発 (脳卒中,TIA,死亡) と放射線再発 (再発) の分析.
- 神経画像データ,病歴,検査結果 (遺伝的血栓性,白血球症など) を含め,関連する危険因子を特定する.
主要な成果:
- AIS後の11.5年以内に,79人の子供に臨床再発 (脳卒中,TIA,または死亡) が発生し,5年間の再発のない生存率は59%でした.
- モヤモヤ病と低出生体重は,全体的なコホートにおける臨床再発の独立した予測因子でした.
- 遺伝的血栓形成症は,以前は健康な子供たちの臨床再発を予測しました. 179人の患者のうち60人に放射性再発症が発生し,前回のTIA,双極性心筋梗塞,免疫不全,白血球症が重要な危険因子であった.
結論:
- 臨床的および放射線学的再発は,小児AISの後に頻繁に発生する.
- モヤモヤ病と遺伝性血栓形成症は,小児性AISの臨床再発の主要な危険因子です.
- 免疫不全や白血球数の増加 (白血球症) などの既にある状態は,放射線学的再発と関連しており,潜在的感染性または炎症的な関連性を示唆しています.
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