密码性 (ESUS) 中风在第一年中的复发:预测因素和结果-南印度研究
Jithin George1, P N Sylaja1, Sapna E Sreedharan1
1Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Annals of Indian Academy of Neurology
|November 29, 2023
概括
源不明的栓塞性中风 (ESUS) 影响了印度11.21%的缺血性中风. 在一年内,9.4%的患者发生了复发事件,心脏病和成像模式预测了复发.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 脑卒中医学 脑卒中医学
背景情况:
- 源不明的栓塞性中风 (ESUS) 占缺血性中风的很大一部分,印度的数据有限.
- 对于ESUS,每年的复发风险大约为4.5-5%,这凸显了对其预测因素和结果进行进一步研究的需要.
研究的目的:
- 确定印度人口中中风亚型中密码性ESUS的患病率.
- 调查ESUS患者的一年复发风险和结果.
- 为了确定反复出现的ESUS事件的预测因素.
主要方法:
- 一个单一中心的两样性研究包括了在2017年1月至2020年12月期间被诊断患有密码性ESUS的患者.
- 综合性评估包括神经成像 (CT/MRI与血管造影),心电图,胸外心电图和节律监测.
- 功能性结果使用修改的兰金级别进行评估,得分为0-2表示良好结果.
主要成果:
- 234名患者 (11.21%的缺血性中风) 符合ESUS标准,平均年龄为58.2岁.
- 一年复发率为9.4%. 关键的神经成像预测因素包括多重栓塞和表面流域模式.
- 冠状动脉疾病 (CAD) 和特定的成像模式是多变量分析中复发的显著预测因素.
结论:
- 在ESUS队列中,每年复发风险比之前报告的要高.
- 虽然注意到血管风险因素和血管异常,但CAD和多重栓塞模式在成像上显著与复发相关,这表明潜在的心脏基质.
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