关节动的过渡性缺血性发作在患有动脉闭塞或狭窄症的患者中:系统性审查和个人患者数据的元分析
Eva Joëlle Haasdijk1, Yasmin Sadigh2, Gizem Yildirim2
1Department of Neurosurgery, Erasmus MC Stroke Center, Erasmus MC University Medical Centre, Rotterdam, The Netherlands, 560132eh@student.eur.nl.
Neuroepidemiology
|April 17, 2024
概括
肢体震动暂时性缺血性发作 (LSTIA) 是一种罕见的疾病,通常是由动脉狭窄引起的. 内血管干预取得了很高的成功,但对于标准的LSTIA治疗需要更多的研究.
科学领域:
- 神经学 神经学
- 血管医学 血管医学
- 流行病学 流行病学
背景情况:
- 肢体震动暂时性缺血性发作 (LSTIA) 是一种罕见的神经疾病,其特点是肢体不自发地运动.
- 它经常与喉狭窄或闭塞有关,但它的流行病学仍然不太了解.
- 这种疾病往往被误诊,目前还没有标准的治疗方法.
研究的目的:
- 提供关于LSTIA流行病学的全面概述.
- 审查目前对LSTIA的治疗选择.
- 为了解决这种罕见疾病所带来的诊断和治疗挑战.
主要方法:
- 在多个数据库 (Embase,MEDLINE,Web of Science等) 中进行了系统的文献搜索. 在2023年12月之前.
- 对提取的数据进行了个体患者数据元分析 (IPD-MA) 和队列分析.
- 纳入标准侧重于成年患者,有放射性确认的动脉狭窄/闭塞和LSTIA,不包括儿科研究和非原始文章.
主要成果:
- 分析包括55篇与251名患者的文章;81名患者是IPD-MA的一部分,187人在队列分析中.
- LSTIA主要与双边内动脉 (ICA) 狭窄/闭塞 (64%) 相关,通常呈现为单边四肢震动 (83%).
- 内血管干预 (支架,血管整形) 在小队列中显示出100%的成功率,而TIA患者队列中的LSTIA患病率差异很大 (3.5-29%).
结论:
- 关于LSTIA的流行病学存在重大知识差距,需要建立一个大型的国际临床注册表.
- 目前的证据不足以建立LSTIA的标准化治疗方案.
- 进一步的研究对于改善LSTIA的诊断和管理策略至关重要.
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