在缺血性中风和过渡性缺血性发作中,周血管空间负担与未来中风风险之间的关联:系统性审查和元分析
Hanhan Lei1,2,3, Xiaomin Wu1,2,3, Gareth Ambler4
1Department of Neurology, Stroke Research Center, Fujian Medical University Union Hospital, Fuzhou, China.
European neurology
|July 9, 2024
概括
基底腺周血管空间 (BG-PVS) 的较高负担与患有缺血性中风或TIA的患者未来内出血 (ICH) 的风险增加有关. 这一发现突出了BG-PVS作为出血并发症的潜在预测因素.
科学领域:
- 神经学 神经学
- 神经成像是一种神经成像.
- 血管神经学 血管神经学
背景情况:
- 周血管空间 (PVS) 是大脑血管周围的充满液体的空间.
- 在各种神经疾病中观察到增加PVS负担.
- 需要进一步调查PVS负担与未来中风结果之间的关联.
研究的目的:
- 进行一项元分析,研究周血管空间 (PVS) 负担与未来中风事件和死亡率风险之间的关联.
- 专门研究基底质PVS (BG-PVS) 负担与未来内出血 (ICH),缺血性中风和缺血性中风和过渡性缺血性发作 (TIA) 患者的死亡率之间的关系.
主要方法:
- 在PubMed,Embase和Cochrane数据库进行系统的文献搜索,截至2023年12月31日.
- 包括13项观察性研究 (5项前性,8项后性) 涉及20256名患者.
- 使用固定效应和随机效应模型进行元分析,以对PVS负担和临床结果进行调整后的效应估计.
主要成果:
- 较高的基底质PVS负担 (>10 BG-PVS) 与未来内出血 (ICH) 的风险增加显著相关 (aHR 2.79,95% CI: 1.16-6.73).
- 在再输血治疗后7天内,BG-PVS负担和ICH之间没有发现显著的关联,再发性缺血性中风,死亡率或残疾.
- 在半圆中心 (CSO-PVS) 的周血管空间负担与未来的ICH或缺血性中风复发没有显著联系.
结论:
- 较高的基底腺周血管空间 (BG-PVS) 负担是未来内出血 (ICH) 的潜在危险因素,在患有缺血性中风和过时缺血性攻击 (TIA) 的患者中.
- 需要进一步的研究,以阐明中风患者BG-PVS负担的确切机制和临床影响.
相关概念视频
Regulation of Stroke Volume
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...


