用Lecanemab治疗的患者多发性缺血性中风:一个病例报告
Hajar Alammar1,2, Mamadou Diallo1,2, Daniel A Llano1,2,3,4
1Carle Neuroscience Institute, Urbana, IL, USA.
Neurocase
|October 17, 2025
概括
对阿尔茨海默病的粉样蛋白降低疗法可能会增加出血 (ARIA-H) 和缺血性中风的风险. 本案例研究强调了与Lecanemab治疗相关的潜在血管风险.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 神经成像是一种神经成像.
背景情况:
- 粉样蛋白降低疗法,包括针对粉样蛋白β的单克隆抗体,是阿尔茨海默病的新兴治疗方法.
- 这些疗法与粉样蛋白相关的成像异常 (ARIA) 有关,例如大脑 (ARIA-E) 和微出血 (ARIA-H).
- 缺血性事件有事报告,但与这些疗法有关的不系统研究.
研究的目的:
- 报告阿尔茨海默病患者在莱卡内马布治疗期间同时发生ARIA和缺血性心脏病发作的病例.
- 调查粉样蛋白降低疗法与缺血事件之间的潜在关联.
主要方法:
- 一个阿尔茨海默病患者的病例报告用Lecanemab治疗.
- 通过MRI监测粉样蛋白相关的成像异常 (ARIA-E和ARIA-H).
- 进行全面的诊断工作,以确定缺血性心脏病发作的原因.
- 对抗粉样蛋白治疗和缺血事件的现有文献的审查.
主要成果:
- 患者在莱卡尼马布治疗期间出现了ARIA-H和ARIA-E.
- 在MRI上检测到多个无症状的缺血性心脏病发作.
- 在工作期间,没有发现缺血性心脏病发作的其他原因.
- 这些发现与之前的病例报告一致,在抗粉胺治疗期间发生缺血性心脏病发作.
结论:
- 以Lecanemab为例的粉样蛋白降低疗法,除了ARIA外,还可能增加缺血性心脏病发作的风险.
- 这项研究表明,有潜在的倾向于发生出血和缺血性血管事件.
- 阿尔茨海默病的潜在微血管病理可能会导致这些与治疗相关的风险.
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