不明原因栓塞性卒中
Embolic stroke of undetermined source
迟冬雨 1宋秀娟1
作者信息
- 1. 河北医科大学第二医院神经内科,河北 石家庄 050000;河北省神经病学重点实验室,河北 石家庄 050000;临床神经病学教育部重点实验室,河北 石家庄 050000
- 折叠
摘要
不明原因栓塞性卒中(ESUS)目前被认为是在影像上表现为栓塞性卒中,且经仔细诊断评估后,未确定特定的或公认的卒中病因的隐源性卒中亚型.据推测,在ESUS患者卒中二级预防中,抗凝治疗比抗血小板治疗更有效.然而,实际上在几项相关ESUS实验中,抗凝治疗相比于阿司匹林既不安全,也不有效.故更确切地理解和判断ESUS的病因是治疗的关键.本文将讨论ESUS概念的背景、定义、诊断,从栓子来源分析其病因及与ESUS的关联,以期提高临床医生的认识.
Abstract
Embolic stroke of undetermined source(ESUS)is currently considered to be a subtype of cryptogenic stroke featuring embolic stroke on imaging but with no specific or recognized cause of stroke identified after careful diagnos-tic evaluation.It was speculated that anticoagulant therapy was more effective than antiplatelet therapy for secondary pre-vention of stroke in patients with ESUS.However,in fact,several ESUS trials showed that anticoagulant therapy was nei-ther safer nor more effective compared with aspirin.Therefore,a more accurate understanding and determination of the eti-ology of ESUS is the key to treatment.In this paper,we discuss the background,definition,and diagnosis of ESUS,and analyze its etiology and the relationship between emboli and ESUS from the perspective of embolus source,with the aim to improve clinicians'understanding of ESUS.
关键词
不明原因栓塞性卒中/非狭窄性大动脉粥样硬化/亚临床房颤/卵圆孔未闭Key words
Embolic stroke of undetermined source/Nonstenotic large-artery atherosclerosis/Subclinical atrial fibrillation/Patent foramen ovale引用本文复制引用
基金项目
河北省医学科学研究课题(20211276)
出版年
2024
国家科技期刊平台
NSTL
万方数据