Embolic stroke of undetermined source: knowledge validated and refuted in the past 10 years
田成林 1郑晴
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作者信息
1. 解放军总医院第一医学中心神经内科，北京100853
折叠
摘要
来源不明的栓塞性卒中（ESUS）是一个国际工作组在2014年提出的概念，旨在以此界定一类卒中患者，并探索在这类卒中人群中应用抗凝治疗进行二级预防的合理性。概念提出10年以来，研究者们针对ESUS的发病机制和防治策略进行了大量研究，但其结果与概念提出当时的一些推测和设想并不十分一致。本文在回顾10年来有关ESUS研究发现的基础上，对ESUS概念中的内在缺陷、研究发现的解读、如何重新认识ESUS的意义以及未来缺血性卒中病因诊断的策略进行了讨论。 Embolic stroke of undetermined source (ESUS) is a concept proposed by an international working group in 2014 to define a class of stroke patients and explore the rationality of secondary prevention by anticoagulation in them. During the decade since the concept was proposed, numerous studies have been conducted on the pathogenesis and prevention strategies of ESUS. However, the research results are not quite consistent with the speculations and assumptions when the concept was proposed. Based on the review of the findings of related studies over the past decade, this article discusses the inherent defects in the ESUS concept, the new idea derived from the research results, the future role of ESUS, and trends in etiological diagnosis of ischemic stroke.
Abstract
Embolic stroke of undetermined source (ESUS) is a concept proposed by an international working group in 2014 to define a class of stroke patients and explore the rationality of secondary prevention by anticoagulation in them. During the decade since the concept was proposed, numerous studies have been conducted on the pathogenesis and prevention strategies of ESUS. However, the research results are not quite consistent with the speculations and assumptions when the concept was proposed. Based on the review of the findings of related studies over the past decade, this article discusses the inherent defects in the ESUS concept, the new idea derived from the research results, the future role of ESUS, and trends in etiological diagnosis of ischemic stroke.
关键词
卒中/抗凝药/栓塞/动脉粥样硬化/来源不明的栓塞性卒中
Key words
Stroke/Anticoagulants/Embolism/Atherosclerosis/Embolic stroke of undetermined source
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