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  • 沈芳,邢鹏飞,黄石仁,张萍,沈红健,张永巍,吴涛,邓本强*.阿替普酶静脉溶栓治疗卒中预警综合征11例临床分析[J].第二军医大学学报,2018,39(9):1019-1022    [点击复制]
  • SHEN Fang,XING Peng-fei,HUANG Shi-ren,ZHANG Ping,SHEN Hong-jian,ZHANG Yong-wei,WU Tao,DENG Ben-qiang*.Clinical analysis of 11 stroke warning syndrome patients treated with alteplase intravenous thrombolysis[J].Acad J Sec Mil Med Univ,2018,39(9):1019-1022   [点击复制]
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阿替普酶静脉溶栓治疗卒中预警综合征11例临床分析
沈芳,邢鹏飞,黄石仁,张萍,沈红健,张永巍,吴涛,邓本强*
0
(海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433
*通信作者)
摘要:
目的 探讨卒中预警综合征(SWS)的临床特征及静脉溶栓治疗效果。方法 选取2013年9月至2018年1月在我院脑血管病中心接受阿替普酶静脉溶栓治疗的SWS患者11例,分析其临床特点、影像学表现及治疗效果。结果 11例SWS患者都存在脑血管病危险因素,其中7例有高血压病、4例有糖尿病、2例有高脂血症、1例有痛风。症状发作分型:7例为单纯运动型,4例为运动感觉型。磁共振弥散加权成像显示最终10例患者发展为缺血性脑卒中,病灶部位在内囊后肢、壳核、苍白球、放射冠、脑桥;头颈部计算机断层扫描血管成像检查未见大血管狭窄。治疗3个月后9例患者的改良Rankin量表评分为0~1分、1例为2分、1例为3分。结论 穿支病变是SWS发病的主要机制;静脉溶栓治疗不能阻止SWS进展为缺血性脑卒中,但可以改善患者预后。
关键词:  卒中预警综合征  短暂性脑缺血发作  静脉溶栓疗法  预后
DOI:10.16781/j.0258-879x.2018.09.1019
投稿时间:2018-07-16修订日期:2018-08-02
基金项目:上海市科委医学引导项目(124119a8900),上海市科技创新行动计划重点项目(14401970304).
Clinical analysis of 11 stroke warning syndrome patients treated with alteplase intravenous thrombolysis
SHEN Fang,XING Peng-fei,HUANG Shi-ren,ZHANG Ping,SHEN Hong-jian,ZHANG Yong-wei,WU Tao,DENG Ben-qiang*
(Stroke Center, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To investigate the clinical characteristics of stroke warning syndrome (SWS) and to explore the effectiveness of intravenous thrombolysis with alteplase. Methods Eleven patients with SWS, who received intravenous thrombolysis with alteplase in Stroke Center of our hospital between Sep. 2013 and Jan. 2018, were selected. The clinical features, imaging findings and therapeutic effects were analyzed. Results There were risk factors of cerebrovascular diseases in the 11 patients with SWS, in which 7 had hypertension, 4 had diabetes mellitus, 2 had hyperlipoidemia, and 1 had gout. In the classification of symptoms, 7 patients were pure motor type and 4 were motor-sense type. Magnetic resonance diffusion weighted imaging showed that 10 patients developed ischemic stroke. The infarction located in the posterior limb of internal capsule, putamen, globus pallidus, corona and pons. Head and neck computed tomography angiography examination found no large vascular stenosis in the patients. The modified Rankin scale scored 0-1 in 9 patients, 2 in 1 patient, and 3 in 1 patient. Conclusion Perforating artery disease is the main pathogenesis of SWS. Intravenous thrombolysis does not prevent SWS to ischemic stroke, but it improves the prognosis of the patients.
Key words:  stroke warning syndrome  transient ischemic attack  intravenous thrombolytic therapy  prognosis