醒后卒中的昼夜节律和再灌注治疗研究进展  

Research progress of circadian rhythm and reperfusion therapy in wake-up stroke

作　　者：张娴娴 方琪[1] Zhang Xianxian;Fang Qi(Department of Neurology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China;Department of Neurology,Yancheng Third People′s Hospital,Yancheng,Jiangsu 224000,China)

机构地区：[1]苏州大学附属第一医院神经内科,215000 [2]江苏省盐城市第三人民医院神经内科,224000

出　　处：《中华神经科杂志》2020年第1期55-63,共9页Chinese Journal of Neurology

基　　金：国家重点研发计划资助项目(2017YFC14300);江苏省社会发展-重点病种规范化诊疗项目(BE2016670)。

摘　　要：醒后卒中即醒来时发现有神经功能缺损的缺血性卒中,最后正常时间为入睡时,约占所有缺血性卒中的1/4。目前对醒后卒中起病机制仍未明确,醒后卒中患者睡眠中起病,昼夜节律机制是否参与其中值得进一步探索。既往这部分患者因起病时间不明错失再灌注治疗机会,而最近研究结果改变了这一观念。使用影像学评估可对合适的患者进行静脉溶栓或机械取栓治疗,从而改善部分醒后卒中患者预后。文中就近年来最新研究进展进行总结。Wake-up stroke(WUS)is clinically defined as ischemic stroke that is associated with neurological deficits on awakening,accounting for approximately one in five individuals presenting with an acute ischemic stroke.At present,the mechanism of WUS onset is still unclear,and whether circadian mechanisms are involved deserves further exploration.Previously,these patients were missed the opportunity of reperfusion therapy due to unknown onset time.Recent studies have changed this concept.Intravenous thrombolysis or mechanical thrombectomy can be performed in appropriate patients after imaging evaluation,thus improving the prognosis of some patients with WUS.This article summarizes the latest research in recent years.

关 键 词：卒中 昼夜节律 血栓溶解疗法 机械取栓 

分 类 号：R74[医药卫生—神经病学与精神病学]