醒后脑卒中的发病机制、危险因素及治疗研究进展  

Research Progress in Pathogenesis,Risk Factors and Treatment of Wake-up Stroke

作　　者：左妍妍 刘文宇 杜敢琴[1] ZUO Yanyan;LIU Wenyu;DU Ganqin(Department of Neurology,the First Affiliated Hospital/College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院神经内科,河南洛阳471003

出　　处：《医学综述》2023年第21期4599-4603,共5页Medical Recapitulate

基　　金：河南省医学科技攻关计划项目(LHGJ20210582)。

摘　　要：醒后脑卒中主要由卵圆孔未闭、心房颤动等引起的局部脑血管血栓形成或栓塞所致,少数由血流减少引起。目前临床主要采用溶栓及血管内机械再通介入治疗,以尽早实现血管再通、恢复脑血流、挽救缺血半暗带,挽救患者生命。但由于诱发醒后脑卒中的危险因素复杂,如年龄、高血压等,且患者间存在较大个体差异,症状开始起始时间无法断定,其治疗方案的制订/选择(如溶栓时间窗的判断、最佳治疗方式选择)较常规脑卒中有一定特殊性,其危险因素及发病机制对优化醒后脑卒中治疗方案具有指导作用。Wake-up stroke is mainly caused by local cerebral vascular thrombosis or embolism due to patent foramen ovale,atrial fibrillation,etc.,while a few are caused by reduced blood flow.At present,thrombolysis and intravascular mechanical recanalization are mainly used in the clinical intervention to achieve vascular recanalization,restore cerebral blood flow,and save ischemic penumbra as soon as possible,so as to save the patients′lives.However,due to the complex risk factors inducing wake-up stroke,such as age and hypertension,and the large individual differences among patients,the onset time of symptoms cannot be determined,so the formulation/selection of the treatment plans(such as the judgment of thrombolysis time window,the selection of the optimal treatment mode,etc.)has certain particularity compared with regular stroke.Its risk factors and pathogenesis have a guiding role in optimizing the treatment plan of wake-up stroke.

关 键 词：醒后脑卒中 发病机制 危险因素 介入治疗 

分 类 号：R743.31[医药卫生—神经病学与精神病学]