穿支动脉粥样硬化病的影像评估及治疗研究进展  

Research progresses in imaging evaluation and treatment of branch atheromatous disease

作　　者：高聪 李雯婷 廖晓凌[1] Gao Cong;Li Wenting;Liao Xiaoling(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,Beijing100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京100070

出　　处：《中华神经科杂志》2024年第12期1382-1388,共7页Chinese Journal of Neurology

基　　金：科技部战略性科技创新合作项目(2022YFE0209600)。

摘　　要：穿支动脉粥样硬化病(BAD)是急性缺血性卒中的常见类型,占所有缺血性卒中病因的10%~15%,临床上常出现以进行性运动功能缺失为主的早期神经功能恶化(END),导致临床预后较差。BAD患者发生END的机制尚未被阐明,缺乏有效的风险预测指标及治疗方案。随着高分辨率及高场强磁共振等影像技术用于评价载体动脉管壁和穿支动脉形态,BAD病理及进展机制被进一步揭示。一些研究结果表明,使用替罗非班等强化抗血小板或联合抗血小板治疗与阿加曲班等抗凝治疗的有效性和安全性逐渐显现。文中将着重介绍BAD的影像评估及治疗研究进展,以提高临床医生对BAD的认识,早期采取措施预防END的发生、减少复发、改善患者预后。Branch atheromatous disease(BAD)is a common type of acute ischemic stroke,accounting for 10%to 15%of all ischemic stroke etiologies.Clinically,it often presents as early neurological deterioration(END)primarily characterized by progressive motor deficits,leading to poor clinical outcomes.The mechanism of END in BAD patients has not been fully elucidated,and there is a lack of effective risk prediction markers and treatment strategies.With the application of high-resolution and high-field magnetic resonance imaging technologies to evaluate the vessel wall of parent artery and the morphology of penetrating artery,the pathogenesis and progression mechanisms of BAD have been further revealed.Some studies have shown that the effectiveness and safety of using enhanced antiplatelet agents such as tirofiban or combining antiplatelet therapy with anticoagulant treatment such as argatroban are gradually emerging.This article will focus on the research progresses in imaging evaluation and treatment of BAD,aiming to enhance clinicians′understanding of BAD to take early measures to prevent END,reduce recurrence,and improve patient prognosis.

关 键 词：穿支动脉粥样硬化病 影像评估 治疗 早期神经功能恶化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]