短暂性脑缺血发作定义的演变及最新进展

Advance of The Definition of Transient Ischemic Attack

短暂性脑缺血发作(transient ischemic attack,TIA)一概念自从20世纪50年代被提出,其定义几经变革。随着影像学技术的发展以及临床实践经验的积累,对TIA的认识已由关注其临床症状持续时间转变到关注其引起组织学损害过程。2009年6月,美国心脏协会(American Heart Association,AHA)、美国卒中协会(American StroKe Association,ASA)在《Stroke》杂志上发表新指南,完全取消了TIA定义中对症状持续时间的限制,提出TIA与脑梗死的根本区别在于是否存在脑组织梗死的证据。新指南同时提出了"急性神经血管综合症"的概念。本文主要对TIA定义的演变进行简单回顾,并对最新定义进行解读。

The definition of transient ischemic attack （TIA） has been changed a lot since it was first established in 1950s. With the rapid development of imaging techniques and the accumulation of clinical experiences, the research focus on TIA has been converted from the duration of clinical symptom to the process of histological lesions resulted from TIA. In June, 2009, American Heart Association, American Stroke Association published a new guideline in Stroke which canceled the restriction about the duration of clinical symptom. It announced that the basic difference between TIA and cerebral stroke was whether there exists the evidence of cerebral infarction or not. The new guideline also announced the concept of ＂acute ischemic cerehrovascular syndrome＂. This article will simply review the evolution of TIA＇s concept and take some discussion on the new definition .