特鲁索综合征相关缺血性脑卒中发病机制及治疗研究进展

Progress in the pathogenesis and treatment of Trousseau syndrome-related ischemic stroke

近年来,随着癌症发病率的提高,特鲁索综合征(TS)相关缺血性脑卒中呈逐年增长趋势,由此导致高致残率、高致死率,而且短期复发率很高,造成严重后果,此病发病机制复杂且尚不明确,高凝状态被认为是主要的发病机制,非细菌性心内膜炎、抗癌治疗、血管内皮损伤和血流动力学改变等均与疾病发生有关。TS相关缺血性脑卒中的治疗目前国内外尚无统一标准,抗凝被推荐用于此病初期及长期治疗,抗凝药物种类较多,作用机制复杂,但抗凝药物的选择目前国内暂无明确临床指南,溶栓治疗因在超早期非禁忌证的情况下可以降低致残率,是本病急性期可以选择的治疗方法,溶栓治疗的长远获益仍需寻求大样本量的临床证据证实。

In recent years,with the increasing incidence of cancer,Trousseau syndrome(TS)-related ischemic stroke showed an increasing trend year by year,resulting in a high disability rate,high mortality,and a high short-term recurrence rate,resulting in serious consequences.The pathogenesis is complex and unclear,and hypercoagulability is considered to be the main pathogenesis.Non-bacterial endocarditis,anticancer therapy,vascular endothelial injury,and hemodynamic changes are all related to the occurrence of the disease.At present,there is no unified standard for the treatment of TS-related ischemic stroke at home and abroad,and anticoagulation is recommended for the early and long-term treatment of this disease.There are many types of anticoagulant drugs with complex mechanisms of action,but there is no clear clinical guideline for the selection of anticoagulant drugs in China,and thrombolytic therapy can reduce the disability rate in the case of non-contraindications in the very early stage,so it is an acceptable treatment for the acute stage of this disease.The long-term benefits of thrombolytic therapy need to be confirmed by large sample clinical evidence.