急性缺血性脑卒中早期神经功能恶化的预测因素、机制和管理

Predictors,Mechanisms and Management of Early Neurological Deterioration in Acute Ischemic Stroke

急性缺血性脑卒中(AIS)患者常发生早期神经功能恶化(END)。END多指发病后6 h~7 d内,患者虽经积极治疗但神经功能缺损情况仍逐渐进展的AIS。END发生率较高,但由于定义标准不同,END发生率差异较大。高血糖、血压偏高或偏低及大血管闭塞可能为发生END的预测因素。侧支循环建立失败、血栓进展、复发性卒中、脑水肿及出血性转化等可能为END的发生机制。该文将围绕AIS患者发生END的预测因素、机制以及管理等问题进行综述,现报告如下。

Early neurologic deterioration(END)is common in patients with acute ischemic stroke(AIS).END refers to AIS within 6 h to 7 d after the onset of the disease,although the patient has been actively treated,the neurological impairment is still gradually progressing.The incidence of END is higher,but because of the different definition criteria,the incidence of END is different.Hyperglycemia,high or low blood pressure and large vessel occlusion may be predictors of END.Failure of collateral circulation,thrombosis progression,recurrent stroke,cerebral edema and hemorrhagic transformation may be the pathogenesis of END.This paper focused on the predictive factors,mechanisms and management of END in AIS patients,and was reported as follows.