Objective: To evaluate incidence and prognosis of lacunar stroke in a prospective, population-based patient registry. Methods: The authors included first-ever strokes occurring between 1994 and 1998. They assessed inc...Objective: To evaluate incidence and prognosis of lacunar stroke in a prospective, population-based patient registry. Methods: The authors included first-ever strokes occurring between 1994 and 1998. They assessed incidence, risk factors, mortality, and recurrence in patients with lacunar stroke. Results: The authors identified 491 patients (15.3%) with lacunar stroke (252 men and 239 women) and 2,153 patients (67.3%) with nonlacunar stroke (998 men and 1,155 women). Crude annual incidence rate for a first-ever lacunar stroke was 33.0/100,000 (95%CI 30.2 to 36.0). At the univariate logistic regression analysis among patients with lacunar stroke there was a higher proportion of cigarette smoking and hypercholesterolemia and a lower proportion of chronic atrial fibrillation than in patients with nonlacunar stroke. For lacunar stroke, the 30-day case-fatality rate was 4.3%(95%CI 2.5 to 6.1) and the 1-year case-fatality rate was 13.0%(95%CI 10.0 to 16.0). During the first year of follow-up the average annual stroke recurrence rate was lower in patients with lacunar (2.83%; 95%CI 1.36 to 4.30) than in those with nonlacunar stroke (5.10%; 95%CI 4.17 to 6.03) while from the second year onward, rates were similar in both groups. Conclusion: In the short term, patients with nonlacunar stroke had more vascular events, but in the long term, the risk of death and of stroke recurrence was similar.展开更多
在由脑小血管病(cerebral small vessel disease,CSVD)引起的腔隙性卒中(lacunar stroke,LS)的发病机制中,血栓栓塞的重要性仍然存在争议。尽管抗血小板药已经被广泛用于LS后的二级预防,但支持这种做法的良好卒中病因学分型试验证据有...在由脑小血管病(cerebral small vessel disease,CSVD)引起的腔隙性卒中(lacunar stroke,LS)的发病机制中,血栓栓塞的重要性仍然存在争议。尽管抗血小板药已经被广泛用于LS后的二级预防,但支持这种做法的良好卒中病因学分型试验证据有限。英国剑桥大学的Koohi等试图应用双样本孟德尔随机化方法对抗凝功能改变是否在LS和CSVD中起因果作用进行了评估。展开更多
在腔隙性卒中患者中进行长期双重抗血小板治疗(dual antiplatelet therapy,DAPT)对预防复发性卒中的有效性尚不清楚。因此,日本医科大学的Nishiyama等针对西洛他唑联合抗血小板卒中预防研究(Cilostazol Stroke Prevention Study for Ant...在腔隙性卒中患者中进行长期双重抗血小板治疗(dual antiplatelet therapy,DAPT)对预防复发性卒中的有效性尚不清楚。因此,日本医科大学的Nishiyama等针对西洛他唑联合抗血小板卒中预防研究(Cilostazol Stroke Prevention Study for Antiplatelet Combination,CSPS.com)进行了一项亚分析,旨在比较DAPT和单药抗血小板治疗(single antiplatelet therapy,SAPT)预防慢性腔隙性卒中复发的安全性和有效性。展开更多
腔隙性梗死是一种常见的卒中类型，主要由脑小血管疾病引起。抗血小板治疗对于腔隙性梗死二级预防的有效性尚未确定。美国皮质下小卒中二级预防（Secondary Prevention of Small Subcortical Strokes，SPS3）试验研究组进行了～项多中...腔隙性梗死是一种常见的卒中类型，主要由脑小血管疾病引起。抗血小板治疗对于腔隙性梗死二级预防的有效性尚未确定。美国皮质下小卒中二级预防（Secondary Prevention of Small Subcortical Strokes，SPS3）试验研究组进行了～项多中心双盲临床试验，纳入经M砌确诊的3020例近期有症状性腔隙性梗死患者，在接受阿司匹林（325mg／d）治疗的基础上，随机分组接受氯毗格雷（75mg／d）或安慰剂治疗。主要转归指标为任何复发性卒中，包括缺血性卒中和颅内出血。展开更多
文摘Objective: To evaluate incidence and prognosis of lacunar stroke in a prospective, population-based patient registry. Methods: The authors included first-ever strokes occurring between 1994 and 1998. They assessed incidence, risk factors, mortality, and recurrence in patients with lacunar stroke. Results: The authors identified 491 patients (15.3%) with lacunar stroke (252 men and 239 women) and 2,153 patients (67.3%) with nonlacunar stroke (998 men and 1,155 women). Crude annual incidence rate for a first-ever lacunar stroke was 33.0/100,000 (95%CI 30.2 to 36.0). At the univariate logistic regression analysis among patients with lacunar stroke there was a higher proportion of cigarette smoking and hypercholesterolemia and a lower proportion of chronic atrial fibrillation than in patients with nonlacunar stroke. For lacunar stroke, the 30-day case-fatality rate was 4.3%(95%CI 2.5 to 6.1) and the 1-year case-fatality rate was 13.0%(95%CI 10.0 to 16.0). During the first year of follow-up the average annual stroke recurrence rate was lower in patients with lacunar (2.83%; 95%CI 1.36 to 4.30) than in those with nonlacunar stroke (5.10%; 95%CI 4.17 to 6.03) while from the second year onward, rates were similar in both groups. Conclusion: In the short term, patients with nonlacunar stroke had more vascular events, but in the long term, the risk of death and of stroke recurrence was similar.
文摘在由脑小血管病(cerebral small vessel disease,CSVD)引起的腔隙性卒中(lacunar stroke,LS)的发病机制中,血栓栓塞的重要性仍然存在争议。尽管抗血小板药已经被广泛用于LS后的二级预防,但支持这种做法的良好卒中病因学分型试验证据有限。英国剑桥大学的Koohi等试图应用双样本孟德尔随机化方法对抗凝功能改变是否在LS和CSVD中起因果作用进行了评估。
文摘腔隙性梗死是一种常见的卒中类型，主要由脑小血管疾病引起。抗血小板治疗对于腔隙性梗死二级预防的有效性尚未确定。美国皮质下小卒中二级预防（Secondary Prevention of Small Subcortical Strokes，SPS3）试验研究组进行了～项多中心双盲临床试验，纳入经M砌确诊的3020例近期有症状性腔隙性梗死患者，在接受阿司匹林（325mg／d）治疗的基础上，随机分组接受氯毗格雷（75mg／d）或安慰剂治疗。主要转归指标为任何复发性卒中，包括缺血性卒中和颅内出血。
